• The Korean Journal of Pain
• /
• v.20 no.1
• /
• pp.40-45
• /
• 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
• /
• v.9 no.2
• /
• pp.293-297
• /
• 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.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
• /
• v.1 no.1
• /
• pp.1-12
• /
• 1996

A paleomagnetic study was carried out on three gravity cores recovered from the KODOS-90 area in the North Pacific to obtain a magnetostratigraphic information and to correlate the magnetic records between cores. The sediments bear a stable remanent magnetization and the polarity sequence of the three cores can be correlated with the gomagnetic polarity time scale for the Plio-Pleistocene. The abrupt change in the magnetic susceptibility profile at 285 cm depth of the gravity core 26 indicates the presence of a major hiatus. The average sedimentation rates of the gravity cores 08 and 26 are about 2.7 and 1.4 times higher than that of the gravity core 20 (0.09 cm/100yr), respectively.

• Journal of Chest Surgery
• /
• v.16 no.3
• /
• pp.399-404
• /
• 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
• /
• v.28 no.2
• /
• pp.122-128
• /
• 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
• /
• v.36 no.4
• /
• pp.395-405
• /
• 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.

• Journal of the Korean Geotechnical Society
• /
• v.29 no.1
• /
• pp.71-80
• /
• 2013

Before and after the test constructions, and after an 11-month hiatus from the pilot pile installations, the in-situ tests (CPT, SPT) were carried out at the ground adjacent to the noise- and vibration-free screw concrete piles installed by 2 kinds of construction methods (i.e., the toe-jetting shoe type, the pre-digging type). In the toe-jetting shoe type construction methods, after construction, the soil strength within 3.5D (where, D = pile diameter) from the pile center decreased greatly by about 46% of the original ground and, after an 11-month hiatus, a strength recovery adjacent to the piles appeared about 71% of the original ground. In the pre-digging type construction methods, a strength recovery adjacent to the piles appeared 100% of the strength of the original ground.

• Journal of Chest Surgery
• /
• v.5 no.1
• /
• pp.13-18
• /
• 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
• /
• v.51 no.5
• /
• pp.482-487
• /
• 2001

A pancreatic pseudocyst with a mediastinal extension is a rare clinical entity. Intrathoracic symptoms such as dysphagia or dyspnea due to compression or associated pleural effusions are quite common. The pseudocysts transverse the diaphragm via the esophageal hiatus or aortic hiatus or by eroding directly through the diaphragm. Here, we report a case of a pancreatic pseudocyst with a mediastinal extension presenting as dysphagia and dyspnea. The diagnosis was confirmed by computerized axial tomography of the chest and abdomen. Usually, the proper management of a large pseudocyst includes percutaneous or surgical internal drainage, but in this case the mediastinal components disappeared with conservative medical treatment.

• Journal of the Korean Arthroscopy Society
• /
• v.13 no.2
• /
• pp.170-173
• /
• 2009

Wiring techniques in the fixation of patellar fracture are commonly used. Rigid fixation is essential for early rehabilitation. Breakages of wires after the fixation of patellar fracture are common with extracapsular migration if not removed for long term. But, we experienced a case of patellar fracture with early breakage of wiring and migration of the broken wire fragment into the popliteal fossa through the popliteal hiatus in 64- year-old man and we successfully treated this case, using both arthroscopic and open procedures. So we report this unusual case with a review of current literatures.