• Journal of Korean Neurosurgical Society
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• v.67 no.5
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• pp.550-559
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• 2024

Objective : This study focuses on identifying potential complications following oblique lumbar interbody fusion (OLIF) through routine magnetic resonance (MR) scans. Methods : From 650 patients who underwent OLIF from April 2018 to April 2022, this study included those with MR scans taken 1-week post-operatively, and only for indirect decompression patients. The analysis evaluated postoperative MR images for hematoma, cage insertion angles, and indirect decompression efficiency. Patient demographics, post-operatively symptoms, and complications were also evaluated. Results : Out of 401 patients enrolled, most underwent 1- or 2-level OLIF. Common findings included approach site hematoma (65.3%) and contralateral psoas hematoma (19%). The caudal level OLIF was related with less orthogonality and deep insertion of cage. Incomplete indirect decompression occurred in 4.66% of cases but did not require additional surgery. Rare but symptomatic complications included remnant disc rupture (four cases, 1%) and synovial cyst rupture (four cases, 1%). Conclusion : This study has identified potential complications associated with OLIF, including approach site hematoma, contralateral psoas hematoma, cage malposition risk at caudal levels, and radiologically insufficient indirect decompression. Additionally, it highlights rare, yet symptomatic complications such as remnant disc rupture and synovial cyst rupture. These findings contribute insights into the relatively under-explored area of OLIF complications.

• Earthquakes and Structures
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• v.8 no.6
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• pp.1363-1386
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• 2015

The October 23 2011 Van Earthquake is studied from an earthquake engineering point of view. Strong ground motion processing was performed to investigate features of the earthquake source, forward directivity effects during the rupture process as well as local site effects. Strong motion characteristics were investigated in terms of peak ground motion and spectral acceleration values. Directiviy effects were discussed in detail via elastic response spectra and wide band spectograms to see the high frequency energy distributions. Source parameters and slip distribution results of the earthquake which had been proposed by different researchers were summarized. Influence of the source parameters on structural response were shown by comparing elastic response spectra of Muradiye synthetic records which were performed by broadband strong motion simulations of the earthquake. It has been emphasized that characteristics of the earthquake rupture dynamics and their effects on structural design might be investigated from a multidisciplinary point of view. Seismotectonic calculations (e.g., slip pattern, rupture velocity) may be extended relating different engineering parameters (e.g., interstorey drifts, spectral accelerations) across different disciplines while using code based seismic design approaches. Current state of the art building codes still far from fully reflecting earthquake source related parameters into design rules. Some of those deficiencies and recent efforts to overcome these problems were also mentioned. Next generation ground motion prediction equations (GMPEs) may be incorporated with certain site categories for site effects. Likewise in the 2011 Van Earthquake, Reverse/Oblique earthquakes indicate that GMPEs need to be feasible to a wider range of magnitudes and distances in engineering practice. Due to the reverse faulting with large slip and dip angles, vertical displacements along with directivity and fault normal effects might significantly affect the engineering structures. Main reason of excessive damage in the town of Erciş can be attributed to these factors. Such effects should be considered in advance through the establishment of vertical design spectra and effects might be incorporated in the available GMPEs.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.43-47
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• 1994

Prompt recognition and proper treatment of esophageal perforation or rupture may ax~ert death or minimize complications. We have experienced sixteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Hallym Medical college during the period fromJan. 1986 to Sep. 1993. The ratio between male and female patient was 13:3 and their age ranged from 23 years to 67 years old. The major cause of esophageal perforations was spontaneous rupture in 7 cases[45%], surgical trauma in 2 cases[12%], instrumental trauma in 2 cases[12%], and others in 5 cases[31%]. The common site of esophageal perforation was in the lower third portion of the esophagus[10 cases, 62%]. The most consistent symptom of esophageal perforation was chest pain in 11 cases, temperature elevation within a few hours was 9 cases.Contrast roentgenographic studies demonstrated the perforation in all but 2 of the 16 patients. The frequent complications of esophageal perforation were empyema in 7 cases[45 %] and mediastinitis in 2 cases[12%]. fourteen patients had suture closure and drainage with 2 deaths, and 2 patient received only drainage procedures. The mortality rate was 12%[2 cases] and cause of death was sepsis and aortic rupture.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.418-421
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• 1994

The usage of autosuture instruments and techniques in resection of bronchovascular structures gained increasing acceptance amongst surgeons in the recent years. The manipulation of these devices are simple, safe, and shortens operating time by avoiding numerous ties and sutures. We have been using autosuture instruments in most of pulmonary resections in Yongdong Severance hospital, and had a satisfactory results. However, we recently have experienced post-pneumonectomy rupture of left pulmonary vein on postoperative one day where the rupture site was in the border of left atrium and left pulmonary vein where the stapler was fired. The patient underwent emergency operation to control massive bleeding and successfully managed by left atrial suture.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.416-424
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• 1989

We have performed eight, single transplantations of right lung in dogs from September, 1988 to March 1989 at the Thoracic & Cardiovascular Surgical department, Yonsei University, College of Medicine, Seoul, Korea. We wrapped bronchial anastomosis site with great omentum and used cyclosporin in preoperative and postoperative periods in seven cases except one. The one without wrapping the bronchial anastomotic site with omentum and using cyclosporin died due to bronchial anastomotic site rupture in postoperative fourth day. If there is no reason to choose one side over the other, we would generally choose to do left-sided transplant as this is technically somewhat easier because of the long length of recipient bronchus and the ease of clamping the left atrium proximal to the pulmonary veins. The right atrium limits the amount of left atrium that can have incorporated into the clamp proximal to the pulmonary veins on the right side. But we had chosen to do right-sided transplant of lung because we must take variable technical experiences on right sided lung transplant in dogs. We have to anastomose one of pulmonary vein and left atrial wall on right-sided transplant easily only with double ligation of one pulmonary vein because right atrium limited the clamp of left atrium proximal to pulmonary veins with decreased venous return and cardiac output in some dogs. All seven dogs with right-sided lung transplant had survived more than one day with good condition except one. The one dog have to be sacrificed to evaluate the difference between the gas analysis in pulmonary venous and arterial blood in post-operative eight hours. We found hemorrhagic pulmonary edematous changes of contralateral left lung in this dog. And also all dogs have to be sacrificed for the evaluation of surgical problems, anytime in post-operative periods without any cardiopulmonary resuscitative efforts when the general condition would be worse progressively. We found no any surgical technical errors in seven dogs except one with thrombi in suture site of left atrium. There were hemorrhagic pulmonary edematous changes of transplanted right lung in one, of contralateral left lung in one, of contralateral left lung with double ligation of its pulmonary artery in one, thrombi around left atrial sutures sites in one, multiple air leakage in one bronchial rupture in one due to rejection or infection. There were accidental extubation and delayed intubation in one and unknown cause of death in one.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.471-478
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• 1988

We evaluated forty cases of traumatic diaphragmatic injuries that we have experienced from Jan. 1972 to Dec. 1987. 28 patients were male and 12 were female[M:F=2.3:1]. The age distribution was ranged from 4 to 71 years with mean age of 26. The diaphragmatic injuries were due to blunt trauma in 27 cases[traffic accident 22, fall down 3, others 2] and penetrating trauma in 13 cases[stab wound 11, gun shot 1, other 1]. In the blunt injury,14 cases of 17 were diagnosed and treated within 24 hours in the left diaphragmatic injury but only 3 cases of 7 cases in the right diaphragmatic injury were diagnosed and treated within 24 hours. All cases except one in penetrating injury were diagnosed and treated within 12 hours. In the blunt injury, the rupture site was located in the left in \ulcorner7 cases and in the right in 7 cases. In the penetrating injury, the rupture site was located in the left in 11 cases and in the right in 2 cases. The repair of 37 cases were performed with thoracic approach in 20 cases, thoracoabdominal approach in 12 cases and abdominal approach in 5 cases. Over all mortality was 17.5%[7/40] and postoperative mortality was 11%[4/37]. The causes of death were hypovolemic shock[3], combined head injury[2], acute renal failure[1] and septic shock with ARDS[1].

• Earthquakes and Structures
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• v.9 no.1
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• pp.93-109
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• 2015

Based on the reconnaissance of buildings in Dujiangyan City during 2008 Wenchuan earthquake, China, structural damage characteristics and the spatial distribution of structural damage are investigated, and the possible reasons for the extraordinary features are discussed with consideration of the influence of urban historical evolution and spatial variation of earthquake motions. Firstly, the urban plan and typical characteristics of structural seismic damage are briefly presented and summarized. Spatial distribution of structural damage is then comparatively analyzed by classifying all surveyed buildings in accordance with different construction age, considering the influence of seismic design code on urban buildings. Finally, the influences of evolution of seismic design code, topographic condition, local site and distance from fault rupture on spatial distribution of structural damage are comprehensively discussed. It is concluded that spatial variation of earthquake motions, resulting from topography, local site effect and fault rupture, are very important factor leading to the extraordinary spatial distribution of building damage except the evolution of seismic design codes. It is necessary that the spatial distribution of earthquake motions should be considered in seismic design of structures located in complicated topography area and near active faults.

• Journal of Embryo Transfer
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• v.32 no.4
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• pp.331-336
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• 2017

A 2-year-old female Maltese dog was presented with a history of anemia and vaginal hemorrhagic discharge. Physical examination revealed severe vaginal hemorrhagic discharge, abdominal pain, pale mucous membranes, low blood pressure and dehydration. Results of serum biochemistry, hematology, venous blood gas, and electrolyte canine C-reactive protein (CRP) test revealed severe normocytic normochromic anemia, severe neutropenia, a high level of CRP, hypoglycemia, and imbalanced electrolytes. Abdominal ultrasound examination showed focal hypoechoic defect with loss of layering in uterine horn wall. A laparotomy revealed a clear reddish fluid in the abdomen, the fistula of left and right uterine horn, the purulent discharge from fistula, and symptoms of septic peritonitis near by the fistula site. The bitch underwent ovariohysterectomy and recovered without complication. Histopathological diagnosis of the uterine fistula site was adenocarcinoma.

• Journal of Trauma and Injury
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• v.32 no.2
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• pp.122-125
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• 2019

A 73-year-old man, who, in an inebriated state, had slipped in a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. Based on the chest and abdominopelvic computed tomography, he was diagnosed with multiple rib fractures and hemopneumothorax on the left hemithorax and was found to have a bony fragment in the spleen. He had not presented peritonitis and exsanguinous symptoms during the observation period. Seven days later, computed tomography of the abdomen showed suspected diaphragmatic injury and a retained foreign body in the spleen. On exploration by video assisted thoracoc surgery (VATS), a herniated omentum through the lacerated site of the diaphragm was observed. After omentectomy using Endo Gia, the foreign body in the spleen was observed through the lacerated site of the diaphragm. Traumatic diaphragm rupture with a foreign body, in the spleen, was successfully managed by video assisted thoracic surgery via the lacerated site of the diaphragm.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.82-89
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• 1977

A rupture of a dissecting aneurysm of the aorta is life threatening disease and calls for emergency surgical treatment. The author recently experienced one case of ruptured dissecting aneurysm of the descending thoracic aorta complicated with left hemothorax who was recovered after emergency operation of Aug. 11, 1976. The patient was a 43 years old farmer with known hypertension [260/120] for 20 years but without any venereal disease and had experienced sudden throbbing chest pain. Chest film and aortogram revealed this case ruptured aneurysm of descending thoracic aorta complicated with left hemothorax. In this case, large dissecting aneurysm extend from proximal part of left subclavian artery below diaphragm and involved with 3.0 and 4.0cm sized elliptical rupture in proximal part of descending thoracic aorta. And so, neither fenestration procedure nor replacement of dacron artificial vessel was suitable for this case. Finally, only the rupture site of aneurysm was treated by covering with fibrous pleura and teflon patch. The post-operative management of this case was planned to control hypertension with antihypertensive drugs. The follow-up was possible up to date about 2months. The patient has been doing well with ordinary activities except mild chest discomfort.