• The Korean Journal of Pain
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• 제20권1호
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• pp.40-45
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• 2007

Background: Caudal block is useful when anesthesia for surgery or treatment for chronic pain is needed, but this procedure has a failure rate of up to 25% even when it performed byan experienced physician. This high failure rate is usually due to improper needle placement. Methods: After gaining approval of the ethics committee, 46 patients received caudal blocks under ultrasound guidance; these were performed after the anatomical structures in the sacral hiatus had been measured with ultrasound. All these procedures were performed by the same anesthesiologist. The position and direction of the needle were identified using fluoroscopy by injecting a radio-opaque contrast through the needle. The time taken from thelidocaine injection to verification of the needle was measured and the planned nerve block was then carried out. Results: All cases of needle insertion into the sacral canal under ultrasound guidance were successful. The average duration of the procedure and the trial count were $134.1{\pm}10.1seconds$ and $1.2{\pm}0.1$, respectively. In 12 of the 46 cases (26%), the needle deviated either left or right in the sacral canal, so the direction of the needle had to be adjusted. The distance between two cornua, the depth of the sacral hiatus and the thickness and length of the sacrococcygeal ligament were $17.1{\pm}0.4$, $3.9{\pm}0.3$, $2.3{\pm}0.1$ and $24.9{\pm}0.9mm$, respectively. Conclusions: Ultrasound guidance can increase the success rate of inserting a needle into the sacral canal. However, even when ultrasound is used, the needle can deviate either left or right in the sacral canal.

• Journal of Chest Surgery
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• 제9권2호
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• pp.293-297
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• 1976

One mid-esophageal carcinoma underwent esophagogastrectomy using an exclusive right thoracic approach entailing mobilization of the stomach through the esophageal hiatus. 62 year old male farmer was admitted with chief complaints of dysphagia and weight loss of 5 Kg. for 6 months, and regurgitation after soft meal for one week prior to this admission. Preoperative esophagogram revealed stricture with fungating mass at the level of the carina, which was diagnosed as squamous cell carcinoma at the time of esophagoscopic biopsy about 33 cm from incisor. Bronchoscopy revealed no invasive lesion or carinal fixation, and laboratory examinations were excellent for operative intervention. An exclusive right thoracic approach through right 5th rib bed was made for radical esophagectomy, mobilization of the stomach through the esophageal hiatus and primary esophagectomy. Postoperative recovery was uneventful except increased bronchial secretion due to senile emphysema, and follow up for 5 months after esophagectomy revealed good functioning esophagus with mild epigastric fullness after meal. Exclusive right thoracic approach for radical esophagectomy seems to be the procedure of choice in selected cases.

• 한국해양학회지:바다
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• 제1권1호
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• pp.1-12
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• 1996

북태평양의 KODOS-90 지역에서 채취한 4-6 m 길이의 중력 코아 3개를 대상으로 자기층서 확립 및 코아들 간의 상호대비를 위하여 고지자기 연구를 수행하였다. 연구된 퇴적물은 자기적으로 안정된 잔류자화를 보유하고 있으며, 이 들의 자기극성(Polarity)변화는 지자기층서표(Geomagnetic Polarity Time Scale) 의 플라이오-플라이스 토세(Plio-Pleistocene) 기간과 대비된다. 중력 코아 26의 대자율은 285 cm 지점에서 급격한 변화를 보여 주어, 이 지점에 비교적 오랜기간 의 결층(Hiatus)이 존재함을 지시한다. 각 코아의 자극변화에 의한 평균 퇴적속도 는 중력 코아 20에서 0.09 cm/1000yr 이며, 중력 코아 08과 중력 코아 26은 중력 코아 20에 비하여 각각 약 2.7배와 1.4배의 상대적으로 높은 퇴적율을 보여준다.

• Journal of Chest Surgery
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• 제16권3호
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• pp.399-404
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• 1983

In general, hiatal hernia is rare incidence among diaphragmatic hernia in Korea especially in pediatric group. Recently great interest in hiatal hernia has not led to common agreement concerning the pathophysiology, method of diagnosis, clinical picture, Indications, and type of treatment. At 1981 and 1983, two cases of congenital hiatal hernia [type I, III] were surgically treated,which surgical Intervention was modified Hill`s operation and gastropexy. Postoperatively, clinical and radiological examination were proved no regurgitation, no dysphagia and well passage of barium.

• The Korean Journal of Pain
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• 제28권2호
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• pp.122-128
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• 2015

Background: Caudal epidural injections have been commonly performed in patients with low back pain and radiculopathy. Although caudal injection has generally been accepted as a safe procedure, serious complications such as inadvertent intravascular injection and dural puncture can occur. The present prospective study was designed to investigate the influence of the depth of the inserted needle on the success rate of caudal epidural blocks. Methods: A total of 49 adults scheduled to receive caudal epidural injections were randomly divided into 2 groups: Group 1 to receive the caudal injection through a conventional method, i.e., caudal injection after advancement of the needle 1 cm into the sacral canal (n = 25), and Group 2 to receive the injection through a new method, i.e., injection right after penetrating the sacrococcygeal ligament (n = 24). Ultrasound was used to identify the sacral hiatus and to achieve accurate needle placement according to the allocated groups. Contrast dyed fluoroscopy was obtained to evaluate the epidural spread of injected materials and to monitor the possible complications. Results: The success rates of the caudal injections were 68.0% in Group 1 and 95.8% in Group 2 (P = 0.023). The incidences of intravascular injections were 24.0% in Group 1 and 0% in Group 2 (P = 0.022). No intrathecal injection was found in either of the two groups. Conclusions: The new caudal epidural injection technique tested in this study is a reliable alternative, with a higher success rate and lower risk of accidental intravascular injection than the conventional technique.

• Ocean and Polar Research
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• 제36권4호
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• pp.395-405
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• 2014

A 570 cm-long sediment core was retrieved at $9^{\circ}57^{\prime}N$ and $131^{\circ}42^{\prime}W$ in 5,080 m water depth from the northeast equatorial Pacific and its stratigraphy was established with $^{10}Be/^9Be$ and paleomagnetic measurements. Successive AF demagnetization reveals eight geomagnetic field reversals. In the reference geologic time scale, the eight reversal events correspond to an age of about 4.5 Ma. However, $^{10}Be/^9Be$-based age yields 9.5 Ma at a depth of 372 cm. Such a large discrepancy in determined ages is attributed to an extremely low sedimentation rate, 0.4 mm/kyr on average, of the study core and resultant loss or smoothing of geomagnetic fields. The composite age model reveals a wide range in the sedimentation rate - varying from 0.1 to 2.4 mm/kyr. However, the sedimentation rate shows systematic variation depending on sedimentary facies (Unit II and III), which suggests that each lithologic unit has a unique provenance and transport mechanism. At depths of 110-80 cm with a sedimentation rate of about 0.1 mm/kyr, ancient geomagnetic field reversal events of at least a 1.8 Myr time span have not been recorded, which indicates the probable existence of a hiatus in the interval. Such a sedimentary hiatus is observed widely in the deep-sea sediments of the NE equatorial Pacific.

• 한국지반공학회논문집
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• 제29권1호
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• pp.71-80
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• 2013

2가지 시공법(즉 선단분출형슈방식, 선행굴착방식)으로 시공한 무소음 무진동을 위한 스크류콘크리트말뚝의 인접지반에서 시공 전 후 및 11개월 경과 시 원위치시험(CPT, SPT)을 실시하였다. 선단분출형슈방식 시공법의 경우 시공 직후 말뚝 중심~3.5D(여기서 D : 말뚝직경)의 영역에 있는 지반의 강도는 원지반 강도의 46%정도로 크게 감소하였으며 시공 후 약 11개월 경과 시 말뚝 인접 지반의 강도회복은 원 지반 강도의 71%정도로 나타났다. 선행굴착방식 시공법의 경우 11개월 경과 시 말뚝 인접 지반의 강도는 원지반의 전단강도까지 회복되는 것으로 나타났다.

• Journal of Chest Surgery
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• 제5권1호
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• Tuberculosis and Respiratory Diseases
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• 제51권5호
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• pp.482-487
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• 2001

저자들은 연하곤란, 호흡곤란, 상복부동통으로 내원한 44세 남자에서 좌측 흉수를 발견하고 흉수 천자와 흉부 및 복부 전산화 단층촬영을 시행하여 종격동올 침범한 췌장성 가성낭종을 진단하고 외과적 시술 없이 총정맥 영양공급과 소마토스타틴 투여등 내과적 치료로 호전된 종격동 췌장성 가성낭종 1례를 경험하였기에 보고하는 바이다.

• 대한관절경학회지
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• 제13권2호
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• pp.170-173
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• 2009

슬개골 골절의 고정 방법에 있어 강선 고정술은 흔히 사용되는 수술 방법중 하나이다. 슬관절의 조기 재활을 위해서는 견고한 고정술이 필요하다. 일반적으로 슬개골 골절의 수술적 내고정술 후 장기간 제거하지 않을 경우, 강선의 파절이 흔히 발생하며, 파절된 강선 조각은 관절막 외부의 연부조직 내에서 이동한다. 그러나, 저자들은 슬개골 골절의 수술 후 조기 파절된 강선 조각이 관절강내의 슬와공을 통하여 슬와부로 이동한 64세 남자를 관절경적 및 관혈적 방법을 이용하여 성공적으로 치료하였으며, 이에 문헌고찰과 함께 보고하고자 한다.