• Journal of Chest Surgery
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• v.41 no.1
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• pp.95-97
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• 2008

Ischemic ventricular rupture is one of the most fatal complications following myocardial infarction, and this requires prompt diagnosis and operation. A 75-year-old female was admitted to the ER in a semicomatous mentality with cyanotic extremities. Cardiac echography was carried out in the ER, and a $1.5{\sim}2\;cm$ thickness of effusion in the pericardium was seen. Because the patient's heart had declined to 35 times per min, an emergency operation was started while giving cardiac massage. After observing a 1 cm rupture on the right ventricular wall and a necrotic hemorrhagic scar with a rupture on the left ventricular apical wall, repair of the ruptured areas with a large Satinsky clamp was carried out to control bleeding without cardiopulmonary bypass. On the 28th day after surgery, she was discharged home with a minimal degree of dyspnea.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.220-224
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• 2007

Extracorporeal membrane oxygenation (ECMO) provides mechanical cardiopulmonary support and has been used for children with severe respiratory failure, intractable heart failure, sepsis, pulmonary hypertension, and as a bridge to heart transplantation. There have been few reports of the use of ECMO to provide cardiac support in children with low cardiac output as a result of arrhythmias. We report the case of a 15-year-old female with circulatory collapse due to refractory ventricular arrhythmia after one and a half repair in Ebstein's anomaly, who was successfully resuscitated using ECMO.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.719-721
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• 2007

Patients with congenital pericardial defect display few symptoms and this is an unusual disease, so it is generally found incidentally in most of the cases. In some cases, symptoms such as chest pain are found due to partial cardiac herniation. We report here on a 14-year-old girl with dyspnea and chest pain that started during physical activity 3 months before the hospital visit. She was diagnosed with herniation of the left atrial appendage with a partial pericardium defect and she was treated with an operation.

• Tuberculosis and Respiratory Diseases
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• v.51 no.5
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• pp.482-487
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• 2001

A pancreatic pseudocyst with a mediastinal extension is a rare clinical entity. Intrathoracic symptoms such as dysphagia or dyspnea due to compression or associated pleural effusions are quite common. The pseudocysts transverse the diaphragm via the esophageal hiatus or aortic hiatus or by eroding directly through the diaphragm. Here, we report a case of a pancreatic pseudocyst with a mediastinal extension presenting as dysphagia and dyspnea. The diagnosis was confirmed by computerized axial tomography of the chest and abdomen. Usually, the proper management of a large pseudocyst includes percutaneous or surgical internal drainage, but in this case the mediastinal components disappeared with conservative medical treatment.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.426-431
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• 2012

Purpose: The aim of this study was to evaluate the effect of temporary mandibular advancement devices (MAD) in obstructive sleep apnea (OSA) patients Methods: 28 patients (male 21, female 7) undergoing temporary mandibular advancement device treatment for OSA were selected from 2011.01. to 2012.02. in the department of Oral & Maxillofacial Surgery at SamsungMedicalCenter. Treatment efficacy was determined by polysomnography (PSG) at baseline & after MAD delivery. The response group was defined as >50% Apnea-Hypopnea Index (AHI) reduction plus post-MAD AHI <10, and the non-response group was defined as <50% AHI reduction. The lateral cephalogram was analysed including SNA, SNB, UL, MPH, PAS, PASU, and PAST using V-ceph$^{TM}$ (Cybermed, USA). Results: The responsers were 23 patients, and non-responsers were 5 patients. The AHI was significantly reduced with temporary MAD ($8.08{\pm}7.93$) compared with baseline ($28.51{\pm}20.56$) in the response group (n=23). No significant difference was observed between pre MAD and post MAD except SNB on cephalometric analysis. Among 11 patients successfully treated with the temporary device, 9 patients said that using permanent device brings better effect too. Conclusion: These results indicate that the Temporary MAD could not be the only effective tools on OSA but also be used to predict patient's reactivity about permanent appliance treatment. Further studies are warranted to evaluate the relations between temporary MAD and permanent MAD.

• The Journal of the Korean dental association
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• v.53 no.1
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• pp.47-56
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences Untreated OSAS can cause various problems such as hypertension, diabetes, stroke, cardiac disease, daytime sleepiness. Various treatments are available, including non-surgical treatment such as medication or modification of life style, surgical treatment, continuous positive airway pressure (CPAP) and oral appliance (OA). Oral appliance is known to be effective in mild to moderate OSA, also genioglossus muscle advancement (GA) or maxillomandibluar advancement (MMA) is a good option for OSA patients with muscular or skeletal problems. Although the prevalence of OSA is increasing, the proportion of the patient treated by dentist is still very law. Dentists need to understand the mechanism of OSA and develop abilities to treat OSA patients with dental problems. The purpose of this paper is to give a brief overview about OSA and the dentist's role in OSA patients.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1290-1297
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• 1998

Bronchocentric granulomatosis(BCG), first defined in 1973, consists of granulomatous replacement of bronchial mucous membrane, often with heavy eosinophilic reaction within and about the involved bronchi. Etiologic factors are from hypersensitivity reaction for aspergillus, most often from idiopathic form, and in others from being associated with mycobacterium, ecchinococcus, rheumatoid disease, ankylosing spodylitis, and glomerulonephritis. Diagnosis is responsible only for pathologic findings and, in many cases, is confirmed in postoperative findings with misleading for tumor, tuberculosis, infectious or Wegener's granulomatosis. We report a case of bronchocentric granulomatosis associated with aspergillus.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.449-454
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• 1996

Functional upper airway obstruction due to vocal cord dysfunction is being increasingly recognized and has been variously described as "Munchausen's stridor", "Emotional laryngeal wheezing", "Nervous asthma". It's features are symptoms of acute reversible recurrent dyspnea associated with an inspiratory stridor, normal anatomy of the upper airway, demonstration of variable severe exthrathoracic upper airways obstruction with pathologic adduction of the vocal cord at bronchoscopy. The patients with this condition are frequently misdiagnosed as asthma and the diagnosis is often delayed. So they can present a serious medical problem and are exposed to the complication of treatment and investigation. We report a case of functional upper airway obstruction due to vocal cord dysfunction who showed paradoxical vocal cord motion at bronchoscopy and typical features of variable exthrathoracic obstruction on Flow-volume loop during a symptomatic period.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.7.3-8
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• 1977

In the ENT fields, epidermoid cysts occur infrequently in the oral region and often situated on the floor of the mouth or the submental region. Moreover, epidermoid cyst on the laryngeal surface of the epiglottis occurs rarely. Authors experienced a case of epiglottic epidermoid cyst and treated successfully by transhyoid pharyngotomy approach and marsupialization. It was 46 years old male patient who has been suffered from intermittent sorethroat for 2 years prior to admission, hoarseness for 2 months and dyspnea for 1 month. Indirect laryngoscopy revealed a pigeon egg-sized, round, smooth tumor mass on the laryngeal surface of the epiglottis which had soft consistency on digital examination. Biopsy proved epidermoid cyst. Marsupialization of the cyst by transhyoid pharyngotomy approach was performed and the postoperative course was uneventful.