• Journal of Trauma and Injury
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• v.22 no.2
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• pp.199-205
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• 2009

Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.402-407
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• 1997

The records of 28 patients with traumatic diaphragmatic injuries seen at Masan Samsung Hospital from march 1986 o March 1995 were reviewed. We treated 21 male and 7 female patients ranging in ages from 5 to 68 years. Thc diaphragimatic injuries were due to blunt trauma in'20 cases(Trawc accident 18, compression injury 1, Human trauma 1) and penetrating injuries 8 cases (all stab wound). Most common symptoms were dyspnea 27 (96%), chest pain 26 (93%), abdomianl pain 8 (29%), comatose mentality 36 (11 %). Chest X-ray were elevated diaphragm in 20 cases(71%) find hemothorax in 18 cases (64%) and 25 cascs (89%) were diagnosed or suspected as diaphragmatic inju,rims prcopcrativcly. The repair of 28 cases were performed with thoracic approach in 20 cases, abdominal approach 7, thoracoabdominal approach in 1 cases. There were 5 death (18%) and all death related to the severity of associated injury. (hypovolcmic shock 3, combined head injury 1, renal failure 1).

• Journal of Chest Surgery
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• v.23 no.1
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• pp.128-136
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• 1990

A Clinical analysis was performed on 717 cases of the chest trauma experienced at department of thoracic and cardiovascular surgery, Soonchunhyang Chunan Hospital from Mar. 1985 to Jun. 1989. 1. The sex ratio was 2.89:1 with male predominance. The patients in 75 % of total cases was between 3rd to 5th decade. 2. The most common causes were traffic accident in non-penetrating thoracic injury and stab wound by knife in penetrating injury. 3. The hemothorax, pneumothorax and hemopneumothorax were observed in 306 cases[42.7 %]. 4. The left thorax was the preferred site of penetrating and non-penetrating thoracic injury. The rib fracture was prevalent between 4th to 8th rib. 5. The open thoracotomy was performed in 55 cases[7.7 %] 6. The overall mortality was 3.07 %[22 cases] and causes of death were hypovolemic shock, adult respiratory distress syndrome, sepsis, disseminated intravascular coagulation, renal failure and pneumonia.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1213-1220
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• 1990

During the period of January 1979 to December 1988, 220 patients with empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School Hospital. There were 167 males[75.9%] and 53 females[24.1%] ranging from 18 days to 76 years of age. Occurrence ratio of left and right empyema was 1 : 1.9. The underlying pathologic lesions of empyema were pneumonia[30.9%], pulmonary tuberculosis[22.7%], chest trauma[8.6%] and postoperative complications. In bacteriologic study, staphylococcus, pseudomonas and streptococcus accounted for 26.4%, 11.8% and 9% respectively, and 25% were not identified. Surgical treatment modalities were thoracentesis[10 patients, 4.5%], closed thoracostomy[132, 60%], closed rib resection drainage[4.2, 6%], modified Eloesser’s operation[37, 16.8%], decortication[27, 12.3%], decortication with pulmonary resection[6, 2.7%], thoracoplasty[2, 0.9%], muscle flap closure [1, 0.5%], and staged pneumonectomy[1, 0.5%], The mortality rate was 2.3% and the complications were sepsis[9 patients]. acute renal failure[4], and paralytic ileus[3].

• Journal of Chest Surgery
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• v.7 no.1
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• pp.47-60
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• 1974

During the past 10 years 114 patients with empyema have been treated in hospital of Chonnam University. There were 87 males and 27 females ranging from 20 days to 70 years of age. The etiology was pyogenic pneumonia in 36.7%, tuberculosis in 22.7%, paragonimiasis in 8.8%, post-thoracotomy in 5.4%, post-trauma in 4.4%, lung abscess in 3.5%, malignancy in 3.5%, post-esophageal operation in 1.8%, and sterile in 10.5%. The over-all mortality rate was 2% [3 patients]. The majority of deaths occurred in patients with associated systemic illness [liver cirrhosis in I, and renal tuberculosis in I] and resistant tuberculosis for anti-tuberculosis drugs in one patient. Adequate drainage and obliteration of the pleural space continues to be the most important aspect of treatment and can frequently be achieved by closed chest tube thoracostomy in acute empyema especially in children. The more chronic thick-walled or loculated cavities require open drainage [open window therapy], decortication, thoracoplasty, sterilization, and myoplasty for closure of tracheobronchial fistula.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.877-884
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• 1992

From October, 1986, to June, 1992 16 patients, 13 male and 3 female patients ranging in age 28 to 70 years, were operated on for thoracic aortic aneurysm, The etiology of these patients was atherosclerotic in 10, cystic medial necrosis in 4, and trauma in 2 cases, All patients were treated by use of CPB and circulatory arrest was applicated in one patient, Ten patients had aneurysms involving ascending aorta and six patients had descending aortic aneurysm, Among ten patients with ascending aortic aneurysm, annuloaortic ectasia with aortic regurgitation were seven and all underwent surgery with composite technique [Bentall operation], The other six patients with descending thoracic aneurysm were performed graft replacement. There was no early mortality but two late deaths occurred due to cerebral hemorrhage and renal problems at POD 3mo and 39mo respectively, We obtained satisfactory long-term results and overall survival rate at 5 year was 74.7%.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.706-710
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• 1988

Intravascular hemolysis occurs in the majority of patient with mechanical valve prosthesis. The primary cause is mechanical trauma to red cells from turbulent blood flow through the prosthesis. Degree of hemolysis is dependent upon the type, size and material of valve and aggravated by paravalvular leakage. Clinically important hemolytic anemia is required medical management or consideration of reoperation. In severe hemolysis, reoperation is recommended without delay when seems to be renal failure. In this case, postoperative severe mechanical hemolysis was developed immediately after aortic valve replacement with St. Jude medical valve in a 13 year-old male patient. Neither significant paravalvular leakage nor valvular dysfunction was found through redo, but the mechanical valve was strongly suspected the cause of severe hemolysis. The St. Jude Medical valve was changed with Ionescu-Shiley bioprosthesis and any significant clinical problems were not noted through the postoperative course.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.146-151
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• 2017

X-linked hypophosphatemia (XLH) is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. A 14 year old male and a 38 year old female with XLH were referred to the Department of Conservative Dentistry for endodontic treatment. The dental findings were periapical abscesses without obvious trauma or caries. Conservative endodontic treatment was performed in teeth with pulp necrosis and abscess. In case 1, the treated teeth showed improvements in bone healing, without clinical symptoms. However, in case 2, the implants and the treated tooth showed hypermobility, and the final restoration was therefore postponed. Early diagnosis, periodic examinations, and communication with the patient's pediatrician are important in the dental management of patients with XLH.

• Clinical and Experimental Pediatrics
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• v.61 no.3
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• pp.95-100
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• 2018

Purpose: This study aimed to evaluate the clinical findings in pediatric rhabdomyolysis and the predictive factors for acute kidney injury (AKI) in Korean children. Methods: Medical records of 39 Korean children, who were newly diagnosed with rhabdomyolysis from January 2008 to December 2015, were retrospectively analyzed. The diagnosis was made from the medical history, elevated serum creatinine kinase level >1,000 IU/L, and plasma myoglobin level >150 ng/mL. Patients with muscular dystrophy and myocardial infarction were excluded. Results: The median patient age at diagnosis was 14.0 years (range, 3-18 years), and the male to female ratio was 2.5. The most common presenting symptom was myalgia (n=25, 64.1%), and 14 patients (35.9%) had rhabdomyolysis-induced AKI. Eighteen patients (46.2%) had underlying diseases, such as epilepsy and psychotic disorders. Ten of these patients showed rhabdomyolysis-induced AKI. The common causes of rhabdomyolysis were infection (n=12, 30.7%), exercise (n=9, 23.1%), and trauma (n=8, 20.5%). There was no difference in the distribution of etiology between AKI and non-AKI groups. Five patients in the AKI group showed complete recovery of renal function after stopping renal replacement therapy. The median length of hospitalization was 7.0 days, and no mortality was reported. Compared with the non-AKI group, the AKI group showed higher levels of peak creatinine kinase and myoglobin, without statistical significance. Conclusion: The clinical characteristics of pediatric rhabdomyolysis differ from those observed in adult patients. Children with underlying diseases are more vulnerable to rhabdomyolysis-induced AKI. AKI more likely develops in the presence of a high degree of albuminuria.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.804-810
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• 1998

Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).