• Title/Summary/Keyword: Rib fracture

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Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

The Clinical Value about Pulmonary Tuberculosis of Indirect Chest Radiography in Physical Examination for Conscription (징병 신체 검사시 집단 흉부 간접 방사선 촬영의 폐결핵 관련한 진단적 유용성)

  • Park, Sung Bin;Choi, Byeong-Kyoo;Ha, Keun Woo;Seo, Joon Beom
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.356-360
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    • 2005
  • Background : This study examined the clinical utility of using indirect chest radiography during a physical examination of new conscripts for determine the presence of pulmonary tuberculosis. Methods : Over an eight-month period, this study examined 25386 people who underwent a physical examination after conscription. The abnormal findings on mass miniature radiography were followed-up using direct chest radiography. The positive predictive value of mass miniature radiography and direct chest radiography was compared. The incidence, degree of infiltration and clinical outcome of active pulmonary tuberculosis were also evaluated during a follow-up examination. Results : The positive rate of mass miniature radiography was 1.19% (n=302). Various lesions were identified: Parenchymal lesions (n=109), mediastinal lesions (n=6), cardiovascular lesions (n=45), pleural lesions (n=49), bony lesions (n=90) and miscellaneous lesions (n=7). The incidence of active pulmonary tuberculosis by mass miniature radiography was 0.26% (n=67). The first diagnosis was made in 50 people; active pulmonary tuberculosis (n=42), pneumonia (n=1), a mediastinal mass (n=1), a rib fracture (n=2) and a pneumothorax (n=4). Most cases of active pulmonary tuberculosis were mildly infiltrated and either improved or were cured by the follow-up examination. Conclusion : Although mass miniature radiography in a physical examination after conscription has limitations, but it is a useful means for detecting the presence of early disease, particularly in active pulmonary tuberculosis.

The effect of steroid for fibrous dysplasia of the humerus combined with multiple cystic lesion (낭종성 병변을 동반한 상완골의 섬유성 골이형성증에서 steroid의 효과 - 증례 보고 -)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bo-Hyun;Won, Jung-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.20-26
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    • 2002
  • Fibrous dysplasia is a benign pathologic condition in which the normal cancellous bone is replaced by the fibro-osseous tissue. It is found mostly in the femur, tibia, skull, rib, and humerus. Clinically it may develops pain, progressive deformity, and pathologic fracture. Curettage with bone graft has been the most popular treatment method thesedays. A 17-year-old female who had fibrous dysplasia of the humerus combined with multiple cystic lesion was treated by intralesional steroid injection into the lesion total 2 times. The follow-up plain X-ray which was taken 11 months after steroid injection reveals decrease in size and increase in bone density and cortex thickness. The follow-up MRI reveals significant decrease in size and signal intensity. The signal intensity was decreased to that of normal bone marrow in T2 weighted image. She complains no pain and lives symptom free in last follow-up at 2 years and 8 months after steroid injection.

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A Clinical Analysis of 24 cases of Cardiac Contusion and Cardiac Concussion (둔상에 의한 심타박상과 심좌상의 임상적 고찰)

  • 이계선;정진악;금동윤;안정태;이재원;신제균
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.270-275
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    • 1999
  • Background: In the patients with thoracic injury, we suspect simultaneous cardiac contusion or concussion. We analyzed the patients with possible cardiac injury by electrocardiography, serum creatine kinase (CK), creatine kinase isoenzyme fraction (CK-MB) screening, followed by two dimentional echocardiogram (2-DE) to access the severity of injury. Material and Method: From January 1997 to April 1998, 15-month retrospective study of suspicious myocardial injury was undertaken in including 24 patients admitted for suspected cardiac injury. All patients with history or signs of blunt chest injury were checked serially and the serial CK, CK-MB fraction, electrocardiography (EKG) analysis screening were followed by 2-DE. Result: The age range was between 20-40 years and were predominant male patients in(M:F=3:1). Most common causes of injury were traffic accidents, 15 patients(62.5%). Associated injuries involved multiple rib fractures, sternal fracture and such. EKG findings on the cardiac concussion were within normal limits, EKG findings on the cardiac contusion were nonspecific ST and T wave abnormality. In cardiac contusion patients, CK-MB fraction did not increase significantly on admission but on 2nd, 3rd, 4th hospital days, it increased significantly (p=0.0080, 0.0130, 0.0130). The average admission days were 9.22 in concussion and 26.18 in contusion patients(p=0.0075). Most common complication was the adult respiratory distress syndrome(7 cases), 5 out of the patients with ARDS were mechanically ventilated. There were no deaths. Conclusion: We believe the serial checks of CK-MB, EKG and subsquent two-dementional echocardiographic sector scanning are presently the most sensitive indicators available for structural and functional cardiac injury.

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An Experimental Study on the Structural Performance of Lateral Resistance in Steel Elevator Pit (강재엘리베이터 피트 측압저항 구조성능에 관한 실험적 연구)

  • Hong, Seong-Uk;Kim, Tae-Soo;Baek, Ki-Youl
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.23 no.3
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    • pp.1-8
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    • 2019
  • Steel elevator pit was developed for the purpose of minimizing the excavation, simplifying the construction of the frame and economical efficiency by improving the problems that occurred in the existing reinforced concrete. It is common to apply conventional RC method through excavation to underground structures such as underground floor collector well and elevator pit. In recent years, the use of steel collector well and steel elevator pits to reduce construction costs by minimizing the materials of steel and concrete has been continuously increasing. The steel elevator pit is an underground structure and then the performance of the welding part and the structure system is important. Specimen with only steel plate and concrete without studs could support the load more than 3 times than the specimen with deck only. Therefore, even if there is no stud, the deck (steel plate) rib is formed and the effect of restraining the steel plate and the concrete during the bending action can be expected. However, since sudden fracture in the elevator pit may occur, stud bolt arrangement is necessary for the composite effect of steel plate and concrete. It is expected that the bending strength can be expected to increase by about 15% or more depending with and without stud bolts.

A Study on Health Status of the 1,559 Korean Applicants Applying for the Coal Miners in West Germany during the Year of 1972 and 1973 (우리나라 독일광부(獨逸鑛夫) 지원자(志願者)에 대(對)한 건강상태(健康狀態)에 관(關)한 조사연구(調査硏究))

  • Jun, Hyun-Sook;Choi, Sam-Sup
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.383-393
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    • 1974
  • The importance of the health care for the miners not only concerns the productivity of the enterprises but also as a fundamental human right, it has to be secured and protected by the society and the government. The Korean coal miners began to find their works at overseas since 1963 when the Korean government selected and dispatched its miners to West Germany. As years go by, the demand and the supply of the coal miners, the program of the coal miners health care became the important tasks to be solved and the further studies and research were necessary to support these tasks achievement. The writers made a statistical analysis on health status of the 1,559 Korean applicants applying for the coal miners in West Germany during the year of 1972 and 1973 by the using of the data of physical examination which were directed by the Korea Overseas Development Cooperation. The standard of physical examination which was applied for coal miners applying the jobs in West Germany was authorized by the Government Office of Labor in 1967. The results are as following; 1. The applicants were from the various provinces throughout Korea; Gang Weon 50.2%, Jeon-Nam 16.8%, Chung-Nam 13.7%, Gyeong-Nam 10.5%, City of Seoul 5.4%, and others 3.7%. 2. The ages of the applicants were from 20 to 44. The age group of 25-29(36.3%) and of 30-34(55.2%) together occupied the 91.5 per cent of the total applicants. 3. Among the 1,559 applicants 52.1 per cent passed the physical examinations. The tendency were shown that as the age increased, the passing rate decreased, and the married applicnts had lower passing rates compared to the unmarried applicants. 4. The height of the applicants averaged $168.4{\pm}4.74(cm)$ and the weight averaged $61.3{\pm}5.65(kg)$. 5. The average vision of the left eye of the applicants was $0.92{\pm}0.23$ and the right eye was $0.91{\pm}0.30$. 6. The mean value of the systolic blood pressure of the applicants was $145{\pm}13(mmHg)$ and the diastolic blood pressure was $85{\pm}8(mmHg)$. 7. Fifteen hundred and fifty-nine applicants were taken chest X-ray and 17.2 per cent were found abonrmal. For each 1,000 applicants, 46 Pulmonary calcification and fibrosis, 45 chronic bronchitis, 27 pleural thickening and adhesion, 20 pulmonary tuburculosis, 11 anomalies of the rib, 10 pulmonary infiltration and 21 others diseases were found. 8. Lumber X-ray examination showed that 23.9 per cent (372 applicants) were found abnormal. For each 1,000 applicants, 77 osteoarthritis, 56 lumbarization, 15 fracture of vertebrae, 15 spondyloarthritis, 14 deformity of vertebrae, 13 spina bifida, 12 sacralization, 12 spondylolysis, and 5 others diseases were found. 9. In total, 47.9 per cent of 1,559 applicants failed the physical examinations, and the main causes for the failure were shown to be 7.1% of anomalies of spine, 6.3% of osteoarthritis, 4.7% of pulmonary calcification and fibrosis, 4.6% of chronic brochitis, 3.6% of hypertension (only), 3.4% of fracture of vertebrae. 3.1% of underweight(under 57.0kg), 2.0% of spondyloarthritis, 2.0% oe pulmonary tuberculosis, 1.7% of pleurisy, 1.0% of spina bifida, 1.5% of syphilis, 1.5% of color blindess, and 1.0% of underheight(under 160.0cm).

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A Clinical Study on Multiple Myeloma (다발성 골수종의 임상적 고찰)

  • Hwang, Hyeong-Ki;Lee, Choong-Ki;Hyun, Myung-Soo;Shim, Bong-Sup;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.106-113
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    • 1991
  • A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings : 1. The peak incidence was in 7th decade and male to female ratio was 1.8 : 1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group(SWOG) : plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III(84%) 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%. Kappa to Lambda ratio of 1.1 : 1. 6. Hematologic & biochemical fingins revealed anemia with <8.5% of hemoglobulin in 42%, hypercalcemia with < 10.6mg% of serum calcium in 22%, azotemia >2.0mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull(65%), rib(42%), L-spine(35%), pelvis(23%), T-spine(19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeoloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.

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