The diaphragmatic injury results from blunt or penetrating thoracoabdominal trauma. The diagnosis of diaphragmatic injury is difficult in the immediate postinjury period and is often delayed by late visceral herniation. Accurate diagnosis of diaphragmatic injuries is important, because overlooked and delayed diagnosis commonly lead to incarceration and strangulation of bowel. Despite of various diagnostic methods, the diagnosis is often missed and delayed. The development of video-assisted thoracoscopy can make it possible to diagnose the diaphragmatic injury safely and accurately. We experienced two cases of diaphragmatic injuries diagnosed by thoracoscopy. In first case, We found the rupture of the right diaphragm with herniation of liver in a 33-year-old female by thoracoscopic examination. She had visited Emergency Room, complaining of abdominal and pelvic pain and mild dyspnea after traffic accident. Chest X-ray showed elevation of the right hemidiaphragm. Chest CT and ultrasonogram revealed no abnormality except for diaphragmatic elevation. Another case was a 24-year-old female with laceration of diaphragm by stab wound on the left lower chest. With suspicion of diaphragmatic injury, thoracoscopic examination was performed. Both patients were successfully treated by a repair of injured diaphragm by approach via thoracotomy. The postoperative courses were uneventful.
Accidents, Traffic ; Adult ; Delayed Diagnosis ; Diagnosis ; Diaphragm ; Dyspnea ; Emergency Service, Hospital ; Female ; Humans ; Lacerations ; Liver ; Pelvic Pain ; Rupture ; Thoracoscopy* ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Wounds, Stab ; Young Adult

No abstract available.
Catheters*

No abstract available.
Child* ; Humans

The stress or fatigue fracture is well known in military medicine, but it is an unusual occurrence in civilian practice. The stress fracture of metatarsal bone is familiar to most, but in the tibia it is unusual. The clinical symptoms of pain, swelling and limping following strenuous activity were seen in the affected lower leg and proceeded radiological evidence of fracture. 17 cases of stress fracture of tibia were investigated in a military hospital between March 1973 and May, 1974. The results of this study are as follows, 1. The fractures mainly occurred in the upper one third of the tibia (13 cases among 17). 2. The cases with only callus formation were more frequent than the cases with fracture line on the tibia (11 cases among 17). 3. If pain occurs in the lower leg after strenuous activity, there should be attention with serial radiological checking.
Bony Callus ; Clinical Study ; Fractures, Stress ; Hospitals, Military ; Leg ; Metatarsal Bones ; Military Medicine ; Tibia

Many injuries of the hand have been occurred in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Whatever the material, the aim of tendon suture is not only restoration of a strong mechanical union but also sliding function of the tendon. Thus the question has always been after what delay active mobilization can be allowed or encouraged. If immobilization allows fibroblasts to invade the tendon extremities and form a scar mass, its prolong leads to adhesion and loss of normal sliding. On the other hand, one can admit that early passive or active mobilization, even if only over a short distance may distend the adherences and transform them into a kind of mesotenon assuring a better sliding function. Before permiting early motion, several factors must be considered such as tensile strength of the suture material, holding power of the suture for the tnedon, bulkiness of the repair and stress that must be withstood. Thus it is the purpose of this study to analysis and comparing of tensile strength and morphological changes in the healing process of tendon tissues by different suturing methods. For this study deep flexor tendon on third toe of adult chicken with an initial weight of about 2Kg was used. The animals were divided into 4 sutured groups which including different suturing methods. Suturing methods used were interrupted suture, Bunnels lace suture, Kessler suture and end-weave anastomosis, which have been applied frequently in tendon surgery. All suture material used were the same size 4-0 Ethilon which has least tissue reaction but high strength. In the animals, after the sharp dissection of the distal portion of the deep flexor tendon on third toe, the tendon stumps were approximated and sutured by 4 different methods. Then a long leg cast in the position of flexion of the foot and ankle joint was applied. On operation day and fifth, tenth, fourteenth and twenty-first postoperative day; the animals were sacrified and the specimens were gained. The measurement of the tensile strength of the sutured tendon was performed through the use of force transducer with the recording of polygraph for permitting continous monitoring of a progressively increasing load until the failure of tendon repair. Specimens stained with hematoxylin-eosin and Massontrichrome stain were observed during 42 days after operation. The findings are as follows. 1. The tensile strength of sutured tendon groups using interrupted suture, Kessler suture, and end-weave anastomosis were reduced maximally on fifth postoperative fay and the tensile strength of Bunnel's lace suture group was reduced maximally on tenth postoperative day. Thereafter the strength was increased progressively on entire experimental groups. 2. The tensile strength of end-weave anastomosis group was the strongest among all experimental groups during experimental period. 3. Just after the repairs of injured tendon, the order of strength was Bunnel. Kessler and inerrupted suture but the strength was nearly approximated on 21st day. 4. The morphological healing process of interrupted and Kessler suture were better than that of Nunnel and end-weave suture. From these morphological and physical results, it is suggested that Kessler suture is better suturing method in tendon repair.
Adult ; Animals ; Ankle Joint ; Chickens ; Cicatrix ; Extremities ; Fibroblasts ; Foot ; Hand ; Humans ; Immobilization ; Leg ; Methods ; Nylons ; Sutures ; Tendons ; Tensile Strength ; Toes ; Transducers ; Transplants

No abstract available.
Acute Kidney Injury* ; Child* ; Humans

No abstract available.
Gastrectomy*

No abstract available.
Crohn Disease*

Congenital cystic adenomatoid malformation and Extralobar Pulmonary sequestration are very rare congenital anomalies. We experienced a 4 year-old female patient who had Congenital cystic adenomatoid malformation in her lower lobe of left lung. We accidently found extralobar pulmonary sequestration associated with Congenital cystic adenomatoid malformation at operation field. The resection of the left lower lobe and the extralobar pulmonary sequestration were performed. The arterial supply of the extralobar pulmonary sequestration was one anomalous artery arised from the thoracic aorta. The Venous drainage of expralobar pulmonary sequestration was intercostal vein into the azygous vein. The patient was discharged without any problem.
Aorta, Thoracic ; Arteries ; Bronchopulmonary Sequestration* ; Child, Preschool ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Drainage ; Female ; Humans ; Lung ; Veins

Extensive laceration of the lung itself has relatively little attention as a threat to life compared with other intrathoracic organ injuries. The incidence of pulmonary laceration extensive enough to require thoracotomy is rare, but is higher than expected. The diagnosis of extensive pulmonary laceration may be difficult, but this injury should be suspected with attention and early thoracotomy can be carried out in indicated cases. Recently, thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. We experienced a case of extensive pulmonary laceration caused by nonpenetrating trauma, which underwent lobectomy by thoracoscopic surgery. A 21-year-old man who was injured in a motocycle accident was brought to Emergency Room from the scene by an ambulance, and complained of chest pain and dyspnea. A chest roentgenogram showed a hemothorax and fractures of the posterior ends of the right seventh, eighth, and ninth ribs. A chest tube was inserted. Thirteen hundred ml of blood was drained through the chest tube during the next one hour. Emergency right mini-thoracotomy revealed extensive laceration of the lower lobe extending to the pulmonary hilum. The lower lobe was the most badly torn. A lower lobectomy was done by video-assisted thoracic surgery (VATS). He complained less postoperative pain and the postoperative course was uneventful.
Ambulances ; Chest Pain ; Chest Tubes ; Diagnosis ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemothorax ; Humans ; Incidence ; Lacerations* ; Lung ; Pain, Postoperative ; Ribs ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Thorax ; Young Adult