• Title/Summary/Keyword: sternum

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Comparative Effectiveness of Schroth Therapeutic Exercise Versus Sling Therapeutic Exercise in Flexibility, Balance, Spine Angle and Chest Expansion in Patient with Scoliosis (슈로스(Schroth)운동치료와 슬링운동치료가 척추측만증 환자의 유연성, 균형능력, 척추각 및 흉곽 확장에 미치는 효과 비교)

  • Lee, Jun-Ho;Kim, Suhn-Yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.1
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    • pp.11-23
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    • 2014
  • PURPOSE: The purpose of this study suggests the exercise programs for improving the function and structure by applying the Schroth exercise method and sling exercise method to the scoliosis patient. METHODS: The subjects were 16 patients who were diagnosed with scoliosis. They were randomly assigned either to a Schroth exercise group (n=8) that received Schroth exercise program or to a sling exercise group (n=8) that received sling exercise program. Flexibility, static balance, dynamic balance, and spinal angles were measured by using the modified sit and reach test, one leg standing with closed eyes, functional reach test, and Cobb's angle, respectively. The chest expansion were calculated using differences of chest circumference between maximum inspiration and maximum expiration measured under armpits, at the junction between the sternum and xiphoid process, and at the waist. RESULT: Schroth group before and after the intervention there was a difference in the static balance, spine angle, chest expansion (p<.05). sling group before and after the intervention there was a difference in the flexibility, static balance, spine angle, chest expansion (p<.05). There were significantly differences between the both groups for chest expansion thoracic level inspiratory variables at post-exercise. CONCLUSION: These results revealed that two exercise program improved flexibility, static standing balance, spine angle, chest expansion level and ability used as scoliosis management and intervention. Therefore, it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with scoliosis.

Surgical Experience of Funnel Chest (누두흉의 임상적 고찰)

  • Ahn, Byoung-Hee;Hur, Sun
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.316-324
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    • 1990
  • This study is a review of the early postoperative results in fifteen patients who diagnosed funnel chest and underwent the corrective surgical procedure by the sternal turnover[STO] or the sternocostal elevation[SCE] between January 1988 and February 1990. Thirteen among fifteen patients were male. Early eight patients were corrected by the STO and late seven patients by the SCE. Cosmetic result was excellent in one, fair in five, poor in two patients who received the STO and excellent in all patients corrected by the SCE. This unfavorable postoperative result in the STO group was due to the protrusion of inverted xiphisternal joint, the depression along the rejoined costal cartilages and forward tilting of the distal sternum. The lower vertebral indices measured on the lateral chest film were improved postoperatively from 0.42\ulcorner0.08 to 0.30\ulcorner0.05 in the STO group and from 0.31\ulcorner0.05 to 0.24\ulcorner0.03 in the SCE group. There was significant improvement in lower vertebral index in both groups, but it was difficult to compare the postoperative improvement between groups due to the different preoperative status. In the SCE group, the funnel index and the degree of depression measured on the computed tomography were significantly improved from 5.29\ulcorner1.72 and 3.11\ulcorner0.71 to 2.77\ulcorner0.46 and 1.63\ulcorner0.19[P<0.05], but there was no significant change in the degree of flatness postoperatively. This results suggest that sternocostal elevation is more cosmetic procedure than sternal turnover in children and in young adolescents whose funnel index measured on the computed tomography is low.

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The Transmanubrial Approach for Cervicothoracic Junction Lesions : Feasibility, Limitations, and Advantages

  • Park, Jong-Hyun;Im, Soo Bin;Jeong, Je Hoon;Hwang, Sun Chul;Shin, Dong-Seung;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.236-241
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    • 2015
  • Objective : We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. Methods : Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. Results : The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. Conclusion : The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.

Microsurgical Reconstruction of Severe Radionecrotic Wounds Following Mastectomy (흉부의 심한 방사선 괴사 환부에 대한 미세 수술적 재건)

  • Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.114-121
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    • 1998
  • The purpose of this study is to investigate the appropriate management of severe radionecrotic wounds of the anterior chest wall associated with infection of the soft tissues and ribs and exposure of vital structures(heart and lung), and present our strategies for reconstruction of these complicated patients. 9 patients have undergone radical debridement and immediate microsurgical reconstruction for severe radionecrotic wounds of the anterior chest wall over last 7 years. All patients had extensive osteomyelitis of the ribs or sternum, and chronic infection or cutaneous fistulae. 2 patients had pericardial effusions due to longstanding inflammation, and 6 patients had pleural effusions. 2 patients had ipsilateral lung collapse. 10 free flaps were performed for coverage of the huge defects. One patient required 2 free flaps to control the inflammation. 8 free TRAM flaps were used for coverage of the defects and in addition, the rectus abdominis muscle was packed into any deep cavity. 1 patients underwent latissimus dorsi muscle free flap because of previous abdominal surgery. After extensive debridement of the infected, radionecrotic wounds, all 10 free flaps were successful. All the extensive radionecrotic defects of the anterior chest wall were completely healed. Free flaps successfully covered the exposed vital structures of the heart and lungs. Patients with severe radionecrotic defects of the anterior chest wall after ablative breast cancer surgery and radiotherapy were successfully treated by radical debridement and immediate free flap surgery. The TRAM flap together with the rectus muscle is the treatment of choice for these huge defects. The latissimus dorsi muscle flap was the second choice in patients with previous abdominal surgery. The recipient vessel should be carefully selected because of possible radiation damage and inflammation.

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A Case of Schistosomus Reflexus of Holstein Calf in Korea (젖소 송아지에서 반전성열체(schistosomus reflexus) 1례)

  • Hur Tai-young;Kang Seong-jin;Choe Chang-yong;Jung Young-Hun;Cho Yong-il;Son Dong-su;Ryu Il-Sun;Kim Hyeon-shup;Suh Guk-hyun
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.408-411
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    • 2005
  • Schistosomus reflexus is the most common monstrosity found in cases of bovine dystocia and it occurs mostly in cattle. Caesarian section performed and retracted abnormal foetus from dystocia in Holstein cow. It was the first observed schistosomus reflexus Holstein calf in Korea. The body and chest walls were bent laterally and dorsally leaving the thoracic and abdominal viscera exposed. Clefts of the sternum from part of the defect in which there is, simultaneously, lordosis, dorsal reflection of the ribs and complete eventration of viscera, severe ventral curvature of the spinal column, non-union of the pelvic symphysis and dorsal reflection of the pelvic bones with the occiput of the head lying near the sacrum. The limbs are usually ankylosed. The liver was abnormal in shape and cystic in nature. The lung was smaller and thymus were bigger than those of the normal calf, The ruminant stomach was normal, however, abomasum distended with amnionic fluid. The other organ including heart, spleen and internal organ have normal shape.

Early Results of the Sternocostal Elevation for Pectus Excavatum (Sternocostal elavation술의 누두흉 교정효과)

  • An, Byeong-Hui;Seon, Hyeon
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.621-629
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    • 1992
  • Thirteen sternocosal elevations for pectus excavatum were performed on twelve patients between Jan 1989 and Sep. 1991. Eleven among the twleve patients were male. The subjects ranged in age from 2 years to 20 years, with a mean age of 8.33 years[SD=4.80 years], Eleven patients were below 15 years. The early postoperative evaluation by Humphreys` criteria except keloid formation was excellent in all the patients. The lower vertebral index[LVI], configuration index[CI], and upper vertebral index[UVI] were measured on the lateral chest roentgenogram. The LVI and CI improved significantly from 0.31$\pm$0.06 and 1.14$\pm$0.06 preoperatively to 0.25$\pm$0.03 and 0.78$\pm$1.10 postoperatively. The degrees of depression, flatness, and asymmetry and funnel index were measured at the most deformed portion on the computed tomgram performed pre- and postoperatively. The degrees of depression and funnel index improved significantly from 3.32$\pm$0.73 and 5.77$\pm$1. 54 preoperatively to 1.85$\pm$0.14 and 2.96$\pm$0.43 postoperatively, There was no significant change in the degree of flatness however, Six postoperative morbidities occurred in five patients Three were superficial wound infection, two hemopneumothorax, and one reoeration, Reoperation was performed due to forward displacement of the distal sternum below the posterior sternotomy, The findings of this study suggest that the sternocostal elevation is an excellent primary method for the pectus excavatum of children and young adolescents.

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Surgical Treatment of Funnel Chest (누두흉에 대한 외과적 치험)

  • 이종호;정승혁;김병열
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.399-403
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    • 1999
  • Background: Funnel chest is one of the most common anomaly of chest wall, which is manifested by depression of sternum and costal cartilage. Popular operative methods were Ravitch operation and Wada operation. Material and Method: From 1983 to 1996, 21 cases of funnel chest were corrected surgically in the department of thoracic surgery, National Medical Center. Investigated age and sex distribution, combined anomaly,clinical symptom, degree of correction and complication, postoperative satisfaction. We used 2 different surgical methods, one was Wada & its variants(17 cases), the other was Ravitch and it variants(4 cases). Most of operative indications were cosmetic problems. Result: The pre-operative Welch index was 4.188, but this index decreased to 3.46 after the operations.(p=0.046) The degree of correction was higher in Wada & it variant operation than the modified Ravitch operation.(p=0.54) Their results were satisfactory in 20 patients, while unsatisfactory in 1 patient because of a k-wire fracture. There was no recurrence of chest wall depression or postoperative death during the OPD follow up period. Conclusion: We recommend Wada operation in symmetric and small degree of depressive chest wall deformity in preand post school age.

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Genetic parameters for marbling and body score in Anglonubian goats using Bayesian inference via threshold and linear models

  • Figueiredo Filho, Luiz Antonio Silva;Sarmento, Jose Lindenberg Rocha;Campelo, Jose Elivalto Guimaraes;de Oliveira Almeida, Marcos Jacob;de Sousa, Antonio Junior;da Silva Santos, Natanael Pereira;da Silva Costa, Marcio;Torres, Tatiana Saraiva;Sena, Luciano Silva
    • Asian-Australasian Journal of Animal Sciences
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    • v.31 no.9
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    • pp.1407-1414
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    • 2018
  • Objective: The aim of this study was to estimate (co) variance components and genetic parameters for categorical carcass traits using Bayesian inference via mixed linear and threshold animal models in Anglonubian goats. Methods: Data were obtained from Anglonubian goats reared in the Brazilian Mid-North region. The traits in study were body condition score, marbling in the rib eye, ribeye area, fat thickness of the sternum, hip height, leg perimeter, and body weight. The numerator relationship matrix contained information from 793 animals. The single- and two-trait analyses were performed to estimate (co) variance components and genetic parameters via linear and threshold animal models. For estimation of genetic parameters, chains with 2 and 4 million cycles were tested. An 1,000,000-cycle initial burn-in was considered with values taken every 250 cycles, in a total of 4,000 samples. Convergence was monitored by Geweke criteria and Monte Carlo error chain. Results: Threshold model best fits categorical data since it is more efficient to detect genetic variability. In two-trait analysis the contribution of the increase in information and the correlations between traits contributed to increase the estimated values for (co) variance components and heritability, in comparison to single-trait analysis. Heritability estimates for the study traits were from low to moderate magnitude. Conclusion: Direct selection of the continuous distribution of traits such as thickness sternal fat and hip height allows obtaining the indirect selection for marbling of ribeye.

Derodidymus in Korean-Native Calf (한우 송아지의 이두이안체)

  • 강문일;박영석;한동운
    • Korean Journal of Animal Reproduction
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    • v.23 no.1
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    • pp.69-73
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    • 1999
  • A calf with derodidymus was delivered from a 3-year old Korean-native cow with abortion last ime at Jangheong area in Chonnam Province. The anomaly with body weight of 35 kg was born t the normal time of parturition. During the parturition, however, the calf with twin head was onfirmed and the complete amputation between fore and hind limb was inevitably carried out or safety of the dam. The calf had normal skeleton and extremities but had two heads and cervical vertebrae divided from upper thoracic part. At necropsy, there were found totally 3 pairs of ore limbs including two pairs of hypoplastic ones hided in the thoracic limb and also found one air of sternum. One head had incomplete torsion or unilateral hypoplasia of mandible with artly hypoplastic skull. There were marked fusion and torsion from cervical to 3rd thoracic vertebra. No abnormality was found on all organs in the pleural and abdominal cavities except a rectal stricture formed at 5 cm away from the atresia ani.

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Complete Transposition of Great Arteries Combined with VSD and Pulmonic Stenosis (S.D.D.) -One Case Report- (대혈관전위증 (S.D.D.) 치험 1례)

  • 강면식
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.207-214
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    • 1979
  • This 3-year-old girl was observed frequent exertional dyspnea and cyanosis at crying since birth. She was not premature baby and delivered at full term normally. On physical examination, she was underdeveloped-body weight 13.5 kg, height 99 cm.- and cyanotic. There was severe clubbing on fingers. There was grade II/VI ejection systolic murmur on left lateral border of the sternum. The preoperative examinations [EKG, echocardiogram, cardiac catheterization and biventriculogram] showed that complicated T.G.A. combined vena cava[S.D.D.]. Preoperatively, we decided the corrective surgery of Rastelli operation using a. pulmonary valved conduit. The operation was performed under total circulatory arrest using deep profound hypothermia combining with extracorporeal circulation. On operation, the anatomy of the heart showed that, 1. The subaortic conus was seen and subaortic muscles were hypertrophied. 2. The VSD[type II], behind the subaortic conus-about 1 cm. in diameter, was visible only through LV cavity and, 3. The pulmonary valve ring was hypoplastic and pulmonary valvular stenosis was seen also. The subpulmonic area [LV outflow tract] was obstructed with hypertrophied muscle and mitral valve. 4. Left superior vena cava was drained to RA via coronary sinus. 5. LAD coronary artery was originated from right coronary artery and ran anterior to the pulmonary artery. According to above anatomy, we performed the VSD closure with Teflon patch, and Mustard operation combined with LV-to-pulmonary artery bypass graft using the valve contained [Hancock 16 mm] conduit. Postoperatively, adequate blood pressure could be maintained under the state of using inotropic agent [epinephrine]. On the second postoperative day, the patient died of cardiac arrest due to low cardiac output syndrome, acute renal failure and pulmonary edema.

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