• 제목/요약/키워드: Stab

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말초동맥에 발생한 가성동맥류의 외과적 치료 -치험 6례- (Pseudoaneurysms of Peripheral Arteries - A Report of 6 Cases-)

  • 류완준;조창욱
    • Journal of Chest Surgery
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    • 제29권8호
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    • pp.927-930
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    • 1996
  • 인제의대 서울백병원에서는 1986년부터 1994년까지 말초동맥에 발생한가성동맥류환자 6례를 수술 치험하였다. 발생원인은 자상의 일차 봉합술 후 3례, 혈관에 도관삽입 후 2례, 골절상 후 고정 핀을 제거하기 위한 수술 후 1례였다. 발생부위는심부 대퇴동맥 2례, 총대퇴동맥 2례, 쇄골하동맥과 액와동맥에 각각 1례였다. 증상은 박동성 종괴가 4례에서 촉지되었고, 청진시 잡음은 3례, 동통과 종창이 2례, 압통이 1례에서 있었다. 이 중 5례에서 수술을 시행하였다. 수술은 2례에서 심부 대퇴동맥을 결찰하여 가성동맥류를 제거하였다. 단순 가성동맥류의 절제, 요피정맥을 연결하여 성형술, 복재정맥의 첩제를 이용한 성형술을 각각 1례에서 시행하여 가성동맥류를 제거하였다. 1례는 자연 치유되었다.

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삼출액을 동반한 급성심낭염의 임상적 고찰 (Clinical Experience of Acute Pericarditis with Effusion)

  • 박건;윤정섭;김용환;조규도;박재길;왕영필;김세화;이홍균
    • Journal of Chest Surgery
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    • 제24권2호
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    • pp.190-196
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    • 1991
  • Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

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외상성 횡경막 손상에 대한 임상적 고찰 -40례 보고- (Clinical Evaluation of Traumatic Diaphragmatic Injuries (Reports of 40 Cases))

  • 정황규
    • Journal of Chest Surgery
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    • 제21권3호
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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].

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외상성 기관 및 기관지 파열: 3례 보고 (Traumatic Rupture Of Tracheobronchial Tree: 3 Cases Report)

  • 한승세
    • Journal of Chest Surgery
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    • 제10권1호
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    • pp.38-43
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    • 1977
  • With the adevance of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. We have experienced these diseased of the 3 cases in our department. The first case was a 25 year old male who was severe dyspneic and subcutaneous emphysema, hemoptysis, and hemopneumothorax of both side were noted. During tracheostomy, it was found that the 2net ring of the trachea was ruptured. No definitive procedure was made on admission. Corrective surgery was performed with end-to-end anastomosis on 31 post-traumatic day. The second case was a 43 year old female who received multiple stab wounds on the anterior neck and it was found that the cricoid cartilage was transected partially. The injured cartilage was approximated with interrupted suture of No. 600 wire. The third case was a 19 year old male who had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he had suffered from dyspnea, and obstruction of the left main bronchus due to traumatic bronchial rupture was confirmed by means of bronchoscopy and bronchography at two weeks after the trauma. End-to-end anastomosis of the bronchus was performed and the left lung was aerated well. Mild postoperative stenosis of trachea was remained in the first case. Others were uneventful.

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외상성 횡격막 헤르니아: 3례 수술 보고 (Traumatic Diaphragmatic Hernia: A Report of 3 Cases)

  • 유세영
    • Journal of Chest Surgery
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    • 제2권1호
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    • pp.59-64
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    • 1969
  • Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

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하악골 시상골 골절단술시 MINIPLATE에 의한 RIGID FIXATION (RIGID FIXATION BY MINIPLATE IN THE MANDIBULAR SAGITTAL SPLITRAMUS OSTEOTOMY.)

  • 조병욱;이용찬;양용석;유하식
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권2호
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    • pp.48-54
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    • 1990
  • This is a report of 4 cases of the surgical correction of mandibular prognathism with chief complaint of mastication difficulty, facial asymmetry and protrusive chin. We performed sagittal spit ramus osteotomy for the prognathism, we used the repositioning plate for conserving the condylar segment into its original position and fixed the osteotomized bone segments rigidly with adjustable monocortical plate. Intermaxillary fixation was performed during 2 weeks. As a results, we found the following advantage. 1. Rigid fixation effect like the fixation by the tandem screw. 2. Decreased postoprative swelling. 3. It is needless to do the stab incision for the transbuccal set instrument. 4. It is more convenient to perform the rigid fixation in the monocortical plate method than screw technique.

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Early management of parotid gland injury with oral nortriptyline and closed drain

  • Chung, Chan Min;Wee, Sung Jae;Lim, Hyoseob;Cho, Sang Hun;Lee, Jong Wook
    • 대한두개안면성형외과학회지
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    • 제21권4호
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    • pp.253-256
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    • 2020
  • Parotid gland plays the most critical role in saliva secretion in the oral cavity. Parotid gland injuries due to facial trauma can cause various complications such as formation of a fistula or sialocele. Thus, such saliva-related complications can interfere with wound healing and increase the risk of infection. Several previous studies have discussed the treatment of fistula or sialocele. Nonetheless, prevention of such complications is of utmost importance. We present a case of parotid gland injury due to trauma to the cheeks that was surgically treated, with early postoperative management involving oral administration of nortriptyline and closed drainage, without complications.

언어에서의 시간성표현 (Ausdruck der $Temporalit\"{a}t$ in der Sprache)

  • 권영숙
    • 한국독어학회지:독어학
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    • 제1집
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    • pp.247-261
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    • 1999
  • In dieser Abhandlung wurde im Bereich der $Temporalit\"{a}t$ anhand des konzeptorientierten Ansatzes das $Verh\"{a}ltnis$ yon konzeptueller und sprachlicher $Repr\"{a}sentation$ betrachtet. Die $Temporalit\"{a}t$ ist ein abgeleiteter Begriff, den das menschliche$Bewu{\ss}tsein$ im Rahmen seiner kognitiven Entwicklung als $Ma{\ss}stab$ der qualitativen $Ver\"{a}nderung$ und Bewegung von Materie warhnimmt und systematisch konzeptualisiert. Ihre Subkategorien unterscheiden sich in den Sprachen, da bei den $Konzeptualisierungsvorg\"{a}ngen$ durch die Muttersprache bestimmte begriffliche Kategorien eine steuernde Rolle spielen. In diesem theoretischen Hintergrund betrachteten wir, inwieweit die beiden Sprachen, das Deutsche und das Koreanische, im Bereich des Zeitkonzepts auf der konzeptuellen Ebene und auf der Ausdrucksebene verschieden und gemeinsam sind, und wie das $Verh\"{a}ltnis$ zwischen den temporalen Konzepten und den $Ausdrucksm\"{o}glichkeiten$ ist. Die $Temporalit\"{a}t$ des Koreanischen ist in Bezug auf die Basiskategorien der $Temporalit\"{a}t$ mit dem Deutschen mehr oder weniger identisch. Zum Ausdruck der Zeitreferenz haben die beiden Sprachen gemeinsam zwei explizite grammatische und lexikalische $Ausdrucksm\"{o}glichkeiten$, aber die Art und Weise, wie sie zum Ausdruck der Subkategorien der $Temporalit\"{a}t$ eingesetzt werden, sind verschieden. In diesem Zusammenhang kann man sagen, $\dabeta$ es zum Verstandnis der $\dabeta$ in der Sprache nicht reicht, die sprachliche Formen zu betrachten: man $mu\ss$ die Konzepte berucksichten, die durch die sprachlichen Formen $ausgedr\"{u}ckt$ werden.

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인후두의 개방적 외상에 대한 수술적 고찰 (A Surgical Idea for Wide Communicated Wound on Laryngopharynx)

  • 이종원;국태진;이정헌;염시경
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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    • pp.7.4-8
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    • 1982
  • 오늘 날, 물질 문명이 고도로 발달함에 따라 인두 및 인두 손상이 날로 증가하는 경향을 보이고 있다. 교통 사고나 운동 경기는 폐쇄적 외상을 일으키기 쉽고 빈도는 적지만 심각한 증상을 초래하는 개방적 외상의 원인으로는 총상이나 자상 등을 들 수 있다. 인후두의 개방적 외상에서 가장 문제가 되는 것은 적절한 치료에 있다. 이 부위의 외상은 손상의 정도나 범위에 따라 차이는 있지만 신속한 처치가 요구되고 협착이나 누출 등과 같은 심각한 후유증을 남기기 때문에 적절한 치료 방법이 요구되는 것이다. 일반적으로 이에 대한 치료는 적절한 기도 유지를 위한 기관절개술과 단순 봉합등을 일차적으로 시행하고 차후에 후유증에 대한 이차 수술을 시행하는 것이 보통이다. 최근, 저자들은 자상으로 인해 인두 뿐만 아니라 인두까지 광범위한 개방적 외상을 입고 이차 감염까지 일으켜 인후두 조직 및 전경부 피부의 심한 결손을 보인 환자에게 잔여 후두 적출술을 시행한 후 피부봉이나 육경피부변을 사용하지 않고 전경부 피부변을 이용해서 피부 결손부를 얻었기에 문헌적 고찰과 함께 보고하는 바이다.

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흉부손상에 대한 임상적 고찰 (clinical evaluation of chest trauma)

  • 문경훈
    • Journal of Chest Surgery
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    • 제22권1호
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    • pp.123-133
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    • 1989
  • A clinical evaluation was done on 182 cases of chest trauma which experienced at the Department of Thoracic and Cardiovascular Surgery, National Medical Center, from Sep. 1980 to Dec. 1987. 1] Of 182 cases, 125 cases resulted from non-penetrating chest trauma and 57 cases from penetrating wound. 2] The ratio of male to female was 4.87:1, and age groups between 3rd and 6th decade were 71.9%. 3] The most common causes of chest trauma were traffic accident in non-penetrating and stab wound by knife in penetrating cases. 4] Left thorax was the preferred site of chest injury. 5] The incidences of hemothorax, pneumothorax, and hemopneumothorax were 69.6% in non-penetrating and 91% in penetrating. 6] Rib fractures between 4th rib and 8th rib were 68.8% of total rib fracture cases and left side was preferred site. 7] Methods of treatment were conservative management in 24.7%, closed thoracostomy in 54.9%, open thoracotomy in 14.3%, and etc. 8] The incidence of complications, were 11.5% of total cases, and they were atelectasis [8 cases], empyema [3 cases], pneumonia [3 cases], acute renal failure [2 cases], lung abscess [1 case], and etc. 9] The overall mortality was 6%, and causes of death were hypovolemic shock, renal failure, hepatic failure, respiratory failure, septic shock, and etc.

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