• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.235-237
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• 2007

We describe a case of an unruptured basilar top aneurysm that was associated with early rupture after incomplete coiling. A 62-year-old woman with a history of several small infarctions has undergone coiling of unruptured basilar top aneurysm. Two weeks after initial coiling the patient presented with Hunt and Hess grade IV subarachnoid hemorrhage consistent with a ruptured basilar top aneurysm. Repeat angiography revealed a rupture of recanalized basilar top aneurysm. Second embolization with additional coils resulted in complete occlusion. However, her neurological status was not improved afterward and she was transferred to department of rehabilitation one month after hemorrhage with comatous state. To our knowledge, this is the first case of fatal early rupture after coiling of unruptured aneurysm. It has been speculated that coiling could cause injury to aneurysmal wall and facilitate rupture.

• 대한족부족관절학회지
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• 제22권1호
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• pp.21-25
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• 2018

Purpose: To analyze the correlation between a rupture of the hypovascular zone and early single heel raising after Achilles tendon repair. Materials and Methods: From January 2012 to August 2015, 68 patients, who underwent surgical treatment for a Achilles tendon rupture using Krackow method, were analyzed retrospectively. The patients were divided into two groups according to possibility of single heel raises within 3 months postoperatively. During the periodic outpatient observations, the visual analogue scale, Achilles tendon total rupture score (ATRS), and timing capable single heel raises were evaluated. In addition, the preoperative defect size and distance between the calcaneal osteotendinous junction and the rupture site were measured by ultrasound in all cases. Results: Twenty-three patients could perform a single heel raise within 3 months after surgery (early single heel raise group), and fortyfive patients could perform a single heel raise after 3 month postoperatively. The age, gender, body mass index, smoking, and operation delay were similar in the two groups. In addition, the defect size and distance between the calcaneal osteotendinous junction and rupture site as measured by preoperative ultrasound were similar (p=0.379 and p=0.631, respectively). On the other hand, when the rupture site was divided into the hypovascular zone (4~7 cm from calcaneal osteotendinous junction) and non-hypovascular zone, the hypovascular zone rupture rate was significantly lower in the early single heel raise group (60.9%, 14/23; 91.1%, 41/45; p=0.003). In logistic regression analysis, the odds of the hypovascular zone rupture group being capable of early single heel raise were 0.189 (p=0.017). The ATRS score at 3 months and 1 year after surgery were significantly higher in the early single heel raise group (p<0.001). Conclusion: Achilles tendon rupture at the hypovascular zone is a poor prognostic factor for early single heel raise and might affect the prognosis significantly after an Achilles tendon rupture operation.

• Journal of Chest Surgery
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• 제24권5호
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• pp.480-484
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• 1991

Traumatic rupture of the main bronchus is comparatively very rare. With the advent of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. Rupture of the bronchus is an unusual result of nonpenetrating trauma to the chest. Early recognition of bronchial rupture and emergency thoracotomy and management is essential for reducing of morbidity, mortality and late complications. We experienced 3 cases of bronchial rupture caused by nonpenetrating chest trauma with or without rib fracture. Patients were suffered from dyspnea and chest pain. After closed thoracostomy, corrective surgery was performed. Postoperative courses were uneventful and discharged without any complication.

• 대한정형외과 초음파학회지
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• 제4권1호
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• pp.24-27
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• 2011

원위부 요골 골절의 합병증 중 하나인 장무지 신전건 파열은 지연성으로 발생한다고 알려져 있다. 요골 골절과 동시에 발생하는 급성 장무지 신전건 파열은 매우 드문 경우로, 저자들은 문헌 고찰과 함께 증례 보고 하고자 한다.

• 대한족부족관절학회지
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• 제19권3호
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• pp.77-80
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• 2015

Acute Achilles tendon rupture is a frequent injury during sports and recreational activities. Treatments for Achilles tendon rupture have been controversial in recent decades. Traditionally the surgical treatment had benefit over nonsurgical treatment in terms of low rerupture rate and early functional restoration. Recently, nonsurgical treatment was found to show no statistically significant inferiority in re-rupture rate, functional outcome, and calf strength. Whereas, surgical treatment had some complications including adhesion, nerve injury, and infection. Nonsurgical treatment has been increasing due to functional rehabilitation with early weight bearing and restricted early motion. It focuses more attention on the course of caring for patients with deep discussion. There are open repair and minimally invasive repair in terms of surgical treatment. There are various techniques for minimally invasive repair of Achilles tendon, which has some advantages over the open repair. However, the optimal technique for minimally invasive repair has not been established. The number of suture strands is important regardless of suture technique.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1125-1131
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• 1992

Still a lethal injury, traumatic rupture of thoracic aorta occurs more frequently than we expect and comprises significant part of causes of deaths by blunt trauma. We recently experienced a thoracic aortic rupture accompanied by multiple injuries including pericardial and interatrial septal rupture and myocardial contusion in a patient who had been injured in a fall accident. Literatures are reviewed with the concern of early diagnosis, surgical technique and the result of operation.

• Journal of Trauma and Injury
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• 제28권2호
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• pp.67-70
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• 2015

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident.

• Journal of Trauma and Injury
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• 제27권1호
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• pp.5-8
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• 2014

Although blunt traumatic cardiac rupture is an uncommon injury, it can be associated with a high mortality rate. Two cases of cardiac rupture in blunt trauma patients are described herein. In those cases, applications of mechanical support devices such as ECMO (extracorporeal membrane oxygenation) and early surgery for exploration under cardiopulmonary bypass may be helpful for treating blunt chest trauma patients.

• 대한족부족관절학회지
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• 제7권1호
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• pp.78-82
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• 2003

Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.250-256
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• 2017

Objective : Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. Methods : A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture. The proximal control is then switched to the pericallosal artery just proximal to the aneurysm and its intermittent clipping facilitates complete aneurysm dissection and neck clipping. Results : Three such cases are reported : a ruptured pericallosal artery aneurysm with a contained leak of the contrast from the proximal side of the aneurysm, a low-lying ruptured pericallosal artery aneurysm with irregularities on its proximal wall, and a multilobulated ruptured pericallosal artery aneurysm with the parasagittal bridging veins hindering surgical access to the proximal parent artery. In each case, the proposed combined pterional-interhemispheric or subfrontal-interhemispheric approach was successfully performed to establish proximal vascular control far from the ruptured aneurysm and facilitated aneurysm clipping via the interhemispheric approach. Conclusion : When using an anterior interhemispheric approach for a ruptured pericallosal artery aneurysm with a high risk of premature rupture, a pterional or subfrontal approach can be combined to establish early proximal vascular control at the bilateral A1 segments or the origin of the A2 segment.