We report a rare case of traumatic abdominal wall hernia (TAWH) caused by a traffic accident. A 47-year-old woman presented to the emergency room soon after a traffic accident. She complained of diffuse, dull abdominal pain and mild nausea. She had no history of prior abdominal surgery or hernia. We found a bulging mass on her right abdomen. Plain abdominal films demonstrated a protrusion of hollow viscus beyond the right paracolic fat plane. Computed tomography (CT) showed intestinal herniation through an abdominal wall defect into the subcutaneous space. She underwent an exploratory surgery, followed by a layer-by-layer interrupted closure of the wall defect using absorbable monofilament sutures without mesh and with no tension, despite the large size of the defect. Her postoperative course was uneventful.

PurposeThe safety and the efficacy of the compression anastomosis clip (Hand CAC 30) have been demonstrated by animal studies. This study was designed to evaluate the clinical validity of the Hand CAC 30 in enterocolic side-to-side anastomosis after colonic or enteric resections.MethodsA non-randomized prospective data collection was performed for patients undergoing a side-to-side anastomosis using the Hand CAC 30. Eligibility criteria for the use of the Hand CAC 30 were for anastomoses between the colon and the ileum or between two small bowels. The primary short-term endpoint was the rate of anastomotic leakage. Other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the clip elimination time were recorded.ResultsA total of 63 patients (male, 36) underwent an enteric or right-sided colonic resection followed by a side-to-side anastomosis using the Hand CAC 30. Laparoscopic surgery was performed in 36 patients, in whom one patient who underwent a laparoscopic right hemicolectomy was converted to an open procedure (1/32, 3.1%). One patient with ascending colon cancer showed postoperative anastomotic leakage and died of co-morbid ischemic heart disease. There were no other surgical mortalities. The exact date of expulsion of the clip could not be recorded because most patients were not aware of clip elimination. No patients manifested clinical symptoms of anastomotic stricture.ConclusionShort-term evaluation of the Hand CAC 30 anastomosis in patients undergoing enterocolic surgery proved it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

This paper offers a landscape design proposal for the 2014 Dreampark Chrysanthemum Festival within the Sudokwon Landfill Site. This site is located at 58 Baeksukdong, Seo-gu, Incheon, and it has an area of approximately 560,000㎡. Over 1.53million visitors came to this festival on the previous year. This design includes an overall masterplan and a series of planting plans along with a core selection of iconic topiaries. The goal of the design is to create a landscape that improves the value of the place image and local economy as well as celebrates the 2014 Incheon Asian Game.In order to achieve this goal, three design subjects were considered: promoting local pride as a part of Incheon, increasing the aesthetic value of the site based on the brand image, and sustainable placemaking. To promote local pride, the 2km long "Little Incheon" is designed over a wildflower field, which is inspired by Incheon Bridge to give a strong image of the locality. A variety of programs from local gardening participation were introduced to the east part of the site. The design also outlines the vision for the development of Dreampark -a people-oriented gathering place for the entire community with spaces that offer a variety of unstructured recreational and cultural experiences. To increase the aesthetic brand value of the festival, it introduced a variety of wildflower beds scattering through the whole site. It creates a strong brand image for the festival and memories that will encourage visitors to return. Various folktales of Asian countries are displayed by autumn flowers and groundcover plants at the centre of the site, which is the highlight of the festival site. For sustainable placemaking, the design preserves the existing trees and reed beds for wildlife to create natural layers of landscape.In addition, facilities and service centers are designed to be flexible and are centred on the needs of the people using them. Also a festival management scheme was planned in order to operate the site efficiently and economically.

No abstract