• Journal of Chest Surgery
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• v.29 no.12
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• pp.1398-1400
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• 1996

The cardiac anatomic position immediately beneath the sternum leaves it vulnerable to injury when this bone is fractured. Cardiac rupture, however, is uncommon but survival following this injury is rare. We report the case of one patient who survived right ventricle perforation resulting from sternal fracture. The patient developed signs of pericardial tamponade and was brought to the operating theatre immediately for surgery through the emergency anterolateral thoracotomy Perforation of th right ventricle was repaired by direct closure without cardiopulmonary bypass. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and surgery.

• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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• pp.89-93
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• 2005

Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

• Journal of Chest Surgery
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• v.52 no.5
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• pp.372-375
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• 2019

A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.136-140
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• 2021

We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.506-512
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• 2007

Traumatic injury of tooth in children is commonly occurred problem. It is classified into tooth, periodontal tissue, supporting bone, soft tissue injury by it's area and extent. Among the periodontal tissue injuries, traumatically intruded teeth are common in anterior maxillary area, though the occurrence rate is rather low, the pulp and supporting tissue injury is possible by vertical impact. The treatment method of traumatically intruded teeth is various. Observation on the spontaneous reeruption for 3-4 weeks is recommended if the traumatized teeth are deciduous teeth or slightly intruded immature permanent anterior teeth. If this did not occur because the extent of intrusion is severe or the traumatized teeth are mature permanent anterior teeth, orthodontic traction is applied by fixed/removable appliances. At this time, light and continuous force is applied for the extrusive movement of the intruded teeth. When above procedures are impossible, surgical repositioning and fixation is recommended. In these cases, we performed conventional endodontic therapy for pulp necrosis and orthodontic traction with fixed appliance. We obtained satisfactory results and will report that.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.150-155
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• 2008

Purpose: This study was performed to compare the anatomic differences of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries. Materials and Methods: 42 patients were involved in this study: Group I was composed with 14 cases of ankle fractures with syndesmotic injuries; Group II was composed with 14 cases of ankle fractures without syndesmotic injuries; Group III was composed with 14 cases of volunteers. The height averaged 170.1 cm (range, $159{\sim}181$ cm) in group I, 168.9 cm (range, $156{\sim}184$ cm) in group II, and 170.4 cm (range, $161{\sim}77$ cm) in group III. The mean height did not show a statistically significant difference between groups (p>0.05). All patients were taken axial computed tomography. The length of anterior and posterior facets, angle between anterior and posterior facet, and depth of the fibular incisura of the tibia were measured. Results: The mean length of the anterior facet was 11.5 mm (range, $9.2{\sim}15.7$ mm) in group I, 12.2 mm (range, $7.3{\sim}17.0$ mm) in group II, and 10.3 mm (range, $8.7{\sim}14.0$ mm) in group III (p>0.05). The mean length of the posterior facet was 12.3 mm (range, $9.0{\sim}14.5$ mm) in group I, 11.0 mm (range, $7.3{\sim}16.2$ mm) in group II, and 13.0 mm (range, $9.2{\sim}15.9$ mm) in group III (p>0.05). The mean angle between anterior and posterior facet was 139.1 degrees (range, $125.5{\sim}154.0$ degrees) in group I, 144.2 degrees (range, $134.7{\sim}152.6$ degrees) in group II, and 131.5 degrees (range, $117.6{\sim}144.4$ degrees) in group III (p<0.05). The mean depth of the fibular incisura of the tibia was 4.1 mm (range, $3.2{\sim}15.8$ mm) in group I, 4.6 mm (range, $3.1{\sim}7.1$ mm) in group II, and 3.1 mm (range, $1.5{\sim}4.0$ mm) in group III (p<0.05). Conclusion: There are some statistical differences of angle between anterior and posterior facet and depth of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.82-89
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• 2008

Objective:　We compared the prevalence of injury and poisoning in the agricultural and fishery population with that of the general population.Methods: The national health insurance data and agricultufor this study. The age-adjusted standardized morbidity ratio was used to compare the prevalence of all injuries and poisonings of the agricultural and fishery population with that of the general population for the year 2002, as well as the prevalence of certain injuries and poisonings common to the agricultural and fishery population. The age-adjusted standardized morbidity ratio and 95% confidence intervals were attained by using the general population as the standard population group.Results: The age-adjusted standardized morbidity ratio of total injuries and poisonings was significantly high in the agriculture and fishery population. The standardized morbidity ratio was 137.6 in the male agriculture and fishery population and 123.3 in the female agriculture and fishery population. In terms of injuries and poisonings common to the agriculture and fishery population, the age-adjusted standardized morbidity ratio was significantly high regarding the dislocations and strains of lumbar spine/pelvis, shoulder and neck, the fracture of rib/thoracic spine/sternum and pesticide poisoning.Conclusions: The overall prevalence of injury/poisoning was significantly higher in the agriculture and fishery population than in the general population. Various forms of research should be conducted on the injuries of the agriculture and fishery population in the future. In order to compare the differences in the prevalence rates of injuries according to time and region, standard definitions of injuries and occupation related injuries are required.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.738-745
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• 1994

In order to evaluate the myocardial injury in cardiac valvular and coronary surgery, variables of creatine kinase[CK], myocardial band of CK[CK-MB], lactate dehydrogenase[LDH], aspartate aminotrasferase[AST] were measured in the preoperative[Preop], the operation day[POD0], and the first[POD1], third[POD3], fifth[POD5], seventh[POD7], ninth[POD9] day after operation in 29 patients. The subjects were divided into two groups according to the diseases: group V [valvular disease, n=16] and group C[coronary artery disease, n=13]. Each group was subdivided into two subgroups according to the duration of aortic crossclamping time[ACT]; group VI[ACT 120min, n=7] and group VII[ACT>120min, n=9]; group CI[ACT 120min, n=6] and group CII[ACT>120min, n=7]. The results were as followed 1. The values of CK between group V and group C had no significant difference. The values of CK in group CII were significantly greater than those in group CI and the values of CK in group VII were significantly greater than those in group VI. 2. Percentages of CK-MB between groups had no significant difference. 3. The serum levels of LDH in group V were significantly greater than those in group C. The serum levels of LDH in group VII were significantly greater than those in group VI. 4. The serum levels of AST in group VII were significantly greater than that in group VI. We were concluded that myocardial injury was more related with the duration of aortic cross clamping time rather than the type of diseases.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.115-125
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• 2014

Purpose: Stable vital signs (SVSs) are thought to be the most important criteria for successful non-operative management (NOM) of blunt spleen injury (BSI). However, a consistent definition of SVSs has been lacking. We wanted to evaluate the diversity of the definitions of SVSs by using a nationwide survey. Methods: A questionnaire regarding the definition of SVSs was sent to the trauma surgeons working at the Department of Trauma Surgery and Emergency Medicine at a level-I trauma center between October 2011 and November 2011. Data were compared using analyses of the variance, t-tests, ${\chi}^2$ tests and logistic regressions. Results: Among 201 surgeons, 198 responded (98.2%). Of these 198 responses, 45 were incomplete, so only 153 (76.1%) were analyzed. In defining the SVSs, significant diversity existed on the subjects of type of blood pressure (BP), cut-off value for hypotension, technique for measuring BP, duration of hypotension, whether or not to use the heart rate (HR) as a determinant, cut-off value of hypotension when the patient had a comorbidity or when the patient was a child. Of the 153 surgeons whose responses were analyzed, 91.5% replied that they were confused when defining SVSs. Conclusion: Confusion exists regarding how to define SVSs. Most surveyed surgeons felt that a need existed to clarify both the definition of SVSs and the use of SVSs to determine hemodynamic stability for NOM.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1001-1006
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• 1995

From January, 1990 to December, 1994, we have operated 10 patients with cardiac rupture. The patients are divided into two groups according to their clinical manifestation ; five patients in each hemorrhage and tamponade group. The patients in both groups could maintain their vital signs with closed thoracostomy and fluid resuscitation. The effect of pericardiocentesis was especially dramatic in three patients of tamponade group. The average time from injury to admission was 101 minutes and that of the patients who came our hospital via one or two other hospitals was 170 minutes comparing 31 minutes of those who came directly. The average time from admission to operation was 211 minutes. Considering 98 minutes for the diagnosis and preoperative management and another 30 minutes for the preparation for operation, operations were delayed by 83 minutes to get permission. We conclude that this delaying time for transport and operation of heart-ruptured patients should be shortened in order to manage them more effectively.