• The Korean Journal of Pain
• /
• 제5권1호
• /
• pp.63-68
• /
• 1992

One hundred and four patients who complained of chest pain or back pain in the region between scapular were studied. In most cases, anatomical location of pain was in the rhomboid or serratus anterior muscle. Hyperactivity of dorsal scapular nerve or long thoracic nerve which innervate those muscles was thought to be responsible for the pain. The hyperactivity of the nerves may be due to the spasm of the scalenus medius muscle which the nerves meet during their course to the rhomboid or serratus anterior muscles. Therefore, spasmolytic treatment including trigger point injection, physical therapy, laser therapy, or NSAIDs may be effective for the treatment of chest pain or back pain.

• Journal of Chest Surgery
• /
• 제17권3호
• /
• pp.470-474
• /
• 1984

33-year old female was admitted chest surgery department for evaluation of mild chest pain. Chest plain film showed right anterior mediastinal mass and small metastatic daughter mass ipsilateral side. Exploratory thoracotomy was performed 24th Aug. 83 revealed that small nodular parenchymal mass at right middle lobe and large cystic mass at anterior mediastinum which was connected with anterior mediastinal fat. Histological examination confirmed diagnosis as pulmonary hamartoma and thymic cyst individually. We successfully treated these two masses by wedge resection and excision. Although postoperative course was uneventful, the cause and associated relationship between two tumor origin were obscure.

• Journal of Chest Surgery
• /
• 제20권2호
• /
• pp.393-398
• /
• 1987

Unstable angina pectoris is often premonitory to an acute myocardial infarction. Surgical revascularization in this syndrome is of great potential benefit and relatively low mortality. A patient with unstable angina pectoris is reported. A 65-year-old man complained of dyspnea and pain in the left anterior chest. The pain was brought on by mild exercise, occurred at rest and sleeping time. The pain worsened over a month period and more aggravated in intensity and duration. Physical examination showed no abnormalities except hypertension and laboratory data were within normal limits. His anginal pain was not relived by nitroglycerin ingestion. Preoperative coronary angiograms revealed significant obstruction [>90%] of left anterior descending coronary artery. Aorto-left anterior descending coronary bypass with autogenous saphenous vein used as conduit was performed. The postoperative course was uneventful and he was discharged on 16th postoperative day in a healthy condition.

• Journal of Chest Surgery
• /
• 제25권4호
• /
• pp.435-437
• /
• 1992

We experienced one case of immature teratoma at anterior mediastinum. the patient was Syears old female whose complain were cough and chest pain. Chest film showed mass density St the lower half of the Rt chest. Chest CT showed inhomogenous mass which have some calcified area. At the time of operation, 12x10x13cm sized mass have smooth surface and its stump elongated to the thymus. a-FP level, preoperative 22.5ng/ml, was decreased to 9.7ng/ml after operation. Postoperative adjuvant chemotherapy was performed with Vinblastin, Bleomycin and Cisplatin combination. The patient had an uneventful postoperative or postchemotherapy course and was discharged in a good condition.

• Journal of Chest Surgery
• /
• 제57권3호
• /
• pp.291-299
• /
• 2024

Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE. We hypothesized that SAPB would be a superior alternative pain control modality that reduces postoperative pain more effectively than conventional methods. Methods: We conducted a retrospective study of patients who underwent MIRPE between March 2022 and August 2023. The efficacy of pain control was compared between group N (conventional pain management, n=24) and group S (SAPB, n=26). Group N received intravenous patient-controlled analgesia (IV-PCA) and subcutaneous local anesthetic infusion. Group S received bilateral continuous SAPB with 0.3% ropivacaine after a bilateral bolus injection of 30 mL of 0.25% ropivacaine with baseline IV-PCA. Pain levels were evaluated using a Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, 48, and 72 hours postoperatively and total intravenous rescue analgesic consumption by morphine milligram equivalents (MME). Results: Mean VAS scores were significantly lower in group S than in group N throughout the 72-hour postoperative period (p<0.01). Group S showed significantly lower MME at postoperative 72 hours (group N: 108.53, group S: 16.61; p<0.01). Conclusion: SAPB improved immediate postoperative pain control in both the resting and dynamic states and reduced opioid consumption compared to conventional management.

• Journal of Chest Surgery
• /
• 제28권2호
• /
• pp.218-220
• /
• 1995

This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

• Journal of Chest Surgery
• /
• 제55권6호
• /
• pp.485-488
• /
• 2022

Serratus anterior plane block (SAPB) has been used for perioperative pain control during video-assisted thoracoscopic surgery (VATS), and the effects of continuous SAPB have been studied. This procedure is usually performed by the anesthesiologist; however, it could be performed more simply and safely by the thoracic surgeon through the use of meticulous finger dissection to create a space in the deep serratus anterior plane during surgery. We describe 3 cases of surgical catheterization for continuous SAPB in patients with lung cancer during VATS lobectomy, in which postoperative pain was effectively reduced.

• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.148-151
• /
• 1999

This report is a case of 62-year-old man with anterior chest pain and pin pricking pain with allodynia affecting left T5 sensory dermatome for 3 months without history of vesicular skin eruption. He had a history of diabetes mellitus for 10 years and insulin therapy for recent 1 year. EKG, chest PA and rib series were normal. Serologic evaluation of IgG antibody to varicella-zoster virus was positive and was diagnosed as post herpetic neuralgia after zoster sine herpete. He was treated with left T5 nerve root block followed by thoracic epidural blockade and intercostal nerve block for 2 weeks. His VAS score decreased from 10 to 2 after 2 weeks of treatment. After 3 months, he revisited our clinic complaining right side chest pain followed by vesicular skin eruption 8 days after the onset of pain. He was treated as herpes zoster and tolerates well after 4 months.

• 한국전문물리치료학회지
• /
• 제25권4호
• /
• pp.37-45
• /
• 2018

Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.

• Journal of Chest Surgery
• /
• 제17권3호
• /
• pp.497-504
• /
• 1984

The malignant germ cell tumor found in the gonad can originate in the anterior mediastinum. Endodermal sinus tumor[Yolk sac tumor] is a kind of malignant germ cell tumor and is derived from extra-embryonic mesoderm. We experienced a case of primary mediastinal endodermal sinus tumor occurred in 22 year old male patient. His chief complaint was anterior chest pain for 2 days. The tumor located in the anterior mediastinum and invaded upper lobe of the deft lung and pericardium. A left upper lobe resection including phrenic nerve and pericardium was performed and the tumor in the anterior mediastinum was excised. The patient has been treated with combination chemotherapy[Cis-platinum, Vincristine, Actinomycin-D, & Cyclophosphamide} and followed up for 4 months with partial remission.