• Journal of Chest Surgery
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• 제27권12호
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• pp.1047-1051
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• 1994

Airway obstruction may be caused by extreme mediastinal shift and rotation after right pneumonecotmy or after left pneumonecotomy in the presence of right aortic arch.We experienced such a complication after right pneumonectomy, so called right postpneumonectomy syndrome. The patient was 28 years old female, and 4 month ago she had undergone right pneumonecotomy via video assisted thoracoscopic surgery[VATS] for endobronchial tuberculus dissemination and secondary pulmonary infection. She was treated by mediastinal repositioning which were composed of substernal fixation of pericardium and insertion of expandable prosthesis of 1000 cc capacity. She had good postoperative course and now she feels no obstructive symptoms.

• 한국전문물리치료학회지
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• 제21권3호
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• pp.73-79
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• 2014

The purposes of the current study were to (1) estimate the inter-rater agreement for visual assessment of scapular downward rotation (SDR), (2) develop the scapular downward rotation index (SDRI) as a method to measure SDR objectively and quantitatively, and (3) analyze the intra- and inter-rater reliability of the SDRI. Twenty subjects with scapular downward rotation syndrome (SDRS) were recruited for this study. The visual assessment and the measurement for the SDRI were conducted by two examiners in two sessions each. The SDRI [$(a-b){\div}a{\times}100$] is calculated with the measurement of two linear distances: One is a perpendicular distance from the root of the scapular spine to the thoracic mid-line (a), and the other is a perpendicular distance from the inferior angle of the scapula to the thoracic mid-line (b). Cohen's kappa coefficient was calculated to estimate the inter-rater agreement for visual assessment. Intra-class correlation coefficients (ICCs) with a 95% confidence interval (CI), the standard error of measurement, and minimal detectable differences were calculated to assess intra- and inter-rater reliability of SDR measurement using the SDRI. The results indicated that the kappa coefficient of inter-rater agreement for visual assessment was fair (${\kappa}=.21$). The intra-rater reliability of SDR measurement using the SDRI was excellent for examiner 1 (ICC=.92, 95% CI=.78~.97) and good for examiner 2 (ICC=.82, 95% CI=.55~.93). The inter-rater reliability was moderate (ICC=.73, 95% CI=.32~.89). These findings showed that SDR measurement using the SDRI for subjects with SDRS may be considered reliable and better than the visual assessment.

• Journal of Chest Surgery
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• 제30권12호
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• pp.1254-1258
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• 1997

전폐절제술후 증후군이란 우전폐절제술후 심한 종격동의 이동과 회전에 의하여 기도의 폐쇄와 더불어 심한 호흡부전을 나타내는 질환이다. 유병를은 드물지만, 환자의 증상이 심각하게 나타나므로 유념해야 할 증후군이다. 삼성의료원에서는 1년전 우전폐엽절제술 시행받은 후 발생한 상기 증후군 환자를 대상으로 tissue expander를 이용하여 전위된 종격동 장기를 정상위치로 환원함으로써 좋은 결과를 경험하였기에 이를 보고 하는 바이다.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

• Journal of Chest Surgery
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• 제31권6호
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• pp.624-628
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• 1998

전폐 절제술후 증후군은 드문질환이지만 종격동내 혈관의 정상적인 해부학적인 구조를 가진 대부분의 환자에서 전폐 절제술후에 지연 합병증으로 올수 있다. 이증후군의 임상증상으로는 대개 수술후 1년 이내에 나타나는 호흡곤란과 남아 있는 우측폐의 반복되는 감염이다. 전폐절제술후 이차적인 변화로 종격동이 좌측으로 끌려가면서 심장과 대혈관이 시계방향으로 회전하고 우측폐가 좌측 흉부 전방까지 확장되면서 나타나는 것으로 믿어지고 있다. 이와 같은 변화로 우측 폐동맥과 흉추사이에 끼이면서 기관과 우측 주기관지가 눌려지게 된다. 본 영동세브란스병원 흉부외과에서는 21세 여자환자에서 6년전에 기관지확장증으로 좌측 전폐절제술후 발생한 전폐절제술후 증후군을 좌측 개흉술후 종격동의 박리와 확장 보조물을 삽입하여 종격동 정복(mediastinal repositioning)을 시행하였고 환자의 증상은 수술후 소실되었으며 수술후 별다른 합병증 없이 퇴원하여 외래 추적관찰 중이다.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.154-158
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• 2015

Purpose: The purpose of this study was to propose a new reference point for measurement of the infrasternal angle and to investigate the intra- and inter-rater reliabilities of infrasternal angle measurement using photographs. Methods: Twenty-four healthy male college students participated as subjects in this study. Photographs were taken of subjects in two postures, one standing with the shoulders relaxed and one standing with the shoulders at $150^{\circ}$ abduction. All photographs were analyzed using Image J software. Raters used the photographs to measure the infrasternal angle between the xiphoid process, the medial margin of rib and navel on the right and left sides. The reliability of the infrasternal angle measurement was assessed by means of intraclass correlation coefficients [ICC (3,1)]. The level of statistical significance was set at p<0.05. Results: The intra- and inter-rater reliabilities of the infrasternal angle measurement for the right side at rest were excellent (ICC=0.866 and 0.813, respectively), as were those for the left side at rest (ICC=0.919 and 0.846, respectively). At $150^{\circ}$ shoulder abduction, the intra- and inter-rater reliabilities for measurement of the infrasternal angle on the right side were excellent (ICC=0.972 and 0.778, respectively), as were those for the left side (ICC=0.914 and 0.826, respectively). Conclusion: These findings suggest that this technique can be successfully used to measure the infrasternal angle, thus suggesting a new reference point for determining the length of the internal oblique and external oblique muscles in clinical situations.