• Journal of Chest Surgery
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• v.34 no.6
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• pp.441-446
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• 2001

Background: Electrical breathing pacing has many advantages over mechanical ventilation. However, clinically permanent diaphragmatic pacing has been applied to limited patients and few temporary pacing has been reported. Our purpose is to investigate the feasibility of temporary electrical diaphragm pacing in explothoracotomy canine cases. Methods: Five dogs were studied under the general anesthesia. Left 5th intercostal space was opened. Self designed temporary pacing leads were placed around the left phrenic nerve and connected to the myostimulator. Chest wall was closed after tube insertion with underwater drainage. Millar catheter was introduced to the aorta and right atrium. Swan-Ganz catheter was introduced to the pulmonary artery. When the self respiration was shallow with deep anesthesia, hemodynamic and tidal volume were measured with the stimulator on. Results: Tidal volume increased from 143.3$\pm$51.3 ml to 272.3$\pm$87.4 ml(p=0.004). Right atrial diastolic pressure decreased from 0.7$\pm$4.0 mmHg to -10.5$\pm$4.7 mmHg(p=0.005). Pulmonary arterial diastolic pressure decreased from 6.1+2.5 mmHg to 1.2$\pm$4.8 mmHg(p<0.001). The height of water level in chest tube to show intrathoracic pressure change was from 10.3$\pm$6.7cmH$_{2}$O to 20.0$\pm$5.3 cmH$_{2}$O. Conclusion: Temporary electrical diaphragmatic pacing is a simple method to assist respiration in explothoracotomy canine cases. Self designed pacing lead is implantable and removable. Negative pressure ventilation has favorable effects on the circulatory system. Therefore, clinical application of temporary breathing pacing is feasible in thoracotomy patients to assist cardiorespiratory function.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.306-311
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• 1980

Pure red cell aplasia is unusual cause of anemia and a selective aplastic disorder that affects the erythroid series of the bone marrow. Fifty percent of all patients with red cell aplasia will have a thymoma. Twenty-five to 30% of those who undergo thymectomy will be cured. A 57-years-old man was admitted to the medical department of Korea University hospital with complaints. Physical examination reveals a sick looking man with a pale lip, anemic conjunctiva and subicteric sclera. On auscultation, coarse breathing sound and moist rale was heard on the right lung field. Neither the liver nor spleen was palpable. A blood count showed the erythrocytes to number 2,640,000/mm3 and hemoglobin to be 7.0gm/dl. A white blood cell count was 5,000/mm3 and a platelet count was 328,000/mm3 Reticulocyte count was 0.7%. Examination of the peripheral blood smear showed the red cell, to be normocytic and normochromic. Urine sugar was three positive and GTT was positive. The anterior-posterior and lateral view of Chest X-ray was suggestive of an anterior mediastinal mass. A bone marrow biopsy reveals absence of red cell precursors and a normal myeloid series and megakaryocytes. At thoracotomy in May 1980 an encapsulated, lobulated, benign thymoma, which measured 5x7x5 cm was removed, microscopic examination showed it was of the spindle cell type. The postoperative course was uneventful, but the patient never had a return of hemoglobin to the blood. The patient was discharged on the postoperative] 3 days. At postoperative 1 month, the patient was readmitted for bone marrow study and had no return of red cells to bone marrow. At now, patient has been treated with steroid and the further follow up study will be needed.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1017-1022
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• 1996

Patients with fractured ribs necessarily suffer from severe chest ain, which prevents coughing, deep breathing and bronchial toilette, cause atelectasis and pulmonary shunting. Relief of chest pain is benecial to patients, providing consort and facilitating physiotherapy and effective expectoration. We compared the efficacy of pain relief be!ween continuous epidural analgesia and conventional intramlrscular analgesia in 20 patients with fractured ribs. Among 20 patients, epidural analgesia was done or 10 patients(experimental group) and the remainder ten received intramuscular analgesia(control group). The pain and ROM(range of motion) scores, vital sign, PaO2, forced vital capacity(FVC) and forced expiratory volume for 1 second(FEVI) were checked on immediate admission and 12, 24 hours, third, fifth, and seventh day after starting of continuous epidural block. The pain and ROM scores were decreased and the PaO2, FRC and FEVI were significantly increased in experimental group. The side effects of epidural analgesia were mild and reversible. With th se result, we can suggest that epidural analgesia is more effective for pain relief and restoration of pulmonary mechanics in patients with fractured ribs.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.195-204
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• 1977

Dynamic lung compliance was measured in healthy ten young[mean age, 26 years] male and five young[mean age, 25 years] female. Lung volume was integrated of the rate of flow signal which was obtained by using pneumotachograph and differential pressure transducer[PM 5, Statham]. Intrapleural pressure was measured as that of intraesophagel pressure. Esophageal ballon, 15. 5cm in length, 4ml of luminal capacity and made of thin latex, was connected to the polyethylene tube that had 12-14 side holes and was of 1.5mm of ID. Transpulmonary pressure was traced by means of differential pressure transducer[PM 131, Statham] to which connected the esophageal balloon catheter and connection tube from mouth piece. Lung volume and transpulmonary pressure were photographed by cathode ray oscilloscope camera while the subjects were breathing spontaneously. Dynamic lung compliance loop was displayed on single trace monitor and subtraction was performed for the quasi-static hysteresis. Dynamic lung compliance was measured, 1. by plotting the pressure-volume relationship 2. from the subtracted pressure-volume loop. Results were as follows. 1. Dynamic lung compliances measured by plotting of healthy young male and female were $0.202{\pm}0.06$ and $0.190{\pm}0.023L/cm$ $H_2O$ respectively. 2. When measured from subtraction loop, dynamic lung compliance for male and female were $0.327{\pm}0.107$, and $0.27{\pm}0.06L/cm$ $H_2O$ respectively. 3. Dynamic chest wall and total respiratory system compliance were also measured. 4. Dynamic lung compliance by plotting appeared to be essentially same when compared to that of static compliance reported previously from our laboratory, however, that obtained from subtraction loop revealed higher values than the compliances obtained by plotting and that of static compliance.

• Korean Journal of Veterinary Research
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• v.49 no.4
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• pp.351-354
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• 2009

Diaphragmatic hernias, whether congenital or acquired (traumatic), are rarely observed in the horse. Acquired diaphragmatic hernias typically occur secondary to trauma or an increase in intraabdominal pressure due to falling, heavy exercise, or parturition. Diaphragmatic herniorrhaphy is difficult to perform in adult horses and the horses with symptomatic diaphragmatic hernias usually die. A 10- year old, 340 kg, Jeju horse (crossbred) broodmare with sudden onset of gait disorder and a moderate emaciation was examined. Findings on physical examination included conjunctivitis, dehydration, shallow breathing, dyspnea, weaken heart beat, lack of auscultatable sounds from the gastrointestinal tract, and anorexia. Rectal temperature was $38.4^{\circ}C$ and respiratory rates were moderately increased. There were slight signs of acute colic. The broodmare died one day after non-specific treatment of fluids, nutriment, antibiotics and non-steroidal anti-inflammatory drug. The cause of death was strangulation of the small intestine through a diaphragmatic hernia. The rent was about 2 cm in diameter and located in the central right part of diaphragm. Around 60 cm of small intestine was protruded into thoracic cavity through the rent. The cause of the hernia could not be ascertained. The broodmare had been pastured with many other horses, and the groom had not noticed any aggressive behavior among them. It was, however, speculated that trauma by stallion's attack may have been the cause of the diaphragmatic hernia, because the new horse may be the object of behaviors ranging from mild threats to seriously aggressive kicking, squealing, rearing, and biting.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.221-232
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• 2022

Purpose : In this study, rectus abdominis relaxation intervention was administered to office workers who were experiencing low back pain due to sitting for extended periods of time in an incorrect posture. This study aimed to develop an effective treatment program for individuals who experience low back pain. This was done by verifying changes using the Korean Oswestry Disability Index (K-ODI) and considering kyphosis. Both factors are related to low back pain. Methods : This study included 39 office workers with low back pain. The participants were randomly assigned to three groups. 1) The functional massage and self-stretching (FAS) group (n=14). 2) The diaphragmatic breathing and self-stretching (DAS) group (n=13). 3) The self-stretching (S) group (n=12). All groups applied the intervention for 30 minutes a day, thrice a week for four weeks. All participants were evaluated using the K-ODI and thoracic kyphosis measurements before and after the intervention. Results : The findings of this study are as follows. All three groups had improved K-ODI scores after the intervention. The FAS and DAS groups showed a greater effect than the S group. However, there was no difference in effect between the FAS and DAS groups. Kyphosis was not improved in any of groups after the intervention, and there was no difference between the three groups. Conclusion : This study showed that the FAS, DAS, and S programs were effective relaxation interventions that improved the K-ODI for office workers with low back pain. The FAS and DAS programs were more effective than the S program. Therefore, it is recommended to combine relaxation and stretching of the rectus abdominis muscle for office workers who experience low back pain. Clinically, a relaxation intervention that is most appropriate for the patient, depending on his or her condition, should be.

• Journal of Veterinary Clinics
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• v.40 no.4
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• pp.308-313
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• 2023

A 1-year-old castrated male Korean Shorthair cat presented with dyspnea, anorexia, lethargy, and seizures. Physical examination revealed salivation, right forelimb hemiparesis, and rapid breathing. No abnormalities were detected on auscultation. Laboratory findings revealed increased levels of bilirubin, aspartate aminotransferase (AST), globulin, glucose, and a decreased albumin-to-globulin (A:G) ratio. Both N-terminal pro-B-type natriuretic peptide (NT-proBNP) and feline serum amyloid A (fSAA) levels were significantly elevated. Thoracic radiography revealed mild cardiomegaly and diffuse increased interstitial infiltration with soft tissue opacity in the periphery of the right caudal pleural space. Echocardiography and lung ultrasonography were performed to investigate the cause of mild cardiomegaly and soft tissue opacity in the pleural space. Echocardiography revealed a mild amount of echogenic pericardial effusion, and lung ultrasonography showed an echogenic soft tissue mass with no blood signal in the right caudal pleural space, suggestive of a granulomatous lesion. After obtaining 5 mL of pericardial fluid through pericardiocentesis, cytology of the pericardial effusion sample revealed marked neutrophils and macrophages with no bacteria. IDEXX feline infectious peritonitis (FIP) virus real-time reverse transcriptase polymerase chain reaction (RT-PCR) confirmed the presence of the FIP virus biotype in the sample. This case presents a rarely reported atypical mixed form of FIP in a cat diagnosed ante-mortem using pericardial effusion analysis. In this case, ultrasound examination played a crucial role in the definitive diagnosis of FIP by PCR biotyping through pericardiocentesis. Ultrasonography can be highly beneficial in guiding the diagnosis and evaluation of cats with suspected FIP.

• Journal of Veterinary Clinics
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• v.41 no.2
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• pp.117-122
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• 2024

A 3-year-old spayed female Russian blue cat was presented for dyspnea, nasal discharge, and stertorous breathing. Plain thoracic radiography revealed no specific findings. Computed tomography (CT) was performed to differentiate upper airway tract disorders. It revealed the presence of an iso-attenuating mass measuring 10.0 × 7.9 × 15.6 mm, with mild homogeneous contrast enhancement occupying the rostral nasopharynx. The mass was surgically debulked via a longitudinal incision in the soft palate. Histopathological and immunohistochemistry analysis of the surgically excised mass revealed CD3-/CD79a+ B cell lymphoma with an incomplete margin. The patient underwent hypofractionated radiation therapy, receiving a total of 36 Gray (Gy) in 6 Gy fractions over a six-week period. A follow-up CT examination was performed after 27 months of irradiation and the patient was confirmed to have achieved a complete response. There were no complications related to irradiation. The patient was alive for 40 months without recurrence. This study suggests that hypofractionated radiation therapy combined with surgical debulking could be considered as a treatment option for feline nasopharyngeal lymphoma.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.54-63
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• 1991

Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.99-106
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• 1998

Background: Bronchial asthma is a complex disease, which is characterized by spontaneous exacerbations of airway obstruction and persistent bronchial hyperresponsiveness. Animal models have fallen short of reproducing the human disease, particularly in mimicking the spontaneous and persistent airflow obstruction that characterized in asthma. In animals, airflow obstruction is usually assessed by measuring airflow resistance during tidal breathing under such invasive technique as tracheostomy and anesthesia. A noninvasive technique for measuring pulmonary function in small animals is needed to evaluate long-term changes in lung function during the course of experimentally produced disease without sacrificing the animal. Purpose: The purpose of this study was to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness (AR) to inhaled methacholine in nonanethetized, unrestrained guinea pigs. Method: Guinea pig model of asthma was sensitized by subcutaneous injection with ovalbumin and challenged by inhalation of aerosolized ovalbumin(1% wt/vol ovlabumin). Airflow obstruction of conscious guinea pig was measured as specific airway resistance (airway resistance $\times$ thoracic gas volume). Airway resistance and thoracic gas volume of conscious guinea pig were assessed by body plethysmography before challenge and at regular intervals for as long as 30 minutes after challenge. AR to aerosolized methacholine of asthma group was compared with that of control group in body plethysmography. Result: Asthma model<> developed in 13 (65%) among 20 guinea pigs, in which early responses occurred in the airways after the exposure to inhalation with ovalbumin. Airway challenge with ovalbumin caused increase in specific airway resistance, which peaked at 6 minutes and amounted to a $231.5{\pm}30.4%$ increase from baseline. AR to aerosolized methacholine of asthma model increased significantly compared with control group. Conclusion: These results have showed a useful animal model to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness in nonanethetized, unrestrained guinea pigs.