• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.19-25
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• 2023

Objective: Patients with scoliosis complain of various symptoms such as muscle imbalance, dysfunction, back pain, abnormal posture and gait abnormality. The most basic treatment for scoliosis is to observe the progress based on conservative treatment. Therefore, in this case report, the effect of cytoskeletal manual therapy (CMT), a soft tissue mobilization technique, on pain intensity, muscle thickness, and pressure pain threshold (PPT) in a patient with scoliosis was investigated. Design: A case report Methods: A 25-year-old male diagnosed with scoliosis visited the Neuromusculoskeletal Science Laboratory with chronic back pain. In the laboratory, scoliosis was confirmed through the X-ray image used for his diagnosis, and it was confirmed again through Adam's forward bending test. Pain, pressure pain threshold and muscle thickness were measured to compare the immediate effects of CMT applied in the laboratory for 40 minutes. Treatments were visited two weeks after the first visit and outcome measures were assessed after a total of two visits. Results: After receiving CMT up to the second session, the pain intensity decreased by 4 points and the screening angle decreased by 15 degrees. Muscle thickness decreased in all but 10 mm on the dominant side of the thoracic spine. All of the PPTs increased, and the greatest increase was 3.1 lb on the dominant side of the thoracic spine. Conclusions: CMT showed positive improvement in pain during trunk flexion, spinal curvature, muscle imbalance, and pressure pain, which is considered as an ancillary treatment option for scoliosis management.

• Journal of Chest Surgery
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• 제13권4호
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• pp.496-496
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• Journal of Chest Surgery
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• 제13권4호
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• pp.503-506
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• 대한물리치료과학회지
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• 제2권2호
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• pp.545-562
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• 1995

The purpose of this paper was to provide the understanding of theory, technique, clinical use about arthro kinematic approach. Difference between AKA and Joint mobilization was seen through Table 1, and the relation between AKA and Athro kinematics was seen through Table 2. Examples of AKA techniques were as follow ; 1. Cervical intervertebral joint, left $C_{2/3}$ 2. Thoracic intervertebral joint, left $T_{5/6}$ 3. Sacroiliac joint, left (1) Nutation-upward gliding (2) Nutation-downward gliding (3) Superior distraction (4) Inferior distraction 4. 1st. costovertebral joint, left 5. 2nd. sternocostal joint, left 6. AKA-streching exercise 7. AKA - resistive exercise Symptoms, diagnosis, treatment were discribed for clinical use, and they were expected further that clinical application of AKA might clarify many of joint dysfunction.

• Journal of Chest Surgery
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• 제28권6호
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• pp.610-618
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• 1995

Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

• Journal of Chest Surgery
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• 제14권4호
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• pp.339-344
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• 1981

Eight patients underwent tracheal resection and reconstruction for tracheostomy and postintubation injuries from 1971 to early 1981. The ages ranged from 12 years to 59 years. The patients had 7-cuff stenosis and one stomal lesion in whom intubated long. Four male and four female patients were treated. Cervical approach was used in one, cervicomediastinal in 3 and transthoracic in four. The longest length of resection extended to 4 cm in whom cervico-upper half mediastinal incision and neck flexion were applied. Techniques for obtaining tension-free anastomosis included cervical flexion or division of the inferior pulmonary ligament and mobilization of the right hilum. Concurrent tracheostomy was not needed in all. There was one death at the end of emergency operation from anesthetic accident. Granulations at the anastomosis line, necessitating bronchoscopy, were noted in two and the lesion did not recurred after removal. No restenosis or other complications occurred during long follow-up.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제9권1호
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• pp.103-107
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• 2006

Belsey Mark IV 위바닥주름술은 이전의 역류 방지 수술이 실패하여 재수술을 해야 하는 경우 혹은 식도 열공 탈장이 오래 되어 유착이 있는 경우에 적응증이 된다. 본 증례는 식도 열공 탈장과 GERD로 진단되어 Nissen 위바닥 주름술을 시행하였으나 실패하였고 재수술을 시도하였지만 수술 부위의 유착이 심하여 수술적 접근이 불가능하였다. 저자들은 흉강을 통하여 Belsey Mark IV 위바닥주름술을 실시하였고, 수술 후 증상과 영양상태의 호전을 보인 1예를 문헌 고찰과 함께 보고하는 바이다.

• 융합정보논문지
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• 제9권12호
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• pp.208-215
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• 2019

본 연구는 깊은목굽힘근운동과 등뼈 관절가동운동이 뇌졸중 환자의 통증, 전방머리자세에 미치는 영향을 알아보고자 한다. 연구대상자는 36명은 사전측정 후 무작위로 깊은목굽힘근군(DNFE), 등뼈 관절가동운동군(TROM), 대조군으로 각각 12명씩 배정되었다. 중재 전후에 통증(VAS), 두개척추각도(CVA), 두개회전각도(CRA), 전방머리내밈자세(FHP), 등뼈관절가동범위(TROM)를 측정하였다. 그 결과. DNFE 군과 TROM 군은 중재 전후 VAS, CVA, CRA, FHP, TROM에서 유의한 차이를 보였으며(p<.05), 두 군은 대조군에 비해 VAS, CVA, CRA, FHP, TROM에서 보였다(p<.05). 결론적으로 깊은목굽힘근운동과 등뼈 가동범위운동이 뇌졸중 환자의 전방머리자세와 목통증 회복에 효과적이었다. 그러므로 임상에서 뇌졸중 환자 중재프로그램에 깊은목굽힘근운동과 등뼈 가동범위운동을 적극적으로 활용되기를 바란다.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1508-1515
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• 1992

Between 1975 and 1992, forty five patients with trachea stenosis received tracheoplasty for relief of obstruction. The causes of airway problem are brain contusion[19 cases, 40%], cerebrovascular disease[3 cases, 7%], drug intoxication[8 cases, 18%], psychotic problem[2 cases, 4%], trachea tumor[3 cases, 7%], adult respiratory distress syndrome[9 cases, 20%] and direct trauma[1 case, 2%]. Direct causes of trachea stenosis were complications of tracheostomy[36 cases, 80%], complications of nasotracheal intubation[5 cases, 11%], tumor[3 cases, 6%] and trauma[1 case, 2%]. Thirty one patients underwent the sleeve resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Forteen patients received the Montgomery T-tube for relief of airway obstruction. Four patients have done simple excision of granulation tissue. Two, subglottic stenosis patients were received Rethi procedure[anterior division of cricoid cartilage, wedge partial resection of lower thyroid cartilage and Montgomery T-tube molding] and the other subglottic stenosis patient underwent permanent trachea fenestration. Including cervical flexion in all patients postoperatively, additional surgical techniques for obtain tension-free anastomosis were hyoid bone release technique in two cases, and hilar mobilization, division of inferior pulmonary ligament and mobilization of pulmonary vessel at the pericardium were performed in one case. Cervical approach was used in 39 cases, cervicomediastinal in 12 cases and transthoracic in one case. Complications of tracheoplasty were formation of granulation tissue at the anastomosis site[3 cases], restenosis[9 cases], trachea-innominate artery fistula[2 cases], wound infection[2 cases], separation of anastomosis[2 cases], air leakage[3 cases], injury to a recurrent laryngeal nerve[temporary 8 cases, permanent 2 cases] and hypoxemia[1 case]. Surgical mortality for resection with primary reconstruction was 6.7%, with one death due to postoperative respiratory failure and two deaths due to tracheo-innominate artery fistula.

• Journal of Chest Surgery
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• 제28권7호
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• pp.671-677
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• 1995

Skeletonization of the internal mammary artery [IMA during myocardial revascularization procedures may provide some advantages, compared with the pedicle graft of the artery. In 17 patients undergoing IMA grafting by skeletonization technique, flow through the artery was measured on mean arterial pressure of 50-55 mmHg immediately after cardiopulmonary bypass started [first flow and just before its anastomosis to left anterior descending artery [second flow . In 16 patients except 1 patient whose graft was injured during mobilization, the first flow of IMA graft was 32.3 $\pm$ 7.4 ml/min and the second flow increased to 59.6$\pm$25.9 ml/min without any treatment and the site for anastomosis of the IMA graft was more than 1.0 cm above the bifurcation. On the basis of previous clinical studies, the flow of the skeletonized IMA was greater than that of the pedicle graft [59.6 $\pm$ 25.9 ml/min versus 37.7$\pm$ 14.1 ml/min, p < 0.05 . In comparison between the skeletonized IMA and the IMA graft intraluminally dilated with papaverine solution, there was no significant difference between two flows[59.6 $\pm$25.7 ml/min versus 74.7 $\pm$31.4 ml/min, not significant , but the former showed longer graft and anastomosis of more proximal portion of the graft to left anterior descending artery. In conclusion, the technique of internal mammary artery skeletonization has consistently produced a satifactory conduit for myocardial revascularization procedures. We have adopted IMA skeletonization not only because of the flow, diameter, and vessel length obtained but also because of limited perivascular tissue disruption that occurs during the dissection.