• 대한수의학회지
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• 제27권2호
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• pp.157-166
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• 1987

The distribution of hepatic veins within the liver in 28 Korean native cattles were observed. Vinylite solution was injected into hepatic veins of seventeen specimens for cast preparation. The angiography was prepared in eleven specimens by injecting 30% barium sulfate solution into hepatic veins, and then radiographed on a X-ray apparatus (Shimadzu 800 MA 120 Kvp). 1. About two thirds or three quarters of the circumference of the Vena cava caudalis was embedded in the liver. The embedded portion was about 14~19cm in length. 2. The principal branches of the hepatic veins were Vena hepatica sinistra, Vena hepatica media, Vena hepatica dextra and Vena hepatica dorsolateralis; the three main hepatic veins were Vena hepatica sinistra, Vena hepatica media and Vena hepatica dextra. 3. The Vena hepatica sinistra joins the Vena cava caudal is near the esophageal impression of the liver. It gave off three or five branches to the left lobe. 4. The Vena hepatica media joined at the Vena cava caudalis close to the Vena hepatica sinistra. In all cases, Vena hepatica media opened near the diaphragmatic part of the liver than the Vena hepatica sinistra. It ran obliquely through the medial part of right lobe and quadrate lobe, giving off branches on each side. 5. The Vena hepatica dextra consisted of one(25 cases, 89.29%) or two separate veins(3 cases, 10.71%), joining to the Vena cava caudalis between the right and caudate lobes. 6. The flap of membranous tissue covered the dorsal half of the entrance of the Vena hepatica sinistra, media et dextra into the Vena cava caudalis. 7. The vestige of the ductus venosus persisted in the 12~18 months old cattles. 8. The anastomosis was observed in the intralobar and interlobar areas.

• Journal of Chest Surgery
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• 제50권6호
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• pp.424-429
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• 2017

Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Neonatal Medicine
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• 제18권2호
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• pp.404-408
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• 2011

Scimitar증후군은 우측 폐정맥이 하대정맥을 통하여 좌심방이 아닌 우심방으로 연결되는 부분 폐 정맥 환류이상을 보이면서 우측 폐의 발육부전, 우폐동맥의 발육부전 및 폐 분리증 등과 같은 동반 기형을 보이는 매우 드문 심폐기형 가운데 하나이다. 또한 선천성 항문 막힘증은 출생 후 조기에 잘록 창자 창냄술과 같은 적극적인 수술적 치료가 요구되는 항문 직장 기형의 하나로 비뇨기계 이상, 척추 이상, 기관지 식도루, 식도 폐쇄증 혹은 심혈관계 이상 등이 동반될 수 있다. 그러나, 부분 폐 정맥 환류 이상의 하나인 scimitar증후군이 항문 막힘증과 함께 동반됨을 보고한 예는 아직까지 국내외적으로 없었다. 이에 저자들은 호흡 곤란 및 선천성 편측 폐 발육부전 및 항문 막힘증을 주소로 입원한 신생아에서 진단된 scimitar 증후군 1례를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제10권2호
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• pp.327-336
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• 1977

A chinical analysis was performed on 383 ases of hest injurjes eperienced at Department of thoraci Surgery, Seoul National University Hospital during 21 year period From 1957 to 1977. Of 383 patients o hest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle frcture, 26 of lung contusion, 17 of diaphragmati laceration, 14 of hemoperiardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury paiens were traffi accident vitims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt hest injuries the patients with five or more rib fractures had a 85 per ent incidence of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis (46 cases) and closed thoracotomy (125 cases) but open thoracotomy had to be done on 90 cases (23.5%) because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronhial rupture. The over all mortality was 2.87 per cent (11 among 383 cases), 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1123-1126
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• 2008

폐조직과 흉막의 흉곽의 결손 부위를 통한 돌출로 정의되는 폐탈장은 선천성 또는 후천적일수도 있으며 부위별로 경부, 흉부, 횡경막 탈장이 있다. 8개월된 남아가 4개월간의 지속적인 기침과 흉부 방사선 촬영에서 폐우하엽의 지속적인 음영 증가소견 있어 시행한 흉부 전산화 단층촬영에서 azygoesophageal recess를 통한 폐탈장이 관찰되었다. 아직까지 보고된 적이 없는 azygoesophageal recess를 통한 폐탈장이 저자들에 관찰하게 되어 보고하는 바이다.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.33-40
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• 2017

Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

• Journal of Chest Surgery
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• 제12권4호
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• pp.411-417
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• 1979

During the period of 4 years from August 1, 1975 to August 1, 1979, authors have experienced 100 cases of multiple rib fractures by nonpenetrating injury at Department of Thoracic Surgery, Paik Foundation Hospital in Seoul, Korea. 1. The ratio of male to female patients with multiple rib fracture was 2.6:1 with male predominance and 84% of the total cases were between 20 and 50 years of age. 2. The most common cause of multiple rib fracture was traffic accident and falls accounted for the next largest group. 3. The most common site of rib fracture was 4th rib to 7th rib level on both hemithorax [52%]. 4. Associated injuries were cerebral contusion in 26%, clavicular fracture in 22%, long bone fracture in 22%, pelvic bone fracture in 10%, and scapular fracture in 8%. 5. Early complications and/or result of the multiple rib fractures were lung contusion in 23 cases, subcutaneous emphysema in 21 cases, hemothorax in 21 cases, hemopneumothorax in 6 cases, and flail chest in 12 cases. 6. The flail chests were managed by strapping the chest with adhesive plaster, external traction of flail segment with towel clip, ventilatory assistance for marginal clinical indications, and in cases of complicated with intrathoracic hemorrhage, wire fixation of flail segment through open thoraco-tomy. 7. The principles of therapy for hemothorax and/or pneumothorax were rapid reexpansion of the lungs by thoracentesis [11%] and closed thoracostomy [22%], but open thoracotomy had to be done on 3 cases because of massive bleeding or intrapleural hematoma and diaphragmatic rupture. 8. The over all mortality was 4% [4 among 100 cases] and the cause of all deaths was head injury.

• 정신신체의학
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• 제9권1호
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• pp.93-102
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• 2001

이완반응은 갚은 휴식상태를 말하며, 소위 스트레스반응으로 불리는 투쟁-도피 반응의 생리적 변화와 반대되는 생리적 변화를 일으키게 된다. 따라서 인위적으로 이완반응을 일으킴으로써 이러한 스트레스 반응을 상쇄시킬 수 있다. 이러한 이완반응을 일으킬 수 있는 복식호흡, 명상, 점진적 근육이완기법, 자율이완훈련, 생체되먹이기법 등의 다양한 이완기법들이 제시되어 왔으며, 이들은 다양한 신체, 정신 질환뿐만 아니라 정상적인 스트레스 관리 프로그램에 있어서도 마음과 신체의 안녕을 위해 유익한 도움을 줄 수 있음이 알려져 있다. 이러한 이완기법들은 스트레스 관리를 위한 전체적 과정의 한 부분으로 이해되어야 할 것이며, 자신에 맞는 적절한 기법을 찾아 지속적인 훈련을 함으로써 효과적인 스트레스 관리 방법으로서의 역할을 할 수 있을 것이다. 이에 본 저자는 명상, 점진적 근육이완기법, 자율이완훈련 및 기타 이완기법에 대한 보다 구체적이고 실제적인 방법을 제시하고자 한다. 스트레스와 관련된 다양한 신체, 정신 질환들에 대한 치료적 접근을 함에 있어서, 전통적 치료 방법에 병합하여 이완기법을 사용함으로써 스트레스와 질병 사이의 조절자로 이용할 수 있을 것이다.

• 대한수의학회지
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• 제38권2호
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• pp.379-385
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• 1998

The study was designated to investigate the gross findings following treatment with diethylnitrosamine (DEN) in rats. Forty four male rats (Sprague Dawley), initially 5 to 6 weeks of age and 120 to 150gm in body weight were continuously given water containing 0.01% DEN for 13 weeks and 3~6 rats per week were randomly sacrified at intervals of a week from 8 weeks to 17 weeks. The numbers of rats died until 17 weeks were 11 rats and first death occurred at 10 weeks. Body, liver and spleen weights were weighed and the relative weight levels of the liver and spleen per body weights were increased from 4.4% and 0.5% at control groups to 15.1% and 1.1% at 17 weeks. The numbers of RBC were not varied but PCV were decreased from 44.5% in control group to 27.5% in 16 weeks. A few of greyish-white foci or nodules of tumors were developed or not on the surfaces of the livers at 8 weeks but were developed on all livers after 9 weeks. The diameter of the largest tumor from all rat livers was 35.8 mm at 12 weeks. The numbers of developed tumors per a rat liver were appeared to be about 20 in 13 weeks and about 50~60 in 17 weeks. The diameter of some larger tumors were found to be 3~9mm in 13 weeks and 7~15mm in 17 weeks and more number of tumors were developed in the visceral surfaces than in the diaphragmatic surfaces of the livers. The parenchymae of livers were fragility.