• The Korean Journal of Legal Medicine
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• v.40 no.2
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• pp.61-64
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• 2016

Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.03a
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• pp.118-118
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• 2002

• Journal of Korean Neurosurgical Society
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• v.67 no.3
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• pp.280-288
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• 2024

Brain arteriovenous malformations (bAVMs) are aberrant arteriovenous shunts through a vascular nidus with no intervening capillary beds. They are one of the commonest causes of spontaneous intracranial haemorrhage in children and may be associated with significant morbidity and mortality in cases of rupture. Treatment strategies include microsurgical resection, endovascular embolisation, stereotactic radiosurgery, multimodality treatment with a combination thereof, and particularly in high-grade bAVMs, conservative management. Clinicians involved in treating bAVMs need to have familiarity with the natural history pertaining to bAVMs in terms of risk of rupture, risk factors elevating rupture risk as well as understanding the clinical manifestations of bAVMs. This invited review serves to provide a synthesis on natural history and clinical presentation of bAVMs with particular focus in children to inform decision-making pertaining to management.

• Journal of Chest Surgery
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• v.34 no.5
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• pp.414-417
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• 2001

흉부 대동맥의 비 외상성 자연 파열은 매우 드물지만, 발생시 응급수술이 요하는 위중한 질환이다. 본원에서는 전산화 단층 촬영과 경식도 초음파로 진단하고 부분 대동맥궁 치환술로 성공적으로 치료된 후 흉부 대동맥의 비 외상성 지연 파열 1례를 체험하였기에 문헌고찰과 더불어 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.123-125
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• 2011

Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.360-362
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• 2015

Spontaneous pneumomediastinum (PM) is an uncommon condition in which free air enters the mediastinum. This usually occurs either through esophageal tears after vigorous vomiting, or after alveolar rupture subsequent to a rapid increase in intra-alveolar pressure. Spontaneous PM is a rare entity in anorexia nervosa (AN) and self-induced vomiting is often the cause of PM in patients with AN. We experienced a case of spontaneous PM in an anorexic adolescent, in whom vomiting was not the cause of PM.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1150-1154
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• 1995

Pneumomediastinum[Mediastinal emphysema is characterized by the presence of air in the mediastinum, and classified as spontaneous[occurring without obvious cause or secondary[caused by a trauma or artificial ventilation . To study the clinical evaluation of pneumomediastinum, data were obtained from 20 patients. The incidences of spontaneous pneumomedisastinum were 5 and those of secondary pneumomedistinum were 15 cases. The mean age was 21.2$\pm$3.4 years[$\pm$SD in spontaneous pneumomediastinum and 44.1$\pm$20.0 years[$\pm$SD in secondary pneumomediastinum. There were 16 male and 4 female patients. The common presenting compliants were retrosternal pain in 19 patients[95% , dyspnea in 12[60% , and hoarsness in 2[10% . The predisposing factors were asthma,excessive exercise and vomiting in spontaneous pneumomediastinum;trauma, artificial ventilation, tracheostomy, the rupture of trachea or esophagus in secondary pneumomediastinum. The physical findings were subcutaneous emphysema in 17 patients[85% , Hamman`s sign in 11 patients[55% and decreased cardiac dullness in 2 patients[10% . Spontaneous pneumomediastinums were managed conservatively, however, surigical procedures were needed in secondary pneumomediastinums. There was no recurrence, but one patinet died of tension pneumomedistinum. We concluded that spontaneous pneumomediastinum is uncommon, usually benign, and self-limited and secondary pneumomedistinum due to trauma or artificial ventilation is more increasing, and necessitates the early, aggressive intervention.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.788-793
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• 1989

We have observed 501 cases of spontaneous pneumothorax from January 1981 to June 1989 at the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 57 patients have undergone thoracotomy to treat the pneumothorax after closed thoracostomy. These 57 patients were based on this retrospective clinical analysis, and the results were as follows: The ratio of male to female was 4.2:1 in male predominance and the old aged patients, over 50 years old, occupied 47.3% of all patients. Primary spontaneous pneumothorax was 19 cases and secondary spontaneous pneumothorax was 38 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis emphysema and chronic obstructive pulmonary disease in 35 cases. The indications of thoracotomy were persistent air leakage in 23 cases recurrent pneumothorax in 21 cases, inadequate expansion in 13 cases. Rupture of bullae or blebs were most frequent operative and pathologic findings in persistent air leakage group and recurrent pneumothorax group. In inadequate expansion group, predominant finding was destructive lung lesion. Bullectomy and/or bullae ligation was most effective procedures in 36 cases [63%] for operative management of spontaneous pneumothorax. Duration of preoperative and postoperative chest tube indwelling day was 13.35 days and 8.05 days in persistent pneumothorax group, 8.92 days and 7.77 days in recurrent pneumothorax group, 13.23 days and 10.21 days in inadequate expansion group.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.81-84
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• 2006

Rupture of the rectus femoris at the musculotendinous junction is very rarely reported in the literature, especially which is caused by chronic repetitive stimulation. A 21 year old soldier complained of progressing right thigh pain and mass for 8 weeks after military training. MRI of the right thigh showed inhomogenous mass lesion suspecting soft tissue tumor. However ultrasonographic examination showed torn retracted rectus femoris tendon at musculotendinous junction. One year after primary repair of ruptured tendon, the patient is free from symptoms and returned to full previous activities. Knowledge of this sonographic and MRI finding will help the surgeon to diagnose and treat this rare injury.

• 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.