• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.109-114
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• 1999

Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.393-400
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• 2009

Purpose: The purpose of this study was to examine the effects of unilateral sciatic nerve injury on unaffected hindlimb muscles of rats. Methods: Adult male Sprague-Dawley rats were assigned to one of three groups: control(C) group(n=10) that had no procedures, sham(S) group(n=10) that underwent sham left sciatic nerve transection, and sciatic nerve transection(SNT) group(n=9) that underwent left sciatic nerve transection. At 15 days rats were anesthetized, and the soleus, plantaris and gastrocnemius muscles were dissected. Results: Muscle weight of the unaffected plantaris muscle in the SNT group was significantly lower than in the other two groups. Type II fiber cross-sectional areas of the unaffected plantaris and gastrocnemius muscles in the SNT group were significantly smaller than in the other two groups. The decrease of muscle weights and Type I, II fiber cross-sectional areas of the unaffected three muscles in the SNT group were significantly less than that of the affected three muscles. Conclusion: Hindlimb muscle atrophy occurs in the unaffected side after unilateral sciatic nerve injury, with changes in the plantaris and gastrocnemius muscle being more apparent than changes in the soleus muscle. These results have implications for nursing care, in the need to assess degree of muscle atrophy in unaffected muscles as well as affected muscles.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.531-533
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• 2014

We present a case of angiographically confirmed transection of the cisternal segment of the anterior choroidal artery (AChA) associated with a severe head trauma in a 15-year old boy. The initial brain computed tomography scan revealed a diffuse subarachnoid hemorrhage (SAH) and pneumocephalus with multiple skull fractures. Subsequent cerebral angiography clearly demonstrated a complete transection of the AChA at its origin with a massive extravasation of contrast medium as a jet trajectory creating a plume. We speculate that severe blunt traumatic force stretched and tore the left AChA between the internal carotid artery and the optic tract. In a simulation of the patient's brain using a fresh-frozen male cadaver, the AChA is shown to be vulnerable to stretching injury as the ipsilateral optic tract is retracted. We conclude that the arterial injury like an AChA rupture should be considered in the differential diagnosis of severe traumatic SAH.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.23-27
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• 2014

Purpose: Laparoscopic hernia repair in children is still controversial. The aim of this study was to report our long-term results of the laparoscopic hernia technique, which is based on the same surgical principles as conventional open herniotomy. Methods: Five hundred fourteen pediatric patients with inguinal hernia were included in this study under informed consent. All patients underwent a laparoscopic technique of sac transection and intracorporeal ligation. The asymptomatic contralateral inguinal ring was routinely explored and repaired if a patient had patent processus vaginalis on the contralateral side. Patients were prospectively followed for 5 years. Those who were lost to follow-up were excluded from the study. Perioperative complications and recurrences were evaluated. Results: The mean follow-up period was 29 months. Mean operation time was 27.5 minutes. Forty one percent of the patients had contralateral patent processus vaginalis. Only one hernia recurred (0.19%). We had one case of contralateral metachronous hernia (0.21%) during follow-up period. Conclusion: The long-term follow-up results of our study revealed that laparoscopic hernia sac transection and ligation can be a safe and effective alternative for conventional herniorraphy.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.294-298
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• 2021

Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.813-817
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• 1999

Background: Conventional thoracoscopic thoracic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively embarrassing compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection. The purpose of this study was to assess the result of the limited thoracoscopic sympathetic nerve transection in hyperhidrosis. Material and Method: From May to August 1998, 17 patients underwent limited transection of the sympathetic nerve. For 9 patients with facial hyperhidrosis, we transected only the interganglionic fiber between the first and the second ganglion, whereas the conventional method cuts two interganglionic fibers. Eight patients with palmar hyperhidrosis underwent limited transection of the interganglionic fiber between the second and third ganglion. Result: Sixteen patients had improved symptom postoperatively. There was a recurred facial sweating in 1 patient 1 month after the operation. Among the 9 facial hyperhidrosis patients, postoperative compensatory hyperhidrosis was severe in 4, moderate in 4 and minimal in 1. But in 8 cases of palmar hyperhidrosis compensatory hyperhidrosis was moderate in 3, and minimal in 1, none in 4. Facial sweating was not disturbed postoperatively in all of the palmar hyperhidrosis patients. Conclusion: Limited sympathetic nerve transection is a practical and less invasive method for the treatment of localized hyperhidrosis and may reduce the incidence of compensatory truncal hyperhidrosis and facial anhidrosis in case of palmar hyperhidrosis.

• 한국무역상무학회:학술대회논문집
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• 2002.12a
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• pp.157-174
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• 2002

• Advances in pediatric surgery
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• v.9 no.1
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• pp.52-56
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• 2003

A 10 year old boy was admitted with blunt abdominal trauma by bike handle injury. The patient was operated upon for a generalized peritonitis due to pancreaticoduodenal injury. On opening the peritoneal cavity. complete transection of distal end of common bile duct and. partial separation between pancreas head and second portion of duodenum were found. Ligation of the transected end of the common bile duct. T-tube choledochostomy, and external drainage were performed. A pseudocyst was found around the head portion of the pancreas on the 7th postoperative day with CT. An internal fistula had developed between the pseudocyst and ligated common bile duct. The pseudocyst was subsided after percutaneous drainage. In the case of the undetermined pancreatic injury, percutaneous external drainage can be effective in treating the traumatic pancreatic pseudocyst in a pediatric patient.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.812-816
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• 1985

In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.60-64
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• 2023

Upper extremity vascular injuries occurring with acute compartment syndrome are very challenging to manage in an emergency context in resource-poor settings. The need to always recognize the likelihood of coexisting compartment syndrome guides surgeons to perform concomitant fasciotomy to ensure a better outcome. We managed three vascular injuries in the upper extremities in two patients with concomitant imminent compartment syndrome observed intraoperatively. The first injury was complete brachial artery disruption following blunt trauma, while the second and third injuries were radial and ulnar artery transection caused by sharp glass cuts. Both patients were treated with vascular repair and fasciotomy. Secondary wound coverage was applied with split-thickness skin grafting, and the outcomes were satisfactory. Concomitant fasciotomy potentially improves the outcomes of vascular repair in emergency vascular surgery and should be considered for all injuries with the potential for acute compartment syndrome.