• Journal of Chest Surgery
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• v.41 no.5
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• pp.651-654
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• 2008

Posttraumatic psoudoaneurysrns of the subclavian artery are very rare. A 49-year-old woman who had been involved in a car accident ten years before presentation was initially diagnosed with a mediastinal tumor at a local clinic. Exploratory thoracotomy was performed for evaluation and treatment. During the operation, a hematoma was evacuated, and primary repair was undertaken to stop massive bleeding. Computed tomography angiography revealed a pseudoaneurysm of the left subclavian artery. The patient was treated with aneurysmectomy and end-to-end anastomosis. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.649-652
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• 2009

A 75-year-old man presented with worsening dyspnea and intermittent dysphagia of one month's duration. A plain chest X-ray showed severe tracheal indentation by the right superior mediastinal mass. A chest CT established the diagnosis of a saccular aneurysm arising from the right proximal subclavian artery. Resection of the aneurysm and arterial revascularization was done through a median sternotomy with supraclavicular extension. Aneurysm wall and thrombus culture results were negative and pathology showed an atherosclerotic aneurysm. After the operation, dyspnea and dysphagia were reduced, but he died of advanced stomach cancer 8 months later.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.70-75
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• 1991

Supraclavicular lymph nodes are unique in that they can attract metastases from almost anywhere in the body and most common sites of metastasis from an unknown primary source. 125 cases which had been diagnosed as metastatic supraclavicular lymph node during the period between May 1983 and August 1991, were analysed pathologically, and the following distinctive characteristics could be outlined : 1) The most frequent sites of metastasis from primary lesions are lunge(43%), stomach(23%), lymphoreticular(6%), biliary(5%), esophagus(2%), and pancreas(2%). 2) Histologic examination of metastatic supraclavicular lymph node revealed adenocarcinoma(57%), squamous cell carcinoma(12%), undifferentiated carcinoma(9%), small cell carcinoma(7%), malignant lymphoma(6%), malignant melanoma(1%) and undetermined carcinoma(8%). 3) In cases that histologic type was adenocarcinoma, the most frequent primary sites were stomach(38%), lung(27%) and biliary(8%). 4) In cases that histologic types were squamous cell caricinoma, undifferentiated carcinoma, small cell carcinoma and undetermined carcinoma, the most frequent primary site was lung.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.175-179
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• 1998

The acromioclavicular joint is commonly affected by traumatic and degenerative conditions. Most injuries are due to direct trauma, such as a fall on the shoulder. Although there is general agreement on treatment of type I, Ⅱ, Ⅳ, V and VI acromioclavicular injuries, the treatment of type Ⅲ injuries remains controversial. Sixty patients, ranging in age from 19 to 57 years(average, 32), were evaluated an average of 57.5 (range, 13 to 96) months after surgical reconstruction for Rockwood type Ⅲ Ⅳ, V acromioclavicular dislocation. Phemister method (47 cases), Bosworth (3 cases), Weaver and Dunn method (10 cases) were used to correct displacement. An increase of the coracoclavicular distance of the injured shoulder over the normal shoulder was average 7.1㎜ at initial, average l㎜ on postoperatively, and average 2㎜ at follow-up. Overall, 54 of 60(90%) patients achieved satisfactory results. Degree of increase of the coracoclavicular distance has no inliluence to clinical results.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.88-96
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• 2005

Purpose: To compare and analyze the outcome of primary clavicular lateral end resection method and conventional acromioclavicular (AC) joint reduction method in type III AC dislocation patients over 45 years. Materials and Methods: This study was performed on selected 24 cases of type III AC dislocation patients, over 45 years of age, operated at our hospital from 1998 to 2002. Group I consist of 12 patients who underwent primary clavicular lateral end resection methods (average age: 54.3 years$(45{\sim}72)$). Group II consist of 7 patients using Bosworth methods and 5 patients using Phemister methods (average age: 54.4 years$(45{\sim}71)$). Clinical outcome was evaluated by Weaver and Dunn method. Radiological results were compared by measuring coracoclavicular distance between normal and injured side. Results: As clinical outcome, good was 10 cases(83%); fair 2(17%) in Group I, and good 6(50%); fair 3(25%); poor 3(25%) in Group II. In contrast, the difference of coracoclavicular distance was not statistically significant between two groups before or after surgery, and last follow up. At the last follow up, there was no special correlation between the difference of coracoclavicular distance and clinical outcome. Conclusion: We considered that primary clavicular lateral end resection may be effective for prevention of arthrosis in AC joint in type III AC dislocation patients over 45 years.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.367-370
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• 2003

A 62-year-old male was admitted to our hospital complaining of coldness in both legs and discolorization in the right toes. On angiogram, obstruction of right external iliac artery and left common iliac artery was shown. The patient underwent extended extraanatomic arterial reconstruction due to poor general conditions. From right subclavian artery to right popliteal artery, artery bypass was done with 8 mm PTFE and 6 mm PTFE Suprapubic crossover bypass was done with another 8 mm PTFE from 8 mm PTFE in right inguinal area that was anastomosed with right subclavian artery and left common femoral artery The patient was discharged from hospital and OPD follow up was done. Right leg pain and discolorization of entire toes disappeared and were normalized. We report a case of extended extraanatomic arterial reconstruction: subclavian artery-popliteo-crossover-femoral-PEFE-bypass.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.69-76
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• 1991

A 9-year old boy suffering from cleidocranial dysplasia associated with impacted 4 supernumerary teeth and unerupted all permanent teeth is presented with his mother. The pedigree showed autosomal dominant pattern of inheritance, and the raiographic features of them were very similar in clavicle, skull, vertebrae, peivis and extremities. Although almost of the skeleton was involved with this syndrome, they did not recognize any other problem but except dental problem. In mother, who was wearing removable partial dentures leaving 24 impacted teeth in her jaws, the radiographic abnormalities like cystic lesion were not detected. And in the son, who showed impacted 4 supernumerary and all permanent teeth, we have attempted surgical extraction of the supernumerary teeth and periodic surgical opening of the alveolar bone covering the permanent dentition to induce the eruption of permanent teeth at the proper position, Orthodontic treatment has also been combined to correct class III malocclusion state.

• Tuberculosis and Respiratory Diseases
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• v.50 no.1
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• pp.84-93
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• 2001

Backgrounds : In the absence of distant metastasis, small cell lung cancer (SCLC) patients presenting with supraclavicular lymph node (SCLN) involvement and pleural effusion can benefit from thoracic radiotherapy. But there are some debate as to the prognostic significance of both SCLN involvement and pleural effusion. The purpose of this study was to determine the prognostic significance of SCLN involvement and pleural effusion in SCLC. Methods : Two Hundred and fifteen patients with histologically confirmed small cell lung cancer, who were treated either at the Keimyung university Dongsan hospital and Kyungpook national university hospital from January 1994 to June 1998, were evaluated retrospectively. The patients were classified as having either limited or extensive stage using the Veterans Administration staging system. Results : SCLN was presented in 10.5% of patients(n=21). The median survival was 247 days for patients with SCLN(n=21) and 264 days for patients without(n=194) (p=0.52). After treatment, the median survival was 298 days for patients with SCLN(n=13) and 348 days for patients without(n=115) (p=0.52). SCLN involvement was not correlated with the presence of distant metastases. Median survival was 459 days for patients with a limited stage without SCLN(n=66), 650 days for those with a limited stage with SCLN (n=7) (p=0.96). Pleural effusion was presented in 24.7% of patients(n=52). The median survival was 198 days for patients with pleural effusion(n=52) and 275 days for patients without(n=163) (p<0.05). After treatment, the median survival was 294 days for patients with a pleural effusion(n=25) and 286 days for patients without(n=103) (p=0.39). The presence of pleural effusion was not correlated with that of distant metastases. The median survival was 395 days for patients with a limited stage without a pleural effusion(n=63), 451 days for those with a limited stage with pleural effusion(n=10) (p=0.92). Conclusionsa : In this study, SCLN involvement does not explain the poor survival rate and the relevance to extensive staged disease. Furthermore, the existence of a pleural effusion did not correlated with the presence of distant metastases. However, the presence of a pleural effusion appears to be a minor prognostic factor in our study. Therefore supraclavicular lymph node involvement and the presence of a pleural effusion in SCLC are not poor prognostic factors, which does not justify any amendment to the staging system currently used.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.61-66
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• 2009

Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.34-39
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• 2010

Purpose: The purpose of this study was to present methods and results for the modified Phemister operation, with a suture anchor added for augmentation of the conoid ligament in cases of acute dislocation of the acromioclavicular joint. Materials and Methods: We evaluated 14 cases of acute dislocation of the acromioclavicular joint. This included 11 cases of Rockwood type 3, and 3 cases of type 5. The mean age of patients was 45.2 years. We operated on them using an anchor for augmentation of the conoid ligament in the modified Phemister operation. The average follow-up period was 14 months and post-operative clinical analysis was conducted using the Weitzman classification, VAS Score, Constant Score and KSS Score. Results: According to Weitzman scores, 13 cases were evaluated as excellent, and one case was good. They had mean joint ranges of forward elevation of $170.7^{\circ}$, lateral elevation of 166.4, external rotation of 68.2, and internal rotation to the level of T7. The mean VAS Score was 1.9, mean Constant Score 90.8, and the mean KSS Score 91. Radiologic analysis indicated that all cases had a good result. Conclusion: The modified Phemister operation with a suture anchor added for augmentation of the conoid ligament is very effective clinically in acute dislocations of the acromioclavicular joint.