• PNF and Movement
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• 제12권2호
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• pp.115-121
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• 2014

Purpose: The study aimed to examine the influence of PNF direct and indirect breathing treatments for patients with cervical spinal cord injuries who had breathing problems. Methods: For each cervical spinal cord patient, force vital capacity (FVC), peak expiratory flow, maximum phonation time (MPT), rib cage width, and VAS were measured pre-intervention and four weeks after post-intervention. The indirect method and the direct method were used for interventions. We treated patients with the indirect method using scapular anterior depression pattern, bilateral extensor pattern with rhythmic initiation, and a combination of isotonic. We treated patients with the direct method, applying pressure on the sternum and using rhythmic initiation (hold relax and stretch reflex) for the rib cage. Training occurred for 50 minutes a day and three days per week for four weeks. Results: FVC, MPT, peak expiratory flow, and rib cage width were increased and decreased at the VAS point for rolling after treatment. Conclusion: Patients with cervical spinal cord injuries who had breathing problems felt uncomfortable when they had conversations on a couch. We found that PNF direct and indirect treatments improved rib cage width and breathing functions of patients with cervical spinal cord injuries.

• Archives of Reconstructive Microsurgery
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• 제8권1호
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• pp.1-9
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• 1999

Surgical treatment was performed on the 39 cases out of 76 cases of entrapments of the thoracic outlet. The remaining 36 cases of entrapments were treated by conservatively. The operated cases were categorized as follows. They were 34 cases of scalenus anticus syndrome, 1 of cervical rib syndrome, 2 of costoclavicular syndrome, and 2 of hyperabduction syndrome. 1. Scalenus anticus syndrome : Anterior scalenotomy was performed by simple sectioning of the attachment to the first rib. 2. Cervical rib syndrome : Complete decompressive resection of cervical rib sometimes required both anterior and posterior approaches to avoid over-retraction of the brachial plexus. 3. Costoclavicular syndrome : Partial decompressive claviculectomy was undergone instead of conventional total claviculectomy. 4. Hyperabduction syndrome : The resection of coracoid process was performed as well as conventional tenotomy of pectoralis minor muscle to insure free up-and-down moving of neurovascular bundle at the time of hyperabduction. Every diagnostic maneuver was tested at the time of operation to observe whether or not neurovascular decompression including restoration of radial pulse was sufficient. Despite of the postoperative vascular restoration was inmediate, neurogenic symptoms were improved slowly. Because this entity is essentially chronic nerve injnry, its recovery needed a couple of months or several. Although improvement was slow, ultimate results were definite. Complication was not observed.

• 한국전문물리치료학회지
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• 제16권3호
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• pp.9-15
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• 2009

The purpose of this study was to examine contraction of abdominal muscles on surface electromyographic (EMG) activity of superficial cervical flexors, rib cage elevation and angle of craniocervical flexion during deep cervical flexion exercise in supine position. Fifteen healthy subjects were participated for this study. All subjects performed deer cervical flexion exercise with two methods. The positions of two methods were no volitional contraction of abdominal muscles in hook-lying position with 45 degree hip flexion (method 1) and 90 degrees hip and knee flexion with feet off floor for inducing abdominal muscle contraction (method 2). Surface EMG activities were recorded from five muscles (sternocleidmastoid, anterior scaleneus, recuts abdominis, external oblique, internal oblique). And distance of rib cage elevation and angle of craniocervical flexion were measured using a three dimensional motion analysis system. The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC). The EMG activities, distance of rib cage elevation. and angle of craniocervical were compared using a paired t-test between two methods. The results showed that the EMG activities of sternocleidmastoid and anterior scaleneus during deep cervical flexion exercise in method 2 were significantly decreased compared to method 1 (p<.05). Distance of rib cage elevation and angle of craniocervical flexion were significantly decreased in method 2 (p<.05). The findings of this study indicated that deep cervical flexion exercise with contraction of abdominal muscles could be an effective method to prevent substitute motion for rib cage elevation and contraction of superficial neck flexor muscles.

• Annals of Clinical Neurophysiology
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• 제11권1호
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• pp.28-32
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• 2009

True neurogenic thoracic outlet syndrome (NTOS) is an extremely rare condition, probably occurring with an incidence of one per million. It is often misdiagnosed as carpal tunnel syndrome or benign focal amyotrophy, and careful clinical examination, electrodiagnostic studies, and imaging studies are essential for the correct diagnosis. Here, we report a 23-year-old woman with slowly progressive weakness and atrophy of abductor pollicis brevis who were found to have NTOS caused by cervical rib.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.45-53
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• 2000

연구배경: 단순흉부촬영에서 늑골의 변이에 익숙하지 못한 경우 흉곽 또는 폐 병변으로 오인하게 되는 경우가 있다. 단순흉부촬영에서 늑골의 변이에 대한 외국의 문헌 보고가 소수 있으며 국내에서도 임 등에 의한 보고외에는 문헌 보고가 거의 없는 실정이다. 이에 저자들은 한국 정상 성인에서 발견되는 여러가지 늑골 변이의 종류와 형태 및 그 빈도를 알아보고자 하였다. 방 법: 1996년 1월부터 1998년 9월까지 신체검진을 목적으로 연속적으로 본원을 방문하여 단순흉부촬영을 시행한 성인 5,000명을 대상으로 하였다. 남녀가 각각 2,827명과 2,173명(1.3:1)이었고 연령은 평균 34.6(19-65세)였다. 전 예에서 후전면촬영 사진상 늑골변이의 종류, 위치 및 형태를 보았고 각 변이의 빈도를 계산하였다. 결 과: 총 76명(1.52%)에서 88예의 늑골의 변이가 관찰되었고 남성이 63명(2.23%), 여성이 13명(0.6%)이었다. 88예의 늑골 변이중 이열늑골(bifid rib, n=35)이 가장 흔히 관찰되었고, 늑골의 형성 부전(hypoplasia, n=22), 늑골단의 넓어짐(flaring, n=18), 늑골간의 가교형성(bridging of rib, n=7), 경륵(cervical rib, n=3), 늑골 융합(fusion, n=3) 순으로 나타났다. 이열 늑골은 우측 제 4늑골에서 가장 흔했으며(12/35, 34.3%), 제 5늑골(6/35, 17.1%) 과 우측 제 3늑골(6/35, 17.1%)의 순으로 관찰되었다. 늑골의 형성부전은 제 1늑골에서 가장 흔했다. 늑골단의 넓어짐은 제 4늑골에서(8/18, 44.4%) 흔히 관찰되었고 늑골간의 가교 형성은 제 1-2늑골간에서 흔했다(3/7, 42.9%). 결 론: 성인에서 늑골의 변이는 약 1.52%의 반도를 보였다. 이열 늑골이 가장 흔했고 늑골의 형성 부전, 늑골단의 넓어짐, 늑골간의 가교 형성, 경륵, 늑골융합 등의 순서로 나타났다.

• Journal of Chest Surgery
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• 제26권7호
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• pp.586-590
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• 1993

Thoracic Outlet syndrome is defined to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. It was previously designed due to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib or first rib syndromes. We experienced a case of thoracic outlet syndrome[scalene anticus syndrome] .Patient has been suffered from swelling and numbness of the right forearm and hand for 2 years. Diagnosis was made by preoperative selective angiography. Scalenus anticus and medius muscle resction and first rib resection was done with transaxillary approach. Postoperative course was not eventful.

• Journal of Chest Surgery
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• 제31권9호
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• pp.903-906
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• 1998

양측의 불완전한 경추 늑골을 가진 17세 남자 인쇄공이 10일 전부터 좌측 상지를 약 45도 외향시킬 경우 즉시 심한 통증, 파행, 창백증, 상지의 무기력증이 나타나고, 90도 이상 외향시키면 증상이 악화되어 직장생활을 전혀 할 수 없이 무능력해졌다. 체위변화 쇄골하동맥 조영술상 상지의 90도 외향시 경추늑골 직하 부에서 동맥의 완전 폐쇄 소견을 나타내었다. 쇄골상 절개와 쇄골하 절개의 병용으로 앞경추늑골근절제술, 중간경추늑골근 부분절제술, 경추늑골절제술, 제1 늑골절제술, 동맥박리술을 시행하였다. 수술후 증상이 소실되어 직장에 복귀하였고 술후 10개월인 현재 까지 증상이 없이 지내고 있다.

• Journal of Chest Surgery
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• 제27권6호
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• pp.506-508
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• 1994

Thoracic outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. A 35-year old female was evaluated for right hand numbness. This patient had a history of headache, right shoulder pain, and right hand numbness during 10 months.Preoperative angiography, EMG, and NCV was performed. First rib and cervical rib resection was done with transaxillary approach. After operation, right hand numbness and right shoulder pain were disappeared. Postoperative course was uneventful.

• Journal of Chest Surgery
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• 제28권2호
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• pp.206-208
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• 1995

Thoracic outlet syndrome presents with symptoms resulting from pressure on either the subclavian vessels or the lower trunk of the brachial plexus. It may be caused by a number of abnormalities, including degenerative or bony disorders, trauma to the cervical spine, fibromuscular bands, vascular abnormalities, and spasm of the anterior scalene muscle. We experienced a case of thoracic outlet syndrome [ caused by cervical rib .We report a case with review of literatures.

• Journal of Chest Surgery
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• 제21권3호
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• pp.563-566
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• 1988

Thoracic outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. it was previously designated according to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib and first thoracic rib syndromes. We experienced a case of thoracic outlet syndrome[costoclavicular syndrome] which was caused by posttraumatic left clavicular fracture. Patient had suffered from swelling and cyanosis of left forearm and hand. preoperative vascular doppler test, angiography and venography were performed. First rib resection was done with transaxillary approach. After operation preoperative cyanosis and swelling of left forearm and hand were disappeared. Postoperative course was uneventful.