• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.73-80
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• 2002

Purpose: Weight lifting is a good training to control body weight, to correct body shape and to relieve stress. How-ever if the training is continued by inadequate training method and technique, the risks of the shoulder injuries are relatively high. Main Subject: The rotator cuff injury is the most common disorder to wright lifters and often results from the train- ing program of upright row, military press and pectoral deck. The chances of subacromial impingement in these postures are high because the shoulder rotates under the acromion at 90 abduction state. Shoulder instability in weight lifters can develop due to various causes. aepeated microtrauma and excessive abduction and external rotation may result in laxity of the anterior capsular structure, ligament and muscles. Behind the neck and bench press are high risk training postures. Other than those injuries, idiopathic osteolysis of distal clavicle, acromioclavicular separation, pectoralis major muscle rupture, and triceps muscle rupture nay develop. Conclusion: The best treatment option of the shoulder injury to weight lifters is to eliminate the possible risk elements for the weight lifters in training program and to provide proper and prompt treatment as soon as possible.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.175-175
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• 2008

We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.833-837
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• 1994

Lung contusion due to blunt chest trauma is the most common lung injury and correlated with the clinical course and prognosis. Its diagnosis by CT[Computerized Tomogram] gives a more clear and understandable three dimensional view, by which we are able to measure the volume of the contused and entire lung. Other variables are arterial blood gas, number of rib fracture, presence of hemopneumothorax, sternal fracture and clavicle fracture, number of associated non-thoracic injuries, ventilator time and presence of pulmonary complication. Percentage[%] of lung contusion are expressed as mean $\pm$ standard deviation and data analysis was performed by means of multivariate repeated measures analysis of variance to detect significant differences in variables between positive thoracic injury group and negative group. The paired t-test was used. Differences of percentage of lung contusion between groups were assessed by one-way analysis of variance. Simple linear regression was used to perform correlation analysis in the number of rib fracture and ventilator time. A p value less than 0.05 was considered statistically significant. Pneumothorax and the number of associated other injuries affect the amount of lung contusion and pulmonary complication group has more contused lung volume. Arterial blood gas study shows no correlation with the amount of lung contusion statistically. The number of rib fracture correlated with the amount of lung contusion, which also correlated with ventilator time[r=0.56, p<0.05]. In conclusion, quantitative anlysis of lung contusion by CT predicts the clinical course and treatment such as ventilator care.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.946-948
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• 2006

The patient was a 42-year-old female with breast cancer who had an implantable central venous catheter inserted percutaneously into left subclavian vein for chemotherapy. The postinsertion chest x ray revealed that there was no compressive sigh of catheter. Three months after insertion of the catheter, the patient was admitted to the hospital for 4th chemotherapy. The port was accessed but blood could not be aspirated and the catheter could not be flushed. A chest x ray revealed that the catheter was completely transected at the point where the catheter passed under the clavicle. Percutaneous removal of the distal fragment of the catheter was accomplished. The patient was discharged after successful removal of fragment of catheter.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.196-201
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• 2006

We report two cases of migration of K-wires from the acromioclavicular joint to the neck. A 73-year-old man complained of right shoulder pain for one month and had undergone orthopedic surgery because of acromioclavicular joint dislocation about 27 years earlier. Another 56-year-old man complained of left shoulder pain and neck pain for 5 years and had undergone orthopedic surgery because of acromioclavicular joint dislocation about 25 years earlier. In both cases, we took X-rays to look for the cause of shoulder pain and discovered broken and migrated K-wires in the neck. We removed the K-wires from the trapezius muscle and the paraspinal muscle respectively. K-wire fixation technique is simple and effective but should be followed up with X-rays periodically. In addition, we should warn patients of the possibility of migration of K-wire. And it is desirable for us to avoid using K-wire near major neurovascular structures like the sternoclavicular joint and the clavicle.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.348-352
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• 1987

A 51 year-old male was admitted with the chief complaints of swallowing difficulty and pain on neck and upper chest for 2 months prior to admission: He was taken biopsy under esophagoscopy, and the result was squamous cell carcinoma. Preoperatively we studied the esophagogram and chest CT. On these, we found the main appreciable mass at midesophagus easily. But, we missed the upper cervical unexpected mass. So we performed the esophagectomy and lymph node dissection from upper clavicle level to the esophagogastric junction by thoracic approach as wide as possible, and cervical esophagostomy and feeding gastrostomy also. At that evening we reviewed the studied films in detail, and we found another mass lesion at C4-C6 level of cervical esophagus. We performed the 2nd operation e.g. cervical esophagectomy on next morning without hesitation. Between these two masses, there was almostly normally looking skip area grossly. The squamous cell carcinoma of the esophagus could be multicentric in character and may have skip area. But, we heard little reports until now. The two masses could be different in origin or be same probably by submucosal spreading. Anyway, it was an alarming case to the surgeon not to neglect the another possible lesions in squamous cell type. Postoperative course was uneventful, he took G-tube feeding with no problems on 7th postoperative day. Now he took the postoperative irradiation at out patient department.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.206-211
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• 2003

Palmoplantar pustulosis may be associated with peculiar bone and joint conditions. Initially restricted to the anterior chest wall, these conditions were later found to involve peripheral bones and joints. The same aseptic pseudoinfectious bone and joint lesions were also found associated with severe acne. In 1987, Kahn et al suggested this acronym to describe a number of reports of peculiar bone, joint, and skin lesions published over the last 25 years. SAPHO sydrome stands for synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome. We report one case of SAPHO syndrome: A 27-year-old female presented left clavicular and right sacroiliac joint pain with hyperostosis and pustulosis palmaris.

• Journal of radiological science and technology
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• v.8 no.2
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• pp.11-14
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• 1985

The author came to analize and get the following problems after researched radiographic quality in order to find out the necessary factors to improve in radiographs of frontal projection of the chest selected at random of the adult patients (1545 male, 1520 female) who had been examined in 4 departments of radiology of the general hospitals in Seoul and Kyungki area. 1. Problems of x-ray film or of radiographic cassette appeared in 2.97% radiographs on account of selection of the film size (except costophrenic sinus) (1.79%), poor screen-film contact (0.85%), light leakage of cassette (0,33%). 2. Problems of patients' positioning or breathing appeared in 16.57% radiographs of all because of overlapping of lung apex and clavicle (6.98%), overlapping of scapula and lung field (5.87%), asymmetrical projection of clavicles (1.76%), errors in positioning and breathing of the patient (1.96%). 3. Problems of x-ray exposure factors or film processing appeared in 22.25% radiographs because of over-density (2.64%), under-density (3.95%), fog (0.59%), demonstration density under clavicles or lung marking unsharply (3.82%), not clear of lung marking from breast region (0.94%), not clear the lung marking from the part overlapped of heart and lungs (3.92%), not clear the lung marking from the part overlapped of liver and lung (6.49%).

• Journal of Chest Surgery
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• v.27 no.4
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• pp.328-330
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• 1994

Brachial plexus injury developing after axillary thoracotomy is an uncommon complication. But if it occurs, it may cause annoying events. We recently experienced 2 patients who developed brachial plexus injury after wedge resection by axillary thoracotomy . The first patient was a 22 year-old man with right spontaneous pneumothorax . After wedge resection of the right upper lung by axillary thoracotomy, he complained total paralysis of the right arm. An electromyogram was obtained at 7 days after operation, with the confirmation of brachial plexus injury. He was discharged at 22days after operation and brachial plexus injury was completely recovered 4 months after discharge. The second patient was a 17 year-old man with recurrent right pneumothorax. He underwent wedge resection of the right upper lung by axillary thoracotomy. Electromyogram confirmed the diagnosis of brachial plexus injury in the immediate postoperative period. He was discharged at 15 days after operation and brachial plexus injury was recovered 2months after discharge.Brachial plexus injury after axillary thoracotomy is caused by stretching around the clavicle and tendon of pectoralis minor by fixation of the abducted arm to the frame. Thus, when we perform wedge resection by axillary thoracotomy, we must avoid over-stretching of the brachial plexus in positioning. If brachial plexus injury develops, immediate attention and management with close rapport are important to avoid possible medicolegal problems.

• Journal of Chest Surgery
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• v.45 no.3
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• pp.177-182
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• 2012

Background: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods: Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results: Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion: Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.