• Journal of Chest Surgery
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• 제8권1호
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• pp.29-36
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• 1975

We have experienced 49 cases of tumors of chest wall at St. Mary`s Hospital from Jan. 1963 to Dec.1974. In four cases of them, the reconstruction of chest wall defects performed. 1] Out of 49 cases of tumors of the chest wall, 27 cases were benign tumors, 14 cases metastatic malignant tumors, and 8 cases primary malignant tumors. 2] Twenty-six cases [50%] of tumors of the chest wall were on the bony cage. Among them benign tumors were 9 cases [35%], metastatic malignant tumors 14 cases [53%], and primary malignant tumors 3 cases [12%]. Of these, 24 cases were located on the ribs and 2 cases on the sternum.3] The malignant tumors of bony chest wall were excised in en bloc resection including involved ribs. The wide defects of bony chest wall were reconstructed by means of displacement of neighboring ribs and mobilized diaphragm, in the two osteogenic sarcomas of rib, and of prosthesis with silastic sheets in one rhabdomyosarcoma and one metastatic adenocarcinoma of lung.

• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.353-356
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• 1993

Advent of new imaging modalities such as computed tomography, magnetic resonance imaging and ultrasound contributed greately to the specific imaging diagnosis. However plain chest X-ray is still most prequently used for imaging diagnosis of respiratory disease in clinical pratic and it is important to make a good quality of X-ray film and good interpretation. The optimal chest X-ray should be taken with full inspiration without rotation and motion and the exposure is at the level of barely demonstrable thoracic vertebral disc space. It is recommended that higk KVP technique for detection of lesions which is overlaped by mediastinum, heart and rib cage. It is better to examine chest X-ray film start at some distance(6-8 feet) and closer to the film later on and the reader should not read a film in fatigue condition. The reading room should be quiet and relately dark illumination. It is important, to make a good X-ray film and good interpretation to reduce the observer error.

• Journal of Chest Surgery
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• 제55권3호
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• pp.246-249
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• 2022

Recurrent pectus excavatum (PE) after a Ravitch operation is not uncommon. Extensive costal cartilage resection from the previous Ravitch procedure can lead to an irregular, unstable chest wall depressions with a varying degree of deformity. The optimal approach to cover the chest wall defect and remodel the deformity, remains unknown. We report the case of a 27-year-old woman seeking surgery for the third time for recurrent PE. The patient presented with 2-time recurrent pectus excavatum following a failed Ravitch procedure and subsequent pectus bar repair. The entire chest wall reconstruction and remodeling entailed covering the chest wall defect with 2 titanium plates across both sides of the rib cage, and lifting and fixing the depressed chest wall with 2 parallel pectus bars.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.115-126
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• 2006

Background and Objectives : Training of breath support and laryngeal muscles control are important components in the development of the singing voice. The purpose of this study is to compare characteristics of respiratory and phonatory control on pitch, loudness, register change with untrained males and trained male singers. Materials and Methods : The 11 untrained males and 11 trained male singers participated. Closed Quotient(CQ), fundamental frequency (fo) and relative volume contribution of the rib cage (in percentage rib cage, % RC) and relative volume contribution of abdomen (in percentage abdomen, % AB) were measured during various pitch, loudness, register tasks using /a/ vowel phonation : Legato, staccato with C3-D3-E3-F3-G3 notes and crescendo and decrescendo with C3 note as well as modal register with C3 and falsetto register with C4 note using an integrated analysis system of Respiration, EGG and Voice. Results : (1) When pitch increased with legato task, loudness also increased in untrained male group but maintained in trained male singers. CQ was also increased both untrained and trained male singers but it was not significantly different ($p>.05$). The abdomen contribution to lung volume were significantly predominant both in inhalation and exhalation in trained males singers ($p<.05$). (2) When pitch increased with staccato task, CQ was not significantly different in untrained but significantly different in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$) (3) When loudness increased with crescendo, fo was significantly increased with increasing CQ in untrained males but fo was relatively consistent with increasing CQ in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). (4) Most male singers were able to change register from modal to falsetto register, but untrained males were not. Thus, CQ was significantly different between modal and falsetto register in trained male singers ($p<.05$). The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). Conclusion : Male singers were superior to untrained males in coordination of respiratory and phonatory control on pitch, loudness, register change. Implication are offered regarding how the results might be applied to the voice therapy as well as singing training.

• 한국전문물리치료학회지
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• 제18권4호
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• pp.60-67
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• 2011

Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.317-325
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• 2007

Objective : The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. Methods : We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. Results : The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft(fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. Conclusion : The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.

• Archives of Plastic Surgery
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• 제45권6호
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• pp.593-597
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• 2018

Sternal malunion, or loss, developed after a median sternotomy cannot only be difficult to manage and treat, but also may diminish one's quality-of-life drastically. The technique presented here represents a multispecialty approach in one stage for the reconstruction of an unstable thoracic cage. The procedure utilized a donated sternum and ribs. The sternum with ribs harvested from a single donor included adipose derived stromal vascular fraction (ADSVF) cells with marrow also from the same donor. Autologous muscle flaps, stabilized with acellular dermal matrix were utilized to provide a robust blood supply to the ADSVF cells and bone grafts. Acellular dermal matrix was used to construct the ribs and stabilize the plugs of stem cells and bone. These procedures, in the hands of multispecialty physicians, have led to several successful reconstructions involving complex chest wall deformities. This surgical intervention was performed in a one stage operation. This represents the first successful complete sternal transplant in a patient with return to normal activities and increased quality-of-life.

• Journal of Chest Surgery
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• 제28권6호
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• pp.601-605
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• 1995

Clinical evaluations were performed on 54 cases of the traumatic sternal fracture, those were admitted and treated at the department of Thoracic and Cardiovascular Surgery in Chosun University Hospital during the past 5 years period from January 1990 to December 1994. The frequency was about 7.8% of the nonpenetrating chest trauma. The ratio of male to female was 2 : 1 in male predominance. Average age was 45.7 years old and age distribution was from 18 to 80 years old. The most common cause in the sternal fracture were high decelerating injury[ 38 cases . The most common fracture site was sternal body. Associated intrathoracic organ injuries were cardiac contusion[11cases , hemopneumothorax and pulmonary contusion. Added, thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture and long bone fracture. Abnormal ECG findings were sinus bradycardia[4 cases , sinus tachycardia[3 cases , bundle branch block, atrial fibrillaton, left ventricular hypertrophy and myocardial ischemia. The average days of admission was 19.1 days. All patients were treated with conservative treatment. The complications after treatment were atelectasis[2 cases ,empyema[1 cases , ARDS[1 cases .

• Medical Lasers
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• 제10권2호
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• pp.90-95
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• 2021

Background and Objectives Surgery for harvesting costal cartilage is often required for revision septorhinoplasty due to a lack of septal cartilage in patients with a severely contracted nose, and postoperative scarring on the anterolateral rib cage commonly requires additional treatment. This study aimed to evaluate the therapeutic efficacy and safety of combined polydeoxyribonucleotide (PDRN) and microlens array (MLA)-type nanosecond-domain neodymium (Nd):yttrium-aluminum-garnet (YAG) laser treatment for postoperative scars after costal cartilage harvest surgery. Materials and Methods Nine Korean patients with scars after costal cartilage harvest surgery treated with PDRN injections and MLA-type Nd:YAG laser treatments were retrospectively reviewed. Results Most of the scar lesions exhibited clinical improvement at 2 weeks after PDRN and MLA-type nanosecond-domain laser treatments, and the lesions further improved after adding more treatment sessions. The median Vancouver Scar Scale (VSS) score decreased from 6 (interquartile range [IQR]: 6-7) before combined intralesional PDRN injection and MLA-type, nanosecond-domain Nd:YAG laser treatments to 3 (IQR: 2-4) thereafter. Patient satisfaction after the combination treatments was rated as satisfactory. None of our patients reported major adverse events. Conclusion This case series study demonstrated that combined PDRN and MLA-type, nanosecond-domain Nd:YAG laser treatments are effective and safe for treating scars from costal cartilage harvest surgery.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.228-236
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• 2020

Objective : It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. Methods : Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. Results : In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). Conclusion : In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.