• Title/Summary/Keyword: Vessel injury

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Scalp Free Flap Reconstruction Using Anterolateral Thigh Flap Pedicle for Interposition Artery and Vein Grafts

  • Park, Jun-Hyung;Min, Kyung-Hee;Eun, Suk-Chan;Lee, Jong-Hoon;Hong, Sung-Hee;Kim, Chin-Whan
    • Archives of Plastic Surgery
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    • v.39 no.1
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    • pp.55-58
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    • 2012
  • We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had $4{\times}3cm$ and $6{\times}5cm$ scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.

Study of Loss of Free Flap and Safer Timing of the Operation in Electrical Injury (전기화상에서 시행한 유리피판의 소실과 재건시기에 대한 연구)

  • Chung, Eui Young;Lee, Jong Wook;Koh, Jang Hue;Seo, Dong Kuk;Chung, Chan Min;Jang, Young Chul;Oh, Suk Joon
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.567-572
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    • 2005
  • An electrical burn used to result in the damage of the skin and underlying deep soft tissue injury. Thus, in order to preserve devitalizing tissues and promote the structural survival free flaps with ample blood supply are frequently employed. However, early unpredictable vascular injury and progressive tissue necrosis may cause the free flaps full of hazards. We applied 50 free flaps upon 41 acute electrical burn cases between 1998 and 2004. Injured areas, timing of operation and causes of flap loss were studied. The victim's ages ranged from 13 to 60 years. (an average 37.8 years) Thirteen out of 50 free flaps were lost totally: three cases were due to arterial insufficiency and ten venous congestion. Total loss of flaps were observed in 5 of 12 cases in the postoperative 3 weeks, 6 of 20 cases between 3 and 6 weeks and 2 of 18 cases after 6 weeks. In three of 12 cases the free flap was lost partially in the postoperative 3 weeks, 4 of 20 cases between 3 and 6 weeks and 1 of 18 cases after 6 weeks. The result was statistically significant by a T-test (p<0.05). This study showed that timing of the operation is accountable for the loss of free flap. It is most important to conduct the free flap procedure on an electrical injury at the time when the recipient vessel is definitely discernible and intact so as to minimize the loss of flap and spare the structures.

Product Liability in the Shipbuilding in the "MSC Carla" case (MSC Carla 사례상 선박의 제조물책임)

  • Seo, Jeong Woo;Jo, Jong Joo
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.64
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    • pp.155-185
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    • 2014
  • Liability for the manufacture or supply of defective products can arise in two principle ways, in tort and in contract. English law has long regarded shipbuilding contract as agreement for the sale and purchase of goods. The consequence of which is that unless the Buyer and Builder agree otherwise, terms will automatically be implied into the contract between them as to the quality and performance of the completed vessel. The same principle applies to sub-contracts allied to the shipbuilding contract. On the other hand, one case decisions established that ".... a contract to build a ship, though a contract of sale of goods, has also some characteristics of a building contract", Recently the liability of a manufacturer in tort for physical damage i.e. personal injury and damage to property other than alleged to be defective is now well settled in most countries. Accordingly the Builder may face third party claims in tort more regularly than they have in the past, if the statutory implied terms have not been expressly excluded in contract. In such circumstances, it is necessary for the Builder to be prepared with counter measures to secure the stability of the vessel from its design development, building process, delivery and operation etc. The purpose of this paper is, from the case of "MSC Carla", to review product liability, jurisdiction and the initial date of extinctive prescription, then to suggest counter measures to the Builder.

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Literatural Study on the etiology, symptoms, and treatment with acupuncture about climacteric syndrome (갱년기(更年期) 장애(障碍)의 원인(原因) 치법(治法) 및 침구치료(鍼灸治療)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Lee, Jong Nyeon;Yoo, Dong Yeol
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.287-304
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    • 2000
  • The study was done to evaluate the aetiology, symptoms, and treatment with acupuncture about climacteric syndrome on literature. The results were obtained as follows. 1. The aetiologies of the climacteric syndrome are insufficiency of Chung-Im, outside evil, injury of the five emotions, Labor, exceeding of lust, blood heat, insufficiency of Yin(陰), gathering of phlegm. 2. The climacteric syndrome is to connected with conception vessel, the pulse of Spleen, and Liver. 3. The treatments of climacteric syndrome are nutrition of Kidney and Liver, that of Kidney heat, descending Yang(陽) of Liver, nutrition of blood of heart, having a comunication with Kidney and heart, nutrition of Spleen and Stomarch. 4. For treatment with acupuncture, they have been used the conception vessel, the pulse of Spleen, Bladder, and they use acupuncture points for nutrition of Yin(陰), paece of soul, nurition of blood of Spleen. 5. The acupuncture point in ear for treatment of climacteric syndrome are Pi-Jil-Ha(皮質下), Kyo-Gam(交感), Nae-Bun-Bi-Jeom(內分泌點). These acupuncture points are to connected with estrogen and Kidney functure.

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Effect of Bambusae Caulis in Liquamen(Jukryuk) on Ischemic Damage to 4 Vessel Occlusion and Middle Cerebral Artery Occlusion in Mice (죽력(竹瀝)이 흰쥐의 중대뇌동맥(中大腦動脈) 및 전뇌허혈(全腦虛血) 폐쇄 허혈모델에 미치는 영향)

  • Kim, Jae-Hong;Hong, Jin-Woo;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Cham-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.629-640
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    • 2008
  • Objective : The purpose of this study was to investigate the neuroprotective effect of Jukryuk on 4-vessel occlusion(4-VO) and middle cerebral artery (MCA) ischemia. Method : After administration of Jukryuk, we compared the Jukryuk-treated group, the control, and the sham groups, in view of several points as follows 1) We evaluated the damage characterized by coagulative cell change of pyramidal neurons and pronounced gliosis in each group 2) We counted the number of normal pyramidal shapes after ischemia in each group 3) Immunohistochemistry (cyclooxygenase-2) 4) In focal ischemic injury model, we measured the volume of ischemic area Results : In this experiment, the effect of Jukryuk was determined to be protecting neuron cell shape, reducing the number of neuron cells damaged by ischemia and the volume of the ischemic area. In immunohistochemistry, Jukryuk reduced cyclooxygenase-2 expression Conclusions : According to this study, Jukryuk can protect neuron cells from injury by cerebrovascular ischemia.

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Traumatic Pseudoaneurysm of the Superficial Temporal Artery due to Gardner Traction

  • Lee, Hyun-Seok;Jo, Kwang-Wook;Lee, Sun-Ho;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.291-293
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    • 2010
  • We report a case of pseudoaneurysm of the parietal division of the superficial temporal artery (STA) secondary to iatrogenic head injury due to Gardner traction. A 54-year-old man presented with a pulsatile, cystic, and painless mass in the right anterior temporal region which developed three weeks after head fixation via Gardner traction. At the time of discovery, the mass was 10 mm in diameter, compressible and disappeared after manual compression of the proximal STA. A bruit was audible over the mass, which was thought to be a pseudoaneurysm. A computed tomography angiogram (CTA) showed a pseudoaneurysm of the parietal division of the right ST A. The tip of the pseudoaneurysm was thrombosed and was both red and tender. The pseudoaneurysm was thought to be filled with infected thrombus, and the mass was resected with ligation of the proximal and distal ends of the STA. A pseudoaneurysm of the STA should be suspected when there is a history of possible vessel injury, such as a history of head-pin fixation, and when a patient presents with a pulsatile, cystic mass near the temple. Pseudoaneurysms can be successfully treated by excision.

Mechanism of Lung Damage Induced by Cyclohexane in Rats (Cyclohexane에 의한 랫드의 폐손상 기전)

  • 전태원;윤종국
    • Toxicological Research
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    • v.18 no.2
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    • pp.159-165
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    • 2002
  • Recently, we reported (korean J. Biomed. Lab. Sci., 6(4): 245-251, 2000) that cyclohexane (l.56 g/kg of body wt., i.p.) administration led to lung injury in rats. However the detailed mechanism remain to be elucidated. This study was designed to clarify the mechanism of lung damage induced by cyclohexane in rats. First, lung damage was assessed by quantifying bronchoalveolar lavage fluid (BAL) protein content as well us by histopathological examination. Second, activities of serum xanthine oxidase (XO), pulmonary XO and oxygen free radical scavenging enzymes. XO tope conversion (O/D + O, %) ratio and content of reduced glutathione (GSH) were determined. In the histopathological findings, the vasodilation, local edema and hemorrhage were demonstrated in alveoli of lung. And vascular lumens filled with lipid droplets, increased macrophages in luminal margin and increased fibroblast-like interstitial cells in interstitial space were observed in electron micrographs. The introperitoneal treatment of cyclohexane dramatically increased BAL protein by 21-fold compared with control. Cyclohexane administration to rats led to a significant rise of serum and pulmonary XO activities and O/D + O ratio by 47%,30% and 24%, respectively, compared witれ control. Furthermore, activities of pulmonary oxygen free radical scavenging enzymes such as superoxide dismutase, glutathione peroxidase and glutathione S-transferase, and GSH content were not found to be statistically different between control and cyclohexane-treated rats. These results indicate that intraperitoneal injection of cyclohexane to rats may induce the lipid embolism in pulmonary blood vessel and lead to the hypoxia with the ensuing of oxygen free radical generation, and which may be responsible for the pulmonary injury.

Clinical Study of Neck Base Injury (경저부 혈관손상의 임상적 고찰)

  • 우종수
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.378-384
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    • 1978
  • Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

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Risk factors of fisher on stow net fishing vessel using analysis of adjudication (재결서 분석을 통한 안강망어선에 승선하는 선원의 위험요인)

  • KIM, Wook-Sung;HYUN, Yun-Ki;LEE, Yoo-Won
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.56 no.2
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    • pp.155-162
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    • 2020
  • The adjudication of Korean Maritime Safety Tribunal (KMST) was analyzed to collect basic data to identify the cause of the risk that did not appear in the current data provided by the fishermen's occupational accidents of the National Federation of Fisheries Cooperative (NFFC) in stow net fishing vessel from 2015 to 2019. The personnel's carelessness was the most common in 29 out of 33 accidents (87.9%), followed by 25 cases (75.8%) of inadequacy of instructions, 24 cases (72.7%) of inadequacy of education on hazard factor, 20 cases (60.6%) of no personal protection equipment, 18 cases (54.5%) of poor guard, 17 cases (51.5%) of inadequacy of work method, 16 cases (48.5%) of absence of emergency stop button, 14 cases (42.4%) of work practice of poor safety precautions that affected more than 40% of all accidents as accident causes. These causes had a strong influence on each other, and the ratio of accident causes is high. With this relationship, accidents can be prevented or the severity of human injury can be reduced if types of accident process can be estimated with a scenario, and the key points before the accident in the scenario are switched to safe points.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS WITH ACTIVE ORAL BLEEDING (구강내 과다출혈로 내원한 응급환자에 관한 임상적 연구)

  • Yoo, Jae-Ha;Kang, Sang-Hoon;Kim, Hyun-Sil;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.5
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    • pp.383-389
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    • 2002
  • This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.