• The Journal of Art Theory & Practice
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• no.6
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• pp.77-99
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• 2008

The purpose of this study is to show that the reason behind the ambivalent characteristic displayed in Niki de Saint Phalle's works is in her trauma and how such characteristic can be extracted from her works. During her creative years, Saint Phalle worked on various materials from different genres such as assemblages, shooting paintings, a series on Bride and Monster, 'Nana', 'Tarot Garden'and public sculptures. One commonality found among her various works is the ambivalent characteristic that contains contrasting elements simultaneously. Saint Phalle suffered a terrible psychological damage inflicted by her parents during her childhood. Specifically, she was sexually assaulted by her father and emotionally neglected by her mother, the trauma that affected her for the rest of her life. As a result, she came to develop extreme love- hate relationships with her parents and this became the main reason for the ambivalent characteristic displayed in her works. The love-hate relationship Saint Phalle developed can be identified through various researches done on the subject of the affect of sexual assault. It is common for incest victims to develop ambivalent feelings towards the perpetrator and Saint Phalle was no exception. Dissociation disorder and a snake well explain the trauma from her father. It is a generally accepted belief in the field of psychology that dissociation disorder commonly occurs to children who experience incest. And dissociation disorder is similar to the characteristic of ambivalence in the sense that a single entity contains more than two contrasting elements at the same time. In addition, the amputated doll objects used in her assemblages coincide with the expression of body detachment of people with dissociation disorder. These facts clearly indicate that the trauma from her father is showing through in her works. A snake is a subject matter that reflects the ambivalent tendency of Saint Phalle that resulted from her trauma. She remembers her father's rape as an image of a snake which is related to a phallic symbol in mythology or art reflecting her trauma. Moreover, she displays a similar pattern of ambivalent emotion like love and hate or fear towards a snake and her father. This is also confirmed by her portrayal of a snake as a monster or reversely as a creature with fundamental vitality in her works. The lack of affection from her mother can be explained by her mother's maternal deprivation. It appears that Saint Phalle's mother possessed all the causes for maternal deprivation such as maternal separation, personality disorder and inappropriate attitude towards child rearing. Especially, a study that shows mother's negative attitude towards child breeding tends to increase dissociation experience of children is another important evidence that supports Saint Phalle's dissociation tendency. These traces of Saint Phalle's trauma are clearly revealed in her assemblages and shooting paintings. The violent objects in her assemblages such as a hammer, razor, nail represent the rage and defensiveness towards her father. The objects such as fragments of broken plates of feminine patterns, pots and mirrors that her mother used symbolize the affection towards her mother. On the other hand, the destructed objects can be interpreted as her hate and resentment towards her mother. Shooting paintings contain her extreme fury and hate. Things such as acts of shooting and the image associated with blood after shooting are blunt expressions of her bursts of emotions. I have tried to define and classify the ambivalent characteristics shown in her assemblages and shooting paintings as hate, rage, violence, calm, love and pleasure according to the frame of Thanatos and Eros. Out of the six, hate, rage, violence and clam are associated with Thanatos while love and pleasure are associated with Eros and they correspondingly form an ambivalent structure. These ambivalent characteristics can be found in her assemblages and shooting paintings. The objects in her assemblages such as a razor, saw, hammer imply hate, rage, violence and the silence felt throughout her works represent calmness. And, as mentioned, the feminine objects can be seen as symbolizing love. In shooting paintings, hate, rage, violence can be found in the use of force and in the traces of watercolor after shooting, and a sense of pleasure in her feelings of catharsis after her shooting. Moreover, a shielded calmness can be found on the plywood all covered with plaster before the shooting. This study looked into the ambivalent characteristic of Saint Phalle's works by examining her trauma to find its correlation, and a meaning of this study can be found from the fact that it refocused the origin of Saint Phalle who is generally known as a feminist artist. Additionally, a meaning of the study can be found also from the fact that it examined the ambivalent characteristics of her works through a frame of Thanatos and Eros.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.213-218
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• 1997

Pseudoaneurysm of the thoracic aorta is potentially fatal. However, reports of such cases are rare even in large series. We report four cases of thoracic aortic pseudoaneurysm who underwent surgical repair, The causes were considered as infection in two cases (VSD repair, descending thoracic aortic aneurysm resection) and blunt chest trauma by traffic accident in two patients. The pseudoaneurysms developed on ascending aorta suspected as sites of arterial and cardiolplegic needle insertion in one patient. The others were located at descending thoracic aorta immediatly below the left subclavian artery. One patient died of sepsis associated with bile peritonitis and others were followed up from 10 to 18 months with specific morbidity. This study suggest that the incidence of pseudoaneurysm of the thoracic aorta followed by open heart or aorctic surgery can be repaired succesfuly and careful inspection of associated injury is very important in cases of traumatic thoracic pseudoaneurysm.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.266-271
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• 2015

Reports on a posttraumatic isolated superior mesenteric artery (SMA) dissection are rare. Recently, endovascular stent placement via percutaneous access, instead of vascular surgery, has been widely accepted as the initial treatment for a patient with an isolated SMA dissection or its complications. A 60-year-old female patient was transferred to our hospital due to an isolated SMA dissection after a car accident. The SMA dissection was 8.5 cm in length, and it involved the true lumen, which was severely compressed by the thrombosed false lumen. The patient was closely observed because she did not complain of any specific visceral pain. On the seventh hospital day, she underwent computed tomography (CT) to decide on a further treatment plan, irrespective of the presence of the abdominal symptom. The findings of the follow-up CT showed no difference compared to those of the previous CT. She was discharged with anti-coagulants. One month later, the follow-up CT revealed focally progressing dissecting aneurysms in the false lumen of the dissected SMA and a more severely compressed true lumen. Two self-expandable metallic stents were successfully placed in the true lumen of the dissected SMA, covering two aneurysmal lesions. Herein, we report a successful endovascular treatment with stent placement for treating focally progressing dissecting aneurysms and a severely compressed true lumen in a patient with a posttraumatic isolated SMA dissection.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.162-167
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• 1998

Between January 1976 and March 1997, six patients with delayed presentation of traumatic diaphragmatic hernia occured among the 52 patients of traumatic diaphragm rupture, of whom four males and two females, five by blunt trauma and one by stab wound, one was right side and the rest were left side. In all patients, reduction of herniated organs was accomplished by thoracotomy or thoracotomy with extension to abdomen. Suspicion of the diaphragmatic ruture from the acute traumatic chest injured patient is important and we can use the videothoracoscopy for evaluation and treatment of the traumatic diaphragm rupture

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.35-37
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• 2012

Adrenal hemorrhages caused by blunt abdominal trauma have been frequently reported, and most of the lesions are unilateral. In contrast, bilateral hemorrhage of the adrenal glands after trauma rarely occurs in subjects with predisposing conditions such as coagulopathy, thromboembolism, and sepsis. Furthermore, bilateral hemorrhage of the adrenal glands is potentially fatal by inducing acute adrenal insufficiency. Here,a case of a 40-year-old man who developed traumatic bilateral adrenal hemorrhage after a car accident, without any predisposing condition, is reported. The spontaneous shrinkage of the bilateral lesions revealed in the follow-up abdominal computed tomography (CT) scansupported the aforementioned diagnosis. Fortunately, the patient had no clinical or biochemical evidence suggesting acute adrenal insufficiency. To these authors' knowledge, this is the first South Korean report of traumatic bilateral adrenal hemorrhage in a subject with no predisposing factors.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.187-193
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• 2020

Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.450-452
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• 2010

A 4-year-old male Yorkshire terrier was referred to us with signs of vomiting and unconsciousness due to a blunt head trauma. Gross examinations detected facial edema, subcutaneous hemorrhage and hypersalivation. A survey radiograph located an occipital fragment which was displaced caudally. A three-dimensional computed tomographic reconstruction demonstrated that the ventral portion of the fragment was attached incompletely. Because of the instability of the fragment, it was decided to perform an esquillectomy. After removing the fragment, the defect was reinforced with a muscular flap originating from the splenius muscle. The patient's condition gradually improved except for a slightly ataxic gait. At 20 months follow-up, there was no evidence of ataxia. The neurological status did not deteriorate before starting surgical intervention, although the patient sustained a skull fracture with severe intracranial hemorrhage. It is likely that the fragment being displaced outwardly played an important role in preventing an increase in intracranial pressure which could have led to neurological deterioration.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.100-107
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• 2008

Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was $37.70{\pm}19.78years$ with 36.6% of the patients being under 30 years fo age. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs.

• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.52-60
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• 2001

Purpose: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. Materials and Methods: Patients with narrow range of age (21-25. mean $22.8{\pm}1.3$, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed $21.2{\pm}7.3wks$ after trauma. Results: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight hearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). Conclusion: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.