• Journal of Chest Surgery
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• 제23권5호
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• pp.929-935
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• 1990

Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

• 콘크리트학회논문집
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• 제19권4호
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• pp.475-482
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• 2007

콘크리트 구조물의 사용 년수 증가에 따른 열화 (aging) 방지 및 내구성능 향상을 목적으로 개발된 유무 기합성 표면 침투 보강제의 성능 및 적용성을 실험적 방법으로 입증하였다. 본 연구에서는 무기 재료인 TEOS (tetra-ethoxyorthosilicate)와 유기재료인 acrylate monomer를 용액중축합 방법으로 합성함으로써 졸-겔 반응 (sol-gel process)에 의한 실리케이트의 내구성능 향상 효과와 함께 유기모노머의 부드럽고 유연한 충격 완화층 형성을 통한 콘크리트의 성능 개선 효과와 isobutyl-orthosilicate 등의 성능 개선 물질을 추가함으로써 콘크리트 침투 후의 열화 억제 성능을 향상시켰다. 개발된 유무 기합성 표면 침투 보강제는 침투 후 콘크리트 내부 공극을 물리 화학적으로 안정된 화합물로 충진 시킴으로써 구체 강화에 따른 압축강도 증가 효과는 물론, 염해 및 탄산화, 동결융해 및 복합열화 등의 사용 환경적 열화 요인에 대한 내구성 향상 효과가 높아 콘크리트 구조물의 효율적인 수명 관리 기법으로 활용이 가능할 것으로 판단된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.351-355
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• 2000

두경부 관통성 외상의 기본적 처치는 먼저 초기 단계에서 환자의 정확한 병력 및 이학 검사, 호흡 억제 유무 평가, 중대한 출혈 유무의 평가 등을 시행한다. 중대한 출혈의 평가는 외부 출혈 유무, 급속히 커지는 혈종 유무, 혈류역학적으로 불안정한 생징후를 보이는 경우, 맥박 소실, 저혈량성 쇼크의 소견, 혈종격동이나 혈흉 소견이 있는 경우 등이다. 이러한 경우 즉각적인 외과적 처치를 시행해야 한다. 중대한 출혈의 소견을 보이지는 않지만 혈관 손상이 의심되거나 가능성이 높다고 생각되는 경우로는 혈류 잡음, 삽입 이물질이 큰 혈관에 근접 위치한 경우, 맥박 소실이나 중추 신경학적 문제가 발생한 경우 등이 해당된다. 이때는 혈관조영술과 CT촬영을 시행한 후 보존적으로 관찰을 할지 외과적 처치를 시행할지를 결정한다. 이때도 외과적 처치가 필요한 경우 지체없이 시행한다. 또한 두경부 이몰 삽입에 의해 환자가 자신의 생명에 심각한 위협을 받았다고 느끼기때문에 정신적인 충격을 해소해 주어야 한다.

• Journal of Trauma and Injury
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• 제32권2호
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• pp.93-100
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• 2019

Purpose: Penetrating vascular trauma though less common poses a challenge to all Surgeons. This study was designed to analyse the profile, management modalities of vascular trauma and the outcomes thereof at a Trauma Care Centre in a Tertiary care setting in hostile environment in India. Methods: A prospective review of all patients with arterial and venous injuries being transferred to the Trauma Center at out Tertiary Care Center between June 2015 and May 2018 was done. Demographics, admission data, treatment, and complications were reviewed. Results: There were a total of 46 patients with 65 vascular injuries, 39 arterial injuries and 26 venous injuries. The age range was 21 to 47 years. Nineteen patients had both arterial and venous injuries. A total of 42 cases presented within 12 hours of injury and complete arterial transections were found in 33 cases (80.49%). There were three mortalities (6.52%) and three amputations (8.33%). The overall limb salvage rate was 91.67% with popliteal artery being the commonest injured artery. Poor prognosticators for limb salvage were increasing time to present to the trauma centre, hypovolemic shock, multi-organ trauma and associated venous injuries. Conclusions: Penetrating missile trauma leading to vascular injuries has not been widely reported. Attempting limb salvage even in cases with delayed presentation should be weighed with the threat to life before revascularisation and should preferably be done at a centre with vascular expertise. A team approach with vascular, orthopaedic, general surgeons, and critical care anaesthesiologists all aboard improve the outcomes manifold. Use of tourniquets and early fasciotomies have been emphasized as is the use of native veins as the bypass conduit. This is probably the largest study on penetrating Vascular trauma in anti-terrorism ops from the Indian subcontinent. It highlights the significance of prompt recognition and availability of vascular expertise in optimally managing cases of vascular trauma.

• Journal of Chest Surgery
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• 제29권4호
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• pp.433-439
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• 1996

경북대 학교병원에서는 1980년 1월부터 1995년 7월까지 들상에 의한 횡격 막 손상 환자 32례와 관통상 에 의한 12례를수술 치료하였다. 평균연령은둔상의 경우)7.6세,관통상의 경우29.2세로,들상의 경우 가 평 균 8.4세가 높았다(p<0.05). 진단은 단순 흉부 X-선 사진으로 횡격막 손상을 진단한 경우가 둔상에서는 24례 (75%), 관통상에서는 4fl (33%)였다. 관통상에서는 횡격막 손상의 의심 없이 다른 장기손상으로 수술하여 횡격막 파열이 발견 된 경우가 7례 (58%)였다. 탈장은 둔상시 24례 (75%), 관통상시 5례 (42%)에서 발생 하였다. 탈장이 발생 한 29례의 횡격막 손상의 크기는 10.9 $\pm$ 4.3cm, 발생하지 않은 15례는 3.5 $\pm$ 2.9cm로 양군간의 크기 의 차 이가 있어 (p<0.05) 횡격막 손상의 크기와 탈장과는 밀접한 관계가 있었다. 수출은 진단 즉시 시 행하였으며, 수술시 절개방법은 들상의 경우 20례 (6)%)에서 개흥술, 9례 에서 개 복술, 2례 에서 개흥복술, 1례 에서 개흥술 및 개복술을 분리 시행하였으며, 관통상시에는 6례 (50%)에서 개복술, 4례에서 개흥술, 2례에서 개흥술 및 개복술을 분리 시행하였다. 수술 후 합병증은 둔상시 6례 (19%), 관통 澯\ulcorner3례 (25%)에서 발생하여 비교적 높았다. 수술 후 사망률은 들상의 경우 2례 에서 사망하 였고(6.3%), 관통상의 경우는 사망례가 없어 전체 사망률은 4.5%였다. 결론적으로흥복부 외상시 횡격막 손상의 가능성을 염두에 두어야하며, 둔상의 경우횡격막손상의 크기는 관통상에 의한 경우보다 더 크며, 탈장도 횡격막 손상의 길이 에 비례하여 더 많이 발생하였다.

• Journal of Chest Surgery
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• 제24권6호
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• pp.616-624
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• 1991

Recently, cardiac injury due to blunt thoracic trauma appears to be increasing in frequency. The rising incidence of this mishap may relate to the absolute increase in automobile accidents as well as to more universal recognition that cardiac damage may have been sustained. We have experienced a rare case of ventricular septal defect caused by non-penetrating thoracic trauma. Of further interest is the history of chest trauma, clearly resulting in rupture of the chordae tendineae of the tricuspid valve successfully treated by operation-re-placement with two, 6 - 0, double-armed, expanded polytetrafluoroethylene sutures-2 months later. The unique combination of ventricular septal defect and rupture of the chordae tendineae of the tricuspid valve secondary to non-penetrating thoracic trauma is presented below to emphasize another variety of cardiac injury.

• Journal of Chest Surgery
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• 제28권3호
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• pp.308-312
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• 1995

A 5-year retrospective study of 14 patients with diaphragmatic injuries revealed 9 blunt and 5 penetrating injuries. In the blunt trauma group, 7 were left and 2 were right side. The penetrating diaphragmatic wound consist of 3 left and 2 right sided. Sex ratio was 11: 3, with male predominanace. Preoperative diagnosis was possible in 9 cases and delayed diagnosis [greater than 24 hours occured in 5 cases.Simple chest X-ray was diagnostic or highly suggestive in 7 cases. 7 cases were diagnosed diaphragmatic injuries by computed tomography, fiuroscopy or by explorative operation. All of the cases had association injury. 11 cases of diaphragmatic ruptures were corrected through thoracotomy and 3 cases needed exploratory laparotomy. One death occured after operation due to associated injuries and respiratory failure. Blunt and penetrating diaphragmatic injuries remain a diagnostic challenge and associated injuries, delayed diagnosis determine the outcome.

• Journal of Chest Surgery
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• 제6권2호
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• pp.189-194
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• 1973

A cardiac injury is one of the most dramatic and demanding emergencies than may be cared by the surgeon. Four patients who sustained penetrating wound of the heart have been experienced in the Depart-ment of Thoracic Surgery, Kyungpook National University Hospital. They were 3 males and one female. The age was between 21 and 25. All of this series had stab wounds on the heart by instruments of scissors, gimlet, kitchen knife and glass. Injured sites were two cases of right ventricle, one of the right atrium and one of indifinitive with pericardial laceration. Three of these patients have been successfully treated by emergency thoracotomy with 3-0 silk sutures for myocardial penetrating wounds. One of these patients occurred cardiac arrest during surgery and expired, who was in penetrated right ventricular injury through which massive bleeded. The classic clinical description of tamponade, Beck`s triad, seemed to be useful for making diagnosis of the tamponade but not entirely reliable as diagnostic criterion of the tamponade. In the studing of 3 tamponade cases in these series, the triad of Beck was presented in only two cases. Elevated venous pressure was thought to be a valuable diagnostic factor in pericardial tamponade.

• 해양환경안전학회지
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• 제6권1호
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• pp.77-83
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• 2000

En coastal area, many submarine facilities such as pipes and cables are installed on/under the sea bed. Also, there are heavy traffic due to numerous vessels which call in ports or navigate passages in adjacent water. Therefore, the frequency of dropping anchors will be increased to avoid various dangerous situations. When an anchor is dropped from vessel on the sea bed, the anchor strikes on the sea bed, and then, the anchor penetrates to certain depth into the sea bed. In this case, sometimes submarine facilities on/under the sea bed may be damaged by the strike or the maximum penetrating depth of anchor. In this paper, some approximate equations on the strike and the penetrating depth of anchors have been derived on the basis of actual data, and the results are expected to use as basic design data of related facilities.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.414-416
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• 2012

A 38-year-old man fell from a chair with a chopstick in his hand. The chopstick penetrated his left eye. He noticed pain, swelling, and numbness around his left eye. On physical examination, a linear wound was noted at the medial aspect of the left eyelid. Noncontrast computed tomography (CT) study showed a linear hypodense structure extending from the medial aspect of the left orbit to the occipital bone, suggesting a foreign body. This foreign body was hyperdense relative to normal parenchyma. From a CT scan with 3-dimensional reconstruction, the foreign body was found to be passing through the optic canal into the cranium. The clear plastic chopstick was withdrawn without difficulty. The patient was discharged home 3 weeks after his surgery. A treatment plan for a transorbital penetrating injury should be determined by a multidisciplinary team, with input from neurosurgeons and ophthalmologists.