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Purpose: To evaluate patients who underwent surgical or endovascular treatment after vascular injury related to posterior lumbar disc surgery. Materials and Methods: We retrospectively reviewed seven cases of vascular injuries (four lacerations, one arteriovenous fistula [AVF], and two pseudoaneurysms) related to lumbar disc surgery by a posterior approach from January 1997 to December 2016 at Chonnam National University Hospital. Information of patient characteristics, diagnosis, treatment strategies, and outcomes were analyzed. Results: Five out of seven cases were inhospital cases. In three laceration cases, each patient instantly became hypotensive and a life-threatening arterial injury was suspected. Therefore, the patient was immediately turned to the supine position and surgical repair was performed. The patients with pseudoaneurysm and AVF were treated by endovascular intervention. Remaining two were referred cases under the impression of vascular injuries. One laceration case of them was in preshock condition, and the left common iliac artery was surgically repaired. The other referred patient showed pseudoaneurysm which was treated with stent graft insertion. There was no surgery or endovascular intervention related death and none of the patients suffered any sequela related to vascular injury. Conclusion: Vascular injury associated with posterior lumbar disc surgery is not common, but can be fatal. Early recognition, diagnosis, and prompt treatment are essential to prevent fatal outcomes. Recently, endovascular intervention is increasingly and preferably used because of its low morbidity and mortality. However surgery is still the best option for the patients with unstable vital sign and endovascular approach can be applied to stable patients.
This study was undertaken to investigate to compare the ratio of positive reactions to benzoic acid(BA), sorbic acid(SA) and cinnamic acid(CA) which are well known materials producing non-immunologic contact urticaria. Various concentrations(0.l% to 5%) and different vehicles(petrolatum, water, hydrophilic ointment base) were used in open and 20 minutes closed test using Finn chamber on Scanpor tape. One hundred total subjects were consisted of nonallergic patients and normal persons. The results were as follows ; 1. Total numbers of positive reactions were 69 in closed test(CT) and 60 in open test(OT), regardless of the materials and vehicles. 2. Total riumbers of positive reactions in BA, SA and CA were 68, 31, 35 in CT and 59, 20, 14 in OT respectably. 3. CT showed much more positive reactions than OT with all materials tested except 0.l% SA in water. 4. Hydrophilic ointment base showed a better reactivity than any other vehicles in CT. But in OT, petrolatum, water, hydrophilic ointment base showed better reactivity in BA, SA, CA respectably. 5. Almost all the reactions appeared within 45 minutes and disappeared within 3 hours. Erythema preceded edema and persisted 30 minutes to 1 hour after dissappearance of edema. 6 Itching, burning and tingling sensation were the only symptoms observed except. localized erythema and edema.