• Journal of Chest Surgery
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• v.27 no.12
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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.

• Physical Therapy Korea
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• v.21 no.3
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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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• v.30 no.12
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• pp.1254-1258
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• 1997

Postpneumonectomy syndrome is a disease entity which arises after right pneumonectomy in left aortic arch and left pneumoncectomy in right aortic arch. This syndrome have a feature of severe mediastinal deviation and rotation, and induces severe respirator insufficiency This syndrome is rare, but should be considered when pneumonectomized patient complaints who have severe dyspnea. In Samsung medical center, We report a sucessfully treated patient with postpneumonectomy syndrome, who had experienced right pneumonectomy at 1 years ago.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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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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• v.31 no.6
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• pp.624-628
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• 1998

Postpneumonectomy syndrome is a rare and delayed complication of left pneumonectomy in most patients with normal mediastinal vascular anatomy. This syndrome is characterized by dyspnea and recurrent pulmonary infection in the remaining right lung that typically occur within the first postoperative year. The condition is believed to be secondary to postsurgical changes that include a marked shift of the mediastinum to the left, clockwise rotation of the heart and great vessels, and herniation of the right lung into the left anterior thorax. These changes lead to compression of the trachea or right main bronchus among the thoracic spine and the right pulmonary artery. We report a case of postpneumonectomy syndrome in 15 year-old girl that followed by left pneumonectomy for bronchiectasis 6 years ago. We have inserted an expandable prosthesis in the left thoracic cavity posterior to the heart. After implantation of an expandable prosthesis, an anatomic reposition of the shifted mediastinum was achieved, which resulted in instantaneous and sustained relief. The post-operative course was uneventful and the patient was followed in OPD from after discharge to now.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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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.