• Journal of Chest Surgery
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• 제7권1호
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• pp.13-22
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• 1974

A clinical evaluation was done on 120 cases of chest injury patients treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital for the period of 6 years and 3 months from January, 1968 to March, 1974. 1] Of 120 cases, 52 cases[43. 3%] were non-penetrating injuries and 65 cases[56.7%] penetrating injuries. Of them, 107 cases [89.2%] were males and 13 cases[10.8%] were females. 2] The most common etiology was stab wound[64 cases] and traffic accident[23 cases] was the next. 3] In 70% of all cases, treatment was initiated within 6 hours after receiving trauma. 4] The types of lesions in order of frequency were hemothorax[35 cases], chest wall injuries alone. 27 cases], hemopneumothorax [22 cases], pneumothorax[17 cases]. Of them, right sided lesions were 52 cases[43. 3%] and left sided lesions were 65 cases[54.2%] and 3 cases were bilateral lesions. 5] Repeated thoracentesis and closed thoracostomy were the treatment of choice in most cases in order to reestablish early and rapid reexpansion of the lungs. Open thoracotomy was, however, mandatory on 39 cases[32.5%]. 6] The overall mortality was 5.8% [7 cases]; 5 cases of nonpenetrating injuries and 2 cases of penetrating ones.

• Journal of Chest Surgery
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• 제11권4호
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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%).

• Journal of Chest Surgery
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• 제11권4호
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• pp.501-515
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• 1978

The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

• Journal of Chest Surgery
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• 제11권4호
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• pp.488-500
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• 1978

The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

• Journal of Chest Surgery
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• 제15권4호
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• pp.414-421
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• 1982

200 patients admitted to the Chest Surgery Department of Jeonbug National University Hospital from January, 1974 to December, 1981 were analyzed clinically. The ratio of male to female was 7: 1, which showed male predominance. Distribution of patients according to age disclosed that over half [62%] of the patients was social age between 20 and 49 years. The most common cause of chest trauma was traffic accident [39%], and the next were stab wound, fall down [17.5%], and hit [8.5%] in decreasing order. Common lesions due to chest trauma were as follows; rib fracture [51%], hemopneumothorax, hemothorax, and pneumothorax in decreasing number. The most common cause of rib fracture was traffic accident [50%] and the associated organ injuries were long bone fracture, head injury, spine and pelvic bone fracture, spleen rupture, and liver laceration. Hemothorax, pneumothorax, and hemopneumothorax were treated with insertion of thoracic catheter in 90 cases, pure thoracentesis in 11 cases, and emergency thoracotomy in 11 cases. In flail chest, 6 patients were treated by intramedullary insertion of Kirschner`s wire and the results were good. The incidence of complication was 17%, including atelectasis [11 cases], pyothorax, fibrothorax, pneumonia, and acute respiratory failure. Four patients were died [2%], and the causes were acute respiratory failure in 2 cases, spinal cord injury in one case and head injury in one case.

• Journal of Chest Surgery
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• 제14권4호
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• pp.311-318
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• 1981

A clinical evaluation was performed on 402 cases of chest trauma those were admitted and treated at the department of chest surgery, Chonnam National University Hospital, during the past 13 years and 7 months from Jan. 1968 to July 1980. 1. The ratio of male to female was 5.5:1 in 1968 and 3.4:1 in 1980 with progressive increase of female patient and age from 20 to 59 years is 81.0%. 2. The most common cause of chest trauma was stab wound in penetrating trauma and traffic accidents in nonpenetrating trauma. 3. The most common injury from chest trauma was hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. 4. Hemothorax was observed in 76 cases [18.9%] of total cases and rib fracture was observed in 163 cases [40.5%] of total cases. 5. Rib fracture was prevalent from 4th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and with other organ injuries. 6. Open thoracotomy was performed in 72 cases [17.9%] and others were treated with conservative nonoperative treatment. 7. Overall mortality was 4.5% [19 cases], and common causes of the death were shock and respiratory insufficiency.

• 대한화상학회지
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• 제22권2호
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• pp.66-70
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• 2019

Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

• 동의생리병리학회지
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• 제21권1호
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• pp.145-152
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• 2007

Following CNS injury, inhibitory influences at the site of axonal damage occur. Glial cells become reactive and form a glial scar, gliosis. Astrocyte-rich gliosis relates with up-regulation of GFAP and CD81, and eventually becomes physical and mechanical barrier to axonal regeneration. It is postulated that the astrocytic reaction is absent, regeneration of axons can occur. And it was reported that treatment with anti CD81 antibodies enhanced functional recovery in the rat with spinal cord injury. So in this current study, the author investigated the effect of the water extract of Persicae Semen on the regulation of GFAP and CD81 that increase when gliosis occurs. Persicae Semen decreased the expression of GFAP and CD81 in astrocyte cell by ELISA method. Persicae Semen decreased the RNA expression of CD81 and GFAP. The proteins that separate in whole cell were analaysed by western blot, and the expression of GFAP and CD81 was decreased. In vivo, rats brains were peformed cortical stab wound, the water extracts of Persicae Semen were injected for 7 days, 30 days. As a result, GFAP and CD81 expression were decreased in immunohistochemistry. These findings demonstrate that Persicae Semen decreases GFAP and CD81 expression. Accordingly, Persicae Semen could be a candidate for promotion of axon regeneration after CNS injury.

• Journal of Chest Surgery
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• 제31권6호
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• pp.604-609
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• 1998

흉부외상은 응급실에서 중요한 부분을 차지하고 있다 대부분의 외상은 보존적인 요법으로 치료가 되나, 소수의환자에서는 조기소생술후에 응급 수술이 시행되어져야 한다. 1986년 3월부터 1997년 6월 까지 흉부외상으로 응급수술한 126례을 대상으로 보고하고자 한다. 남자가 96례 여자가 30례 이고, 나이의 분포는 4세에서 72세며 평균 연령은 32.8세이였다. 수상의 원인은 자상 55례(44%), 둔상 70례(55%), 총상 1례(1%)이였고, 조기수술 105례(83%), 후기 수술 21례(17%)이였다. 수술 적응증은 혈흉 및 쇼크 66례(52%), 심압전 27례(21%), 횡격막 파열 33례(27%)을 수술하였다. 대부분의 환자에서는 성공적인 치료가 되었으나, 21례에서 사망하였고, 사망율은 16.6%였다 그리고 사망원인은 불가역적인 쇼크와 저산소증이 흔한 원인이였다.

• Journal of Chest Surgery
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• 제10권2호
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• pp.327-336
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• 1977

A chinical analysis was performed on 383 ases of hest injurjes eperienced at Department of thoraci Surgery, Seoul National University Hospital during 21 year period From 1957 to 1977. Of 383 patients o hest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle frcture, 26 of lung contusion, 17 of diaphragmati laceration, 14 of hemoperiardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury paiens were traffi accident vitims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt hest injuries the patients with five or more rib fractures had a 85 per ent incidence of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis (46 cases) and closed thoracotomy (125 cases) but open thoracotomy had to be done on 90 cases (23.5%) because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronhial rupture. The over all mortality was 2.87 per cent (11 among 383 cases), 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.