• Journal of Chest Surgery
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• v.29 no.11
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• pp.1248-1256
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• 1996

From June 1987 to December 1994, 372 patients underwent operation for resection of esophageal cancer, and 48 patients with metastasis to distant abdominal lymph nodes were analyzed.. The primary tumors were located predominantly in lower thoracic esophagus(n=29). The location of involved lymph nodes were celiac L/N(n=45), common hepatic L/N(n=4), paraaortic L/N(n=l), and retropancreatic L/N(n=l). Most tumors penetrated the esophageal wall(T3,T4, n=43), metastased to regional L/N(N1, n=41), but a few tumors were limited to the esophageal wall(T1,T2, n=5), metastased to distant abdominal L/N without metastasis to regional L/N(NO, n=7). Resectability rate was 87.5%(42/48), and complete resection was possible in 31 patients(64.6%). The most frequent cause of incomplete resection and unresectability was unresectable T4 lesions(n=8), extranodal invasion(n=7). Overall operative mortality and morbidity was 4.2%, 22.9%, and resection mortality was 4.8%. Adjuvant therapy was given to 27 patients, and postoperative follow-up was possible in all patients(median follow-up, 32 months). The 1 year and 3 year survival for resection group was 54.0%, 18.1%(median, 386 days) including operative deaths. Our results suggest that resection of the esophageal cancer with metastasis to distant abdominal lymph nodes(M1LYN) can be done with acceptable mortality and morbidity, and may playa role in long-term survival in carefully selected patients because prognosis is dismal in unresectable esophageal cancer. We recommend that lymph nodes around celiac axis be dissected thoroughly for exact staging and possible prolongation of survival, and multimodality therapy as necessary because most patients with M1(LYN) esophageal cancer do poorly with only primay surgical treatment.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.659-667
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• 2006

Background: Experimental studies of vascular remodeling in the pulmonary arteries have been performed actively. These models required a persistent vascular insult for intimal injury induced by chronic hypoxia, monocrotaline intoxication or chronic air embolism and characterized medial hypertrophy and neointimal formation by active synthesis of the extracellular matrix protein. The purpose of this study was to determine the pattern of pulmonary vascular remodeling after obstruction of the pulmonary vein. Material and Method: Obstruction of the right pulmonary vein with a metal clip was performed in Sprague-Dawley rats $(352{\pm}18g,\;n=10)$ to cause pulmonary vascular disease. Fifteen days later, experimental studies were done and finally the both lungs and hearts were extirpated for experimental measurement. Pulmonary arterial pressure, weight ratio of right ventricle (RV) to left ventricle (LV) and ventricular septum (S) (RV/LV +S weight ratio), and pulmonary artery morphology (percent wall thickness, %WT) were evaluated and compared with normal control groups. Result: Pulmonary hypertension $(38{\pm}12mmHg\;vs\;13{\pm}4mmHg;\;p<0.05)$ and right ventricular hypertrophy (right ventricular/left ventricular and septal weight ratio, $0.52{\pm}0.07\;vs\;0.35{\pm}0.04;\;p<0.05$) with hypertrophy of the muscular layer of the pulmonary arterial wall (percent wall thickness, $22.4{\pm}6.7%\;vs\;6.7{\pm}3.4%;\;p<0.05$) were developed by 15 days after obstruction of the pulmonary vein. Conclusion: Obstruction of the pulmonary vein developed elevation of pulmonary blood pressure and medial hypertrophy of the pulmonary artery. These results are a part of the characteristic vascular remodeling. Theses results demonstrate that obstruction of the pulmonary vein can develope not only high pulmoanry blood flow of contralateral lung but also intima injury inducing vascular remodeling.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.895-908
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• 2018

As modern science is developed and advanced, examination and number of times using radiation are increasing daily. General diagnostic X-ray generator is installed on stationary form, But X-ray generator was developed because patient who is in the intensive care unit, operation room, emergency room can not move to general x-ray room. What we examine patient by x-ray generator is certainly necessary, So patient exposure is inevitable. but reducing radiation exposure is highly important matter about radiation technology, guardian, patient in the same hospital room, nurse etc. For this reason, rule regarding safety control of diagnostic x-ray generator revised for radiation worker, patient and protector proclaim that mobile diagnostic x-ray shield must placed in case of examine different location excluding operation room, emergency room, intensive care unit. But, radiogical technologist is having a lot of difficulties to examine with mobile x-ray generator, diagnostic x-ray shield partition, image plate and lead apron. So, when we use x-ray generator, we manufacture shield tools can be attached to the mobile x-ray generator On behalf of x-ray shield partition and conduct analysis and in comparison to part of body and distribution of dose rate and find way to reduce radiation exposure through distribution of dose rate of patient within the radiogical technologist, medical team. Mobile x-ray generator aimed at SHIMADZU inc. R-20, We manufactured equipment for shielding x-ray scattered x-ray by installing shielding wall from side to side based on support beam on the mobile x-ray generator. Shielding wall when moving can be folded and designed to expand when examine. Experiment measured five times in each by an angle for dose rate of eyes, thyroid, breast, abdomen and gonad on exposure condition of upper and lower extremity, chest, abdomen which is examined many times by mobile x-ray generator. We used dosimeter RSM-100 made by IJRAD and measured a horizontal dose rate by body part. The result of an experiment, shielding decreasing rate of the front and the rear showed 77 ~ 98.7%. Therefore using self-production shielding wall reduce scattered x-ray occurrence rate and confirm can decrease exposure dose consequently. Therefore, through this study, reduction result which is used shielding wall of self-production will be a role of shielding optimization and it could be answer about reduction of medical exposure recommended by ICRP 103.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.172-174
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• 2005

Trauma of the vascular structure is not poplular event. In obstructive atherosclerotic vascular disease, we sometimes have needed bypass surgery. The long length subcutaneous prosthetic vascular graft are vulnerable to injury. But prosthetic vessel rupture after trauma has been rare report. A 68-year-old man was referred to Department of Emergency of the Gyeongsang National University Hospital. After he had had a blunt trauma, he found a newly appearing pulsating mass of 10 cm diameter on his right chest wall. The lesion had a turbulent blood flow in the cavity of the mass by ultrasonographic finding. The lesion was a rupture of superficial prosthetic vascular graft under the skin.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.422-426
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• 2003

Primary cardiac tumor has very low incidence, especially in cases of malignancy. A 29 year old male patient visited our cardiologic clinic for recent aggrevation of dyspnea on exertion and palpitation. Echocardiography showed a large tumor in the left atrium, which suggested the left atrial myxoma. Urgent open heart surgery was taken. The operative finding was fossa ovalis based a large tumor (35$\times$90$\times$50 mm) that invaded the posterior wall of LA and right superior pulmonary vein directly. The tumor was excised well by simple dissection, and the final pathologic report was malignant myxofibrosarcoma. His postoperative course was smooth and he was discharged in good health. Postoperative radiation and chemotherapy had taken with satisfactory clinical outcome.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1320-1323
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• 2001

SAPHO syndrome is an acronym for an increasingly recognized syndrome of synovitis, acne, pustulosis, hyperostosis, and osteitis. Most of the previously reported case are from Japan and Europe. The authors report a case of SAPHO syndrome in Korean female who presented with extrasternal neurologic symptoms. A 60-year-old female with thoracic and right chest wall pain presented with the sternocostoclavicular hyperostosis, and recurrent aseptic osteitis. Previously, she had hystrectomy and thyroidectomy due to uterine malignancy 25 years ago. Also, she started to take medications for palm and sole pustulosis 7 days prior to admission. Through evaluation of clinical, radiological, serological studies, studies was done along with bone needle biopsy for the biological reassessment. The hyperostosis was found in the pedicles of thoracic 8, 9, 10 vertebrae and sternoclavicular joint. Radio-isotope bone scan showed an accumulation of tracer in thoracic vertebra. The bone biopsy from these site showed increased osseous turnover, thickening of trabeculae accompanied by mild acculuation of granulation tissue and round cell infiltration, compatible with mild chronic inflammation with marrow fibrosis. The patient showed good response to conservative management. The authors report a case of SAPHO syndrome with thoracic radiculopathy. It is considered that SAPHO syndrome is related to spondyloarthropathy, and appears to have benign disease process with good prognosis.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.104-110
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• 2007

Streptococcus pyogenes, which is classified to Group A streptococcus (GAS), is one of the most common bacterial pathogens of the childhood infection. This organism can cause acute bacterial pharyngitis, impetigo, peritonsilar abscess or scarlet fever. It can also cause severe invasive diseases such as toxic shock syndrome, sepsis, septic arthritis, necrotizing pneumonia or necrotizing fasciitis. Usually, invasive GAS infections are accompanied by systemic symptoms and signs. Necrotizing pneumonia presents with acute fever, pleuritic chest pain and cough. The progress of disease is usually rapid and typically, pleural effusion develops in the early course of disease. Necrotizing fasciitis is relatively rare but once it has developed, it may be life threatening and cause necrosis of adjacent soft tissues with rapid progress. Clinical manifestations of parapharyngeal abscess are fever, dysphagia or bulging of pharyngeal wall. We experienced three cases of GAS infections which were presented atypically.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.758-763
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• 2010

In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.189-192
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• 2008

Sternoclavicular septic arthritis is a rare condition and it is usually related to predisposing conditions like intravenous drug abuse, diabetic mellitus, trauma and so on. A delayed diagnosis of this disease may cause severe complications like mediastinitis and chest wall abscess. Computed tomography or magnetic resonance imaging is needed to evaluate the complications. If the above complications are present, then joint resection should be considered. We report here on a case of a 52-year-old man who was diagnosed with primary sternoclavicular septic arthritis and he had no predisposing conditions. The pathogen on the aspiration-culture was S. aureus and it was susceptible to cefminox. The patient was cured with administering only antibiotic therapy for 6 weeks; intravenous cefminox therapy for 4 weeks followed by oral cefminox therapy for 2 weeks.