• Journal of Chest Surgery
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• v.13 no.1
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• pp.77-81
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• 1980

We present one case of 26-year-old male having saddle block combined with mitral valvular disease [NYHA Class IV] with auricular fibrillation. The most common cause of emboli is atrial fibrillation. The clinical manifestations of saddle emboli are relatively slow due to development of collateral circulation and large size of lumen of the aorta. The 5month duration of saddle emboli in this case led to severe atrophic changes, coldness, peripheral cyanosis on the both lower extremities, and flexion deformity on the knee and ankle joint of the left lower extremity. We planned staged operation for the saddle block and for mitral stenoinsufficiency and tricuspid insufficiency, because of poor general condition of the patient. The thromboembolectomy of aortic bifurcation was performed through the transabdominal approach without trial of Fogarthy catheter embolectomy, because of expectation of the secondary inflammatory changes of the vessel wall and thrombi which was 3 cm X 1 cm X 0.5 cm in size with irregular surfaced solid in consistency. 1 month later, after thromboembolectomy, mitral valve replacement and tricuspid annuloplasty were performed, with successful early operative result. During operation organized thrombi [1 cm X 0.5 cm] in the left auricle was removed. We wonder if simple management using Fogarthy catheter might be possible to remove the thromboemboli instead of thromboembolectomy by aortotomy in this case.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.2
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• pp.81-90
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• 2006

The Strain Index(SI) has been commonly used to evaluate the musculoskeletal disorders(MSDs) of upper extremities. Recently, the American Conference of Governmental Industrial Hygienists(ACGIH) adopted the Threshold Limit Value for hand activity level (HAL TLV) focused on the hand, wrist, and forearm. The MSDs risks of 37 repetitive works conducted at an automobile climate control system manufacturing factory were evaluated using both the HAL TLV and the SI, and the results by two methods were compared. Also, measured repetitive frequencies of upper limbs joint were mesured using electromyogram and electrogoniometer. The evaluation results of the HAL were related with the repetitive frequency data of upper limbs joint by electrogoniometer, and the NPF was related with %MVC of ECU. The evaluation result of HAL TLV was highly related with the SI score(r=0.66, p<0.01). Of total 37 tasks, 25 tasks(67.6%) were exceeded the TLV and 34 tasks(91.9%) exceeded the SI limit. Although there was a high relationship between the HAL TLV and SI score, the HAL TLV underestimated the risk in comparison with the SI. The correlation coefficients(r) between the HAL TLV data and the repetitive frequency of upper limbs joint were 0.45~0.55(p<0.01). The MSD symptoms was significantly different between high risk groups and low risk groups evaluated by HAL TLV(p<0.01), but was not different between two groups by SI. In conclusion, the HAL TLV is a proper tool for repetitive works.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.118-125
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• 1999

Background and Aims : Nerve conduction study is invaluable in clinical neurology, especially for assessing peripheral neuropathies. Abnormal nerve conduction studies may result not only from peripheral nerve dysfunction itself, but also from other various mechanical, technical, and physiological factors such as age, sex, height and temperature. So we conducted this study to establish the our own normal values. Methods : In this study, from March. 1997 to July. 1998, 40 Korean adults among person came to Health Promotion Center over the age of 20 without any suspicion of neurological deficits were analysed to determine the effect of compound effects of several physiological factors. Results : The nerve conduction velocities of the upper extremity and proximal segments were faster than those of the lower extremity and distal segments. Physiological factors such as age, height and temperature affect the results of nerve conduction studies in multiple regression analysis. The sex difference is recognized over peroneal motor nerve. There are no sex differences in amplitude transformed into normal distribution. The significant physiological factor affecting the amplitude of nerve conduction is age, whereas height and temperature play no role. Conclusions : In multiple regression analysis, height is widespread variable for the nerve conduction velocities and temperature is important variable for lower extremities. The parametric statistical analysis cannot be applied to the amplitude of the compound muscle or nerve action potentials because of marked left shift in distribution. Sqareroot transformation of the CMAP and CNAP may be useful in normalizing the distribution. The most significant physiological factor affection the amplitude is age. Sex differences are not seen in nerve conduction study.

• The Journal of Internal Korean Medicine
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• v.26 no.1
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• pp.252-264
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• 2005

This concerns three patients diagnosed as lateral medullary infarction from cerebral infarction of the brain stem and hospitalized. They were diagnosed and treated for 手足??(paralysis of extremities), 痺症(bi syndrome), 麻木(numbness), 不仁(akinesia), 眩暈(Vertigo) through Oriental Medicine. Improvement in both sense disorder and motor disorder was seen and is therefore reported here. To detect symptoms of a brain stem disorder clinically, pathological symptoms must be isolated and the patient must be screened through radiological and neorological examination. If this is properly and carefully done from the first stage, and according to this diagnosis, with the cycle of the disease considered, a treatment plan can be laid. Modem Medicine offers easy diagnosis for cerebro-vascular disease, but the treatment is less effective than that offered by Oriental Medicine. This report is given with a plea for further research and more reportage of clinical cases of cerebro-vascular disease treated through Oriental Medicine.

• The Journal of Internal Korean Medicine
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• v.15 no.2
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• pp.148-162
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• 1994

A Literature study was done for identifying the effects of Bloodletting on C.V.A. The major results of the study were as follows. 1. The frequency of points of Bloodletting on C.V.A. were in order Twelve well point, Ship son, Gold SalivaJade Fluid, Paekoe, Chungchung, Sugu, Sosang, Taechu, Wijung, Kwanchung, etc. 2. The frequency of meridians of Bloodletting on C.V.A. were in order Extra-point, Tongmaek-kyong, Su-gworum-Shimpo-Kyong, Susoyang-Samcho-Kyong, Sutaeum-Pye-Kyong, Choktaeyang-Panggwang-Kyong. ete. 3. The frequency of the site of points of Bloodletting on C.V.A. were in order four extremities, face, neck and head, etc. 4. The effects of Bloodletting on C.V.A. is clear away heat and alleviate pain, therapy for waking up a patient from unconsciousness, dredge the meridian passage, expel wind-evil and promote blood circulation, emergency treatment for collapse, etc, 5. The effects of Bloodletting on the early stage of C.V.A. were wake up the patient from unconsciousness by clearing away the heat and The effects of Bloodletting on sequence of C.V.A. were dredge the meridian passage, 6. The frequency of points and meridians of Bloodletting on Hemiplegia were in order Twelve well point, Kyonjong, Extra-point, Chok soyang-Tam-Kyong, etc. 7. The frequency of points and meridians of Bloodletting on Aphasia were in order Gold Saliva Jade Fluid, Amun, Extra-point, Tongmaek-Kyong, etc. 8. The frequency of points and meridians of Bloodletting on Quadriplegia were in order Ship son, Twelve well point, Koktaek, Wijung, Extra-point, Chok soyang-Tam-Kyong, etc. 9, The frequency of points and meridians of Bloodletting on Vertigo were in order Four Gods Cleverness, Tuyu. Chanjuk, Paekoe, Taeyang, Extra-point, Yang-Kyong, etc. 10. The frequency of points and meridians of Bloodletting on Headache were in order Taeyang, Paekoe, Taechu, Extra-point, Tongmaek-Kyong, Yang-Kyong, etc. 11. The points and meridians of Bloodletting on Bells palsy were Chichang, Hyopko in Yangmyong-Kyong.

• 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.41 no.1
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• pp.110-115
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• 2008

Malperfusion of a major organ with aortic dissection has various clinical features according branch. The morbidity and mortality rate can increase without suspicion especially postoperative period. Surgical outcomes and prognosis are influenced by early expeditious diagnostic and therapeutic measures are mandatory for successful treatment. The authors report four successful cases of acute aortic dissection with mal perfusion of various organs, such as the brain, kidney, and the lower extremities.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.114-118
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• 1999

Backgrouds: Cervical epidural blocks were used as part of a comprehensive multimodal treatment program for patients with chronic pain in the head, neck and upper extremities. The depth of the epidural space beneth the skin surface varies at different levels of the spinal column in the same patient. It also varies from patient to patient at the same vertebral level. We studied the distance the skin to the cervical epidural space in adults patients at different intervertebral spaces. Methods: Date were gathered from 628 patients having cervical epidural block for relief of cervical and upper extrimity pain. All blocks were performed using hanging drop method after loss of resistance with saline at C5-6, C6-7, C7-T1 intervertebral space. Results: Mean distances for skin to cervical epidural space (DSES) were 5.42 cm, 5.06 cm, 4.68 cm in male, 5.00 cm, 4.61 cm, 4.10 cm in female at C7-T1, C6-7, C5-6 intervertebral space. DSES correlated with body weight, neck circumference and body mass index significantly. Conclusion: In the cervical spine, DSES varies from space to space. The longest DSES were noted at C7-T1 level in male, and the shortest DSES were at C5-6 in female. DSES has significant relationships with weight, neck circumference and body mass index.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.184-187
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• 2003

Synovial sarcoma is usually found near large joints and bursae of the extremities. Only 10% of all synovial sarcomas occur in the head and neck. The most common site affected in the head and neck is the hypopharynx, and very rare in the infratemporal fossa. Treatment of synovial sarcoma of the head and neck is difficult and must have multimodality which consists of operation, radiation and chemotherapy. Prognosis is associated with completeness of resection. We reported a case of synovial sarcoma arising from the infratemporal fossa, the first case in Korea, with review of literature.