Adult ; Back Injuries ; complications ; Granuloma, Foreign-Body ; etiology ; Humans ; Male ; Spinal Cord Diseases ; etiology ; Wounds, Stab ; complications

Dural arteriovenous fistulae (DAVF) is a rare intracranial vascular disease. It is pathologically characterized by direct shunting of the intracranial artery and vein, which results in cerebral ischemia, intracranial hemorrhage, neural deficit and intracranial murmur. The etiological mechanism of DAVF is not well known, but most researchers think it is associated with congenital abnormal development, especially abnormal development of dural blood vessels at the stage of embryogenesis. Recently, some researchers have found that DAVF is also associated with some acquired factors. This article reports a case who developed DAVF within 2 years after debridement of frontal bone fragmentation, depressed fracture, left frontal lobe contusion and superior sagittal sinus injury due to forehead knife-cut injury. The pathogenic mechanism was explored through a review of the related literatures.
Adult ; Angiography, Digital Subtraction ; Arteriovenous Fistula ; etiology ; surgery ; Dura Mater ; injuries ; Forehead ; injuries ; Humans ; Male ; Wounds, Stab ; complications

The case of a severely traumatized pregnant patient, in whom a perimortem cesarean section, in the emergency department, led to the birth of a viable baby, with long-term survivor, is described. A postmortem cesarean section, resulting in fetal survival, performed after 45 minutes of maternal cardiopulmonary resuscitation is reported in a patient with multiple penetrating injuries. A 27-year-old primigravida suffered cardiopulmonary arrest at the 34th week of gestation following multiple knife injuries. Although extensive advanced cardiopulmonary resuscitation was performed for 45 minutes, her vital signs did not return to normal levels. A low segment cesarean delivery was performed, and a female baby was delivered. The time interval between cardiopulmonary arrest and delivery, prior maternal health status, and continued cardiopulmonary resuscitation are important determinants of fetal survival. A perimortem cesarean section is advised in case of multiple penetrating injuries, even after 45 minutes of cardiopulmonary resuscitation, since it may result in fetal salvage.
Adult ; *Cardiopulmonary Resuscitation ; *Cesarean Section ; Fatal Outcome ; Female ; Heart Arrest ; Human ; Infant, Newborn ; Pregnancy ; *Pregnancy Complications ; Pregnancy Outcome ; Wounds, Stab/*complications

A clinical observation was made on 29 cases of bladder rupture who were admitted to the Department of Urology, In Je Medical College Paik Hospital in Pusan during the period from June, 1979 to August, 1983. The results are as followings; 1. Of 133 cases of genitourinary tract injury, bladder rupture were 29 cases (21.7%), there composed intraperitoneal bladder rupture 19 cases, extraperitoneal bladder rupture 10 cases. 2. The 29 cases Comprised 19 males and 10 females (male:female=l.9:1). The most prevalent age group of bladder rupture was 20 to 29 years, showing 13 cases of the total cases (44.8%). 3. The causes of bladder rupture were traffic accident observed in 11 cases (37.9%), direct blow 7 cases (24.1%), iatrogenic 4 cases (13.8%), stab wound 3 cases (10.3%) and spontaneous bladder rupture was seen in 1 case (3.5%). 4. The common symptoms and signs of bladder rupture were abdominal pain, lower abdominal distension and gross hematuria, so on. 5. The common associated injuries with bladder rupture were pelvic bone fracture 10 cases (34.5), Cerebral contusion 7 cases (24.1%), rib fracture 4 cases (13.8%), rupture of posterior urethra 3 cases (10.3%), so on. 6. The retrograde cystography was the most likely to accurately diagnose a ruptured bladder, but 1 case was revealed false negative cystograms because of the large hematoma within the pelvic cavity. 7. In all cases, immediate bladder repair and indwelling urethral catheter, with or without suprapubic cystostomy were performed. 8. We experienced postoperative complications such as, voiding difficulty, vesicocutaneous fistula and epididymo-orchitis, etc.
Abdominal Pain ; Accidents, Traffic ; Busan ; Contusions ; Cystostomy ; Female ; Fistula ; Hematoma ; Hematuria ; Humans ; Male ; Pelvic Bones ; Postoperative Complications ; Rib Fractures ; Rupture* ; Urethra ; Urinary Bladder* ; Urinary Catheters ; Urology ; Wounds, Stab

A clinical observation was made on 29 cases of bladder rupture who were admitted to the Department of Urology, In Je Medical College Paik Hospital in Pusan during the period from June, 1979 to August, 1983. The results are as followings; 1. Of 133 cases of genitourinary tract injury, bladder rupture were 29 cases (21.7%), there composed intraperitoneal bladder rupture 19 cases, extraperitoneal bladder rupture 10 cases. 2. The 29 cases Comprised 19 males and 10 females (male:female=l.9:1). The most prevalent age group of bladder rupture was 20 to 29 years, showing 13 cases of the total cases (44.8%). 3. The causes of bladder rupture were traffic accident observed in 11 cases (37.9%), direct blow 7 cases (24.1%), iatrogenic 4 cases (13.8%), stab wound 3 cases (10.3%) and spontaneous bladder rupture was seen in 1 case (3.5%). 4. The common symptoms and signs of bladder rupture were abdominal pain, lower abdominal distension and gross hematuria, so on. 5. The common associated injuries with bladder rupture were pelvic bone fracture 10 cases (34.5), Cerebral contusion 7 cases (24.1%), rib fracture 4 cases (13.8%), rupture of posterior urethra 3 cases (10.3%), so on. 6. The retrograde cystography was the most likely to accurately diagnose a ruptured bladder, but 1 case was revealed false negative cystograms because of the large hematoma within the pelvic cavity. 7. In all cases, immediate bladder repair and indwelling urethral catheter, with or without suprapubic cystostomy were performed. 8. We experienced postoperative complications such as, voiding difficulty, vesicocutaneous fistula and epididymo-orchitis, etc.
Abdominal Pain ; Accidents, Traffic ; Busan ; Contusions ; Cystostomy ; Female ; Fistula ; Hematoma ; Hematuria ; Humans ; Male ; Pelvic Bones ; Postoperative Complications ; Rib Fractures ; Rupture* ; Urethra ; Urinary Bladder* ; Urinary Catheters ; Urology ; Wounds, Stab

No abstract available.
Aged ; Anti-Infective Agents/therapeutic use ; Drug Therapy, Combination ; Foot Injuries/*complications ; Humans ; Male ; Muscle Relaxants, Central/therapeutic use ; Tetanus/diagnosis/drug therapy/*microbiology ; Tetanus Toxoid/therapeutic use ; Treatment Outcome ; Trismus/diagnosis/drug therapy/*microbiology ; Wounds, Stab/*complications

BACKGROUND: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. MATERIAL AND METHOD: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. RESULT: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. CONCLUSION: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.
Aorta ; Aortic Valve ; Arrhythmias, Cardiac ; Cardiopulmonary Bypass ; Catheterization ; Chest Tubes ; Coronary Disease ; Drainage ; Female ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hematoma ; Humans ; Intensive Care Units ; Intracranial Embolism ; Male ; Mammary Arteries ; Mitral Valve ; Mortality ; Myxoma ; Postoperative Complications ; Reoperation ; Respiration, Artificial ; Rupture ; Sternotomy ; Sternum ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery* ; Transplants ; Wounds and Injuries ; Wounds, Stab