• Journal of Chest Surgery
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• v.28 no.12
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• pp.1167-1173
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• 1995

We evaluated fifty three cases of traumatic diaphragmatic injuries that we have experienced from Jan.1973 to Oct.1994. The age distribution of the pateint was ranged from 1 to 74 years. Sex ratio is 39:14 with male dominence. The traumatic diaphragmatic injuries were due to blunt trauma in 37[Left 22, Right 15 cases and penetrating trauma in 16[Left 9, Right 7 cases. In blunt trauma, Preoperative diagnosis of the diaphragmatic injuries was possible in 27 patients[72% , and in penetrating trauma, 14 patients[88% . Among 37 in blunt traumas, 22[58% cases, and among 16 in penetrating traumas, 13[88% cases were operated within 24 hours. The most common herniated abdominal organ in the thorax was stomach[14/53 . The traumatic diaphragmatic repair of 50 cases were performed by thoracic approach in 23 cases, thoracoabdominal approach in 8 cases and abdominal approach in 19 cases, and in 3 cases, not operated. Hospital mortality [including not operated patients[3 was 17%[9/53 and the causes of death were intracranial hematoma[1 , hypertensive encephalopathy[1 and asphyxia[1 , and among operated patients[6 , combined head injury[2 , multiorgan failure[2 , hypovolemic shock[1 , and pulmonary edema & renal failure[1 . All deaths had related to the severity of associated injuries.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.1
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• pp.14-22
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• 2003

Purpose: To improve self-management in elderly people with hypertension, the researcher examined the effects of an abdominal relaxed breathing exercises using biofeedback on blood pressure. These exercises regulate physical response to stress and lessen the activity of sympathetic nerves. Method: A single-experimental pre-and post-test design was used. Eight elderly people with hypertension participated in the study from April, 6 to June, 14, 2000. Biofeedback was done with soft ware by developed by J & J Company (1-410 form for abdominal respiration training). The abdominal relaxed breathing exercises are based on Mason's suggestion (1985) and were modified by Yu & Song(2001). This program consisted of 4 sessions once a week for four weeks. Data were analysed using SPSSPC+(10.0). Result: There was a significant decrease in systolic and diastolic blood pressure over three different times. There was a significant difference in the level of total stress response, overall health and quality of life but no significant difference in the level of emotional condition over three different times. Conclusion: The results of this study will contribute to the development of nursing strategies for the regulation of blood pressure in older people as the exercises are easy to learn and are a nonpharmacologic approach.

• The KIPS Transactions:PartB
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• v.10B no.2
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• pp.197-204
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• 2003

Because most conventional systems of medical diagnosis focus on small subsets of classes of diseases of particular human organs, it is difficult to diagnosis when dealing with symptoms are related to many diseases. The author proposes an intelligent diagnosis system for diseases associated with acute abdominal pain based on fuzzy relational products (IDS-DAAP) to implement conventional system (DS-DAAP). Compared with DS-DAAP, new approach with IDS-DAAP shows that the system proposed here improves diagnosis rate and reduces diagnosis time.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.87-94
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• 1999

Backgroud: We have performed the CT-guided celiac plexus block (CPB) using anterior approach to evaluate the safety and efficacy of the procedure and to determine the role of CT. Methods: CPB were done in 10 patients (5 men and 5 women: mean age, 58.1 years) with intractable upper abdominal pain due to terminal malignancy of the stomach (n=3), pancreas (n=4), gallbladder (n=2), and liver (n=1). To permit an anterior approach, patients lay supine on the CT scan table during the procedure. One 21-guage Chiba needle was placed just anterior to the diaphragmatic crus between the celiac and superior mesenteric arteries and 10~12 ml of dehydrated alcohol was injected. Degree of pain relief following the procedure was assessed and pain was graded on a numeric rating scale (NRS) from 0 to 10. Results: The results suggest a direct relation between the degree of celiac invasion and the response to the CPB. With CT guidance, it is possible for us to direct the needle into more accurate region, allowing alcohol to be deposited in specific ganglion area. Conclusions: CT-guided CPB using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT-guidance allowed precise needle placement and safe procedure. Careful classification of cases is important to predict the degree of pain relief using the grading system based on the degree of involvement of the celiac plexus.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.287-292
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• 1976

This is a report of a case of congenital esophageal hiatus hernia, occurring in a younger child at the age of one year and two months. The child was suffered from vomiting (intermittently coffee-ground vomitus or blood-flecked vomitus), coughing, and high fever for about 3 months.Diagnosis was confirmed by the radiologic barium study of the gastrointestinal tracts. The herniated organs were entire stomach and a part of the transverse colon. They were located in the right chest. The etiologic pathology was mainly congenital developmental defect of the musculature of the diaphragm, forming the posterior margin of the esophgeal hiatus, and additionally slight shorted esophagus. After reduction of herniated organs back to the abdominal cavity through abdominal approach, herniorrhaphy was performed through transthoracic approach with modified Allison's procedure. At the same time, any associated anomalies, such as hypertrophic pyloric stenosis, were not seen. Postoperative course was uneventful.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.722-725
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• 2007

Morgagni's hernia constitutes about 3% of all the congenital diaphragm hernias. It is usually asymptomatic and it is frequently found coincidentally during routine diagnostic testing in adulthood. It is usually diagnosed by simple chest X-ray, but when this condition is without intestinal herniation, then chest CT or other modalities are necessary. Operative repair is desirable when there is the risk of strangulation of the intestine. The trans-thoracic or trans-abdominal approaches are possible to treat this malady. We report here on one case for which we successfully used a laparoscopic approach to treat this problem.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.34-40
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• 2009

Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.169-173
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• 1997

Cerebrospinal fluid (CSF) rhinorrhea usually occurs as a result of trauma including operation. Unheated CSF rhinorrhea may induce major morbidity such as meningitis and brain abscess, etc. This paper presents a review of four cases of traumatic CSF rhinorrhea Sites of CSF leakage were easily found out by intrathecal fluorescent dye injection. Surgery was performed by external ethmoidectomy approach and dural tear and bone defect was repaired with abdominal fat and free mucosal graft taken from amputated middle turbinates. We conclude that repair using free fat and mucosal graft via external ethmoidectomy approach could be accepted as the intial method of CSF rhinorrhea management.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.34-39
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• 2010

Purpose : The purpose of this study is to find out the evidence concerning the effectiveness of manual therapy intervention in the treatment of low back pain related to spondylolisthesis Methods : 12men with lumbar pain from L5~S1 spondylolisthesis of 2 or 3 grade were treated during 12-week period. The manual therapy applied twice per week. The results of back and radiating pain were measured by VAS, and abdominal muscle strength was measured by Power track II. The measurement of degree of slip in spondylolisthesis was confirmed by the lateral view of X-ray and took a measurements of the anterior displacement of a vertebral body in relation to the vertebral below. Results : 1. There was significant decrease in the back and radiating pain.(p<0.05) 2. There was significant increase in the abdominal muscle strength.(p<0.05). 3. There was significant decrease in the degree of the anterior displacement. Conclusion: The intervention of manual therapy for lumbar spondylolisthesis is effective in back pain, radiating pain, abdominal muscle strength and degree of the anterior displacement. So, nonsurgical treatment should be attempted before surgical treatment.

• The KIPS Transactions:PartB
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• v.11B no.7 s.96
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• pp.855-860
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• 2004

This paper describes knowledge base optimization of an intelligent diagnosis system based on fuzzy relational products(IDS-DAAP) for the diseases with acute abdominal Pain. The knowledge base of IDS-DAAP is composed of the fuzzy rules and the fuzzy membership functions. The author here proposes an advanced intelligent diagnosis system (A-lDS-DAAP) in which the fuzzy rule generation algorithm is applied. Comparing with previous IDS-DAAP and IDS-DAAP-NN, a modified approach with A-IDS-DAAP shows that it improves the diagnosis rate and reduces the time to diagnose.