• The Korean Journal of Pain
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• v.11 no.1
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• pp.155-159
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• 1998

Epidural neurolysis with phenol has appeared in literature since 1960. Complications due to accidental subdural block is a rare and unexpected sensory and/or motor disturbance, but it does occur. A 74 years old woman had postherpectic neuralgia for 3 weeks and VAS score of 10. She was treated with intercostal nerve block and intravenous infusion of lidocaine for 7 days and VAS score decreased to 6. To proceed further, we decided to perform epidural neurolysis with 4% phenol 1.5 ml. During thoracic epidural catherization, we encountered unexpected subdural catheterization in subdurographic finding, but we could not precisely rule out subdural catheterization. We had to check CT for exact location of catheter tip. We then performed subdural neurolysis with phenol. This procedure reduced VAS score to between 3 and 4, and we removed the catheter. She had no complication.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.83-89
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• 1976

This is a report on the cases of benign mediastinal tumors in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the period from 1961 to 1975. Age distribution was from 18 to 62 years old with the highest incidence in the 3rd decade, and sex ratio of male to female was 7 : 8. The tumor were classified as follows; 6 cases of teratoma 5 cases of neurogenic tumor one case of pericardial cyst one case of cystic hygroma one case of dermoid cyst one case of bronchogenic cyst. The symptomatic patients were 10 cases (66.7%) and asymptomatic patients were 5 cases (33.3%), who were found incidentally by routine chest n-ray. The symptoms occurred by compression to the adjacent nerve system in 7 cases, by perforation into the lung with infection in one case of teratoma and by infection of bronchogenic cyst in one case and of teratoma in one case. Complications were Pancoast's syndrome including Horner's syndrome 2 cases, middle lobe syndrome 2 cases, intercostal neuralgia 1 case and bronchitis 1 case. All tumors were surgically resectable with good recovery. In all 10 cases of symptomatic patients, their symptoms disappeared dramatically after operation.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.148-151
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• 1999

This report is a case of 62-year-old man with anterior chest pain and pin pricking pain with allodynia affecting left T5 sensory dermatome for 3 months without history of vesicular skin eruption. He had a history of diabetes mellitus for 10 years and insulin therapy for recent 1 year. EKG, chest PA and rib series were normal. Serologic evaluation of IgG antibody to varicella-zoster virus was positive and was diagnosed as post herpetic neuralgia after zoster sine herpete. He was treated with left T5 nerve root block followed by thoracic epidural blockade and intercostal nerve block for 2 weeks. His VAS score decreased from 10 to 2 after 2 weeks of treatment. After 3 months, he revisited our clinic complaining right side chest pain followed by vesicular skin eruption 8 days after the onset of pain. He was treated as herpes zoster and tolerates well after 4 months.

• Journal of Chest Surgery
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• v.3 no.2
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• pp.121-126
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• 1970

This is a report on a total of 8 cases of benign mediastinal tumors and cysts in Department of Thoracic Surgery, Chonnam University Hospital during the period from 1961 to 1969. The patients age was distributed between 18 and 38 year old with the highest incidence in the age group of second decade. Sex ratio of male to female was 3: 5. The tumors were classificed as follow; 3 case:, of neurogenic tumors, 2 cases of teratomas, one case of pericardial cyst, one case of cystic hygroma, and one case of brochogenic cyst. The symptomatic patients were 5 cases(62. 6%) and asymptomatic patients were 3 cases(37.5%). The symptomatic patients had the symptoms not referable to their lesion and the mediastinal tumors of asymptomatic patients were incidently found by routine chest X-ray. The Symptoms occurred by compression to adjacent nerve system in 3 cases. by perforation into the lung with infection in one case and by infection of bronchial cyst in one case. The complications were Pancoast's syndrome including Horner's syndrome(2 cases), middle lobe syndrome (one case), bro:1chial infection(one case) and intercostal neuralgia(one case). All tbe tumors were surgicai[y resectable with good recovery postoperatively. In 5 cases of the symptomatic patents, their symptoms were disappeared dramatically after operation.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.255-258
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• 2005

Many patients with intractable chest pain visit pain clinics, two of which, with rare cases of an intraspinal tumor and malignant mesothelioma were experiences at our clinic. A 37-year old female patient presented with exacerbating chest pain, but without neurological manifestations, of 15-months duration. Her laboratory findings, such as blood tests, chest X-ray, EKG, abdominal ultrasonography and chest CT, were normal. MRI revealed an intradural extramedullary schwannoma at the T 5 and 6 levels of the thoracic spine. She completely recovered following a laminectomy, with removal of the tumor. The other case was a 65-year old male patient, who presented with chest and back pain in the thoracic area of 6 months duration. He had no cough and dyspnea, and was initially misdiagnosed with intercostal neuralgia; therefore, pain control medication was administered, but all trials were ineffective. Finally, chest CT revealed a malignant mesothelioma, with multiple spine metastases. In conclusion, patients with intractable chest pain should be re-examined both clinically and radiographically.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1577-1583
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• 2000

Objectives : Among the various types of minimally invasive spine surgeries, thoracoscopic surgery is becoming more widely accepted and increasingly utilized. This report delineates our clinical experience using thoracoscopy to resect herniated thoracic discs in 16 patients who suffered from myelopathy or intolerable radiculopathy. Patients and Methods : Between Mar. 1997 and Sep. 1999, 16 consecutive patients underwent thoracoscopic discectomy for treatment of herniated thoracic discs. There were 12 men and 4 women(mean age 43.5 years ; range 18-61 years). Eleven patients presented with myelopathic signs and symptoms from spinal cord compression and 5 patients had incapacitating thoracic radicular pain without myelopathy. The surgical level was varied between T3 and T12. The pathology of specimen were 11 hard discs and 5 soft discs herniations. Thoracoscopic techniques were performed with long narrow spine instruments and high speed drill through 3 or 4 ports under one lung ventilated general anesthesia. During the operation three patients were converted to open thoracotomy due to intolerable one lung ventilation, excessive bleeding and inadequate operation field. The mean operation time was 264min.(range : 100-420min.), and postoperative mean admission period was 11 days. Results : Clinical and neurological outcomes were good in all patients(mean follow-up period 20 months). Among the eleven myelopathic patients, 8 improved neurologically, and 3 stabilized. Among the five radiculopathic patients, 4 recovered completely and no patient had worsened. Postoperative complications were pleural effusion in one case, intercostal neuralgia in one, delayed hemopneumothorax in one, prolonged air leakage in one and pneumonia in one case. Conclusions : Thoracoscopic discectomy needs a steep learning curve to be familiar to anatomical space and handling of endoscopic instruments. However, it is technically feasible and can be effectively performed with acceptable results.

• Herbal Formula Science
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• v.31 no.2
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• pp.99-109
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• 2023

Objectives : Sihosogan-tang (SST) is one of the traditional herbal formula and also one of the Korean medical insurance medicines. It commonly used in the treatment of hepatitis, chronic gastritis, intercostal neuralgia, pleurisy, and depression in East Asia. In the present study, we have demonstrated the anti-inflammatory effects of SST in macrophage cell line. Methods : To investigate mechanism of the anti-inflammatory effect of SST, we examined the productions of nitric oxide (NO) and pro-inflammatory cytokines, and the expressions of inducible NO synthase (iNOS), nuclear factor-κ B (NF-κB) and mitogen-activated protein kinase (MAPK) on RAW 264.7 cells activated by LPS. Results : SST significantly inhibited the expression of iNOS increased by LPS, and also significantly inhibited the production of NO. In addition, SST significantly inhibited pro-inflammatory cytokines such as TNF- α and interleukines. SST inhibited the expression of NF-κB and MAPK activation. Conclusions : These results suggest that SST ameliorates inflammatory response in LPS-activated RAW 264.7 cells through the inhibition of the NF-κB and MAPK pathway. Therefore, this study supplies objective evidence for the anti-inflammatory effect of SST.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.991-1000
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• 1997

Closed thoracostomy with UWSD* which is the most utilized procedure in chest surgery applies general thoracic disorders, trauma and after-thoracic surgery. The University hospital was involved on operating 2341 cases of closed thoracostomy with UWSD except chest tubing after-thoracic surgery for a full six years from January, 1991 to December, 1996. The rate of men and women out of the total 2341 cases was 3.5 : 1, the distribution by age showed that men were 36.6 $\pm21.0$ years old, women were $47.0\pm20.2$ years old and so that the total were 40.0 $\pm$ 20.5 years old. As for indication, spontaneous, secondary and traumatic pneumothorax were the most common, in addition to hemothorax hemopneumothorax, hydrothorax, hydropneumothorax, empyema, chylothorax. The most indwelling period of chest tubing is between eight and fourteen days for 974 cases and the average is 13.7 $\pm$ 6.3 days, The average drainage amount immediately after thoracostomy was 537 $\pm$ 88m1, and in 694 cases(46.0%), the drain amount was 201 ~ 500 ml. The rate of right and left tubing was 52.4 47.6, in 2071 cases(88.5%), the thoracostomy was the first chance and 2210 cases(94.4%) were treated with a single tube drainage. Almost all the patients complained of tube site pain, besides tube site infection, intercostal neuralgia, loss of tube function by the pleural adhesion, intrathoracic infection, incomplete reexpansion of defective lung, hemorrhage caused by the rupture of a blood vessel, subcutaneous emphysema, lung parenchymal rupture, diaphragmatic and intraabdominal trauma, reexpansionary pulmonary edema of one side lung and cellulitis were relapsed. 84.6% of all patients recovered with only clo ed thoracostomy and the rest of patient needed additional some necessary managements and so on to have successful results. There were two deaths(0.1%), caused by reexpansionary pulmonary edema, the cellulitis were complicated by thoracostomy with UWSD on an empyema patients to come to death(due to sepsis). t UWSD = under water seal drainage

• Journal of Chest Surgery
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• v.41 no.4
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• pp.469-475
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• 2008

Background: Video-assisted thoracic sympathicotomy is a definitive minimally invasive treatment for axillary hyperhidrosis. Different techniques exist for controlling axillary hyperhidrosis, but they are temporary and expensive. We compared the results after using two different levels of sympathicotomy for treating axillary hyperhidrosis: T3-T4 and T4. Material and Method: Between June 2002 and May 2007, 30 patients with isolated axillary hyperhidrosis underwent either T3-T4 or T4 thoracoscopic sympathicotomy in the Department of Thoracic & Cardiovascular Surgery at Wonkwang University Hospital. The patients were divided into two groups. Group I (n=15) was composed of patients who underwent T3-T4 sympathicotomy (thermal ablation), and Group II (n=15) was composed of patients who underwent T4 sympathicotomy (thermal ablation). The procedures were bilateral and simultaneous, involving the use of two 2-mm trocars and a 0-degree 2-mm thoracoscope under general anesthesia with single endotracheal intubation. Outcome parameters included satisfaction rate of treatment, degree of compensatory sweating, and postoperative complications. Patients were interviewed by telephone regarding satisfaction and compensatory hyperhidrosis. Result: There were no differences in age between group I and group II. The mean follow-up for the T3-T4 group was $38.7{\pm}2.3$ months, and the mean follow-up for the T4 group was $18.7{\pm}3.6$ months. The immediate therapeutic success rate (within 2 weeks postoperative) was 100% in both groups, and there were no recurrences in either group during the long-term follow-up period. The satisfaction rate was higher (93.3%) in the T4 group than in the T3-T4 group (53.3%), and the incidence of compensatory hyperhidrosis was lower in the T4 group (6.7%) than in the T3-T4 group (46.7%). Postoperative complications included one mild pneumothorax and two instances of intercostal neuralgia. Digital infrared thermographic imaging (DITI) correlated well with postoperative satisfaction. Conclusion: Both techniques proved effective for controlling isolated axillary hyperhidrosis. The T4 group had a higher satisfaction rate and lower severity of compensatory hyperhidrosis. Hence, thermal ablation of the lower interganglionic fibers of the third thoracic sympathetic ganglion on the fourth rib is a more practical and minimally invasive treatment than is the T3-T4 surgical method, according to the degree of compensatory sweating in isolated axillary hyperhidrosis.