• Title/Summary/Keyword: Diaphragmatic

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Diaphragmatic Hernia of the Right Hepatic Lobe Mistaken for Diaphragmatic Paralysis in Adult (성인에서 횡격막마비로 오인한 우엽간 횡격막탈장 1예)

  • Park, Jung-Hyun;Hwang, Ki-Eun;Kim, So-Young;Kim, Hak-Ryul;Yang, Sei-Hoon;Kim, Hwi-Jung;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.5
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    • pp.298-300
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    • 2010
  • Diaphragmatic paralysis can be demonstrated through diaphragmatic elevation on chest X-ray after thoracic lung surgery or the placement of chest tubing. Additional causes of diaphragmatic paralysis are iatrogenic, mass, atelectasis, etc. For the diagnosis of diaphragmatic paralysis, it required some studies (fluoroscopy, computed tomography [CT], magnetic resonance imaging). Diaphragmatic hernia of the liver is a rare clinical entity, usually found after trauma in adults. Congenital diaphragmatic hernia in neonates requires surgery. Non-traumatic diaphragmatic hernia of the liver in an adult is a rare right-sided diaphragmatic hernia. On developing any symptoms, surgery must be performed. When diaphragmatic hernia is incidentally found in adults without trauma, it is placed under observation for a time period. We diagnosed the diaphragmatic herniation of a right hepatic lobe by 16-slice CT scan without surgery.

The effect of acute diaphragmatic breathing exercise using DiP Belt on diaphragm motion and forced vital capacity (딥벨트를 이용한 일회성 가로막 호흡운동이 가로막 움직임과 노력성 폐활량에 미치는 영향)

  • Lee, Jae Seok;Kang, Tae Wook
    • Journal of Korean Physical Therapy Science
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    • v.29 no.2
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    • pp.57-65
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    • 2022
  • Background: This study was to determine whether the diaphragmatic breathing exercise using a DiP Belt(Diaphragmatic Pressure Belt) is effective in increasing the diaphragmatic motion and forced vital capacity. Design: Pretest-Posttest design. Methods: A total of 44 subjects(15 male, 29 female) participated in this study. All subjects were measured the diaphragmatic motion with a sonography and the Forced Vital Capacity(FVC) was measured with a digital spirometer. After 4 weeks, the subjects were intervened the diaphragmatic breathing exercise using a DiP belt and were remeasured for diaphragm motion and FVC. Results: After exercise intervention, quiet breathing significantly increased with the change in diaphragmatic motion and showed a moderate effect size (p<.01, Cohen's d = -0.53). In addition, it was significantly increased in deep breathing and showed a high effect size (p<.001, Cohen's d = -1.32). The mean diaphragmatic contraction pressure increased, but there was no significant difference and the peak diaphragmatic contraction pressure increased significantly (p<.05). Both diaphragmatic contraction pressure showed small effect sizes (respectively Cohen's d = -0.28, -0.33). In spirometry, FVC, Forced Expiratory Volume in 1 second (FEV1), and FEV1/FVC% all increased, but there was no significant difference. Only peak expiratory flow increased significantly and showed a small effect size (p<.05, Cohen's d = -0.41). Conclusion: The DiP belt diaphragmatic breathing exercise that the principle of visual feedback can correct diaphragm breathing in a short time, so it is a useful breathing exercise device that can help the diaphragm breathing exercise in the right way in clinical practice.

Effects of Rib Cage Joint Mobilization Combined with Diaphragmatic Breathing Exercise on the Pulmonary Function and Chest Circumference in Patients with Stroke

  • Kim, Ayeon;Song, Youngwha;Hong, Geurin;Kim, Dajeong;Kim, Soonhee
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.3
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    • pp.2113-2118
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    • 2020
  • Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

Clinical evaluation and surgical intervention for diaphragmatic eventration mimicking peritoneopericardial hernia in a cat

  • Min-Jung Ko;Kyoung-Min Song;Hun-Young Yoon
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.19.1-19.6
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    • 2024
  • A 2-year-old spayed female British Shorthair cat presented with an increased frequency and duration of cough since infant period. Based on radiographic, ultrasonographic, and computed tomography findings, peritoneopericardial diaphragmatic hernia was considered so that repair surgery was planned. During celiotomy, lax diaphragm was identified instead of defect. Transabdominal diaphragmatic plication was performed to resolve lax diaphragm and to prevent recurrence by overlapping relatively normal part of diaphragm. Diagnosed with diaphragmatic eventration postoperatively, the cat showed improvement in clinical signs and imaging results. Transabdominal diaphragmatic plication is a suitable treatment; the patient maintained normally during a 14-month follow-up period.

Diaphragmatic eventration: a case report (횡경막 이완증 1례 보)

  • 김송명
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.144-149
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    • 1984
  • Diaphragmatic eventration is a rare condition in primary diaphragmatic diseases and is found rarely in clinical experience. Diaphragmatic eventration means abnormally high position of diaphragm, which is caused acquired, paralytic or congenital, nonparalytic etiologic origins. This report is presented a symptomatic diaphragmatic eventration of 50 years old woman, who had complained coughing and left chest pain since I year ago prior to admission in Kosin Medical College, Gospel Hospital. A patient who had established accurate diagnosis at pre-operative period. There had been post-operative course uneventfully.

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Congenital Diaphragmatic Hernia - 2 cases report - (선천성 횡경막 이완증 2예)

  • 심재영
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.855-858
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    • 1987
  • Eventration of the diaphragm is a rare anomaly, the cause of which still is not understand completely. Recently we were experienced two cases of diaphragmatic eventration which were successfully treated with surgical diaphragmatic plication at the department of thoracic and cardiovascular surgery, college of medicine, chosun university. Specific complication were not noticed after surgical repair of diaphragmatic eventration with good results.

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Effect of diaphragmatic breathing exercise on Activation of trunk muscle of patients with low back pain (복식호흡 운동이 요통환자의 체간근육 활성화에 미치는 영향)

  • Kim, Kyoung;Park, Rae-Joon;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.311-327
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    • 2005
  • The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

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Effect of Diaphragmatic Breathing Exercise on Activation of Lumbar Paraspinal Muscles of Healthy people. (복식호흡 운동이 요부근육의 활성화에 미치는 영향)

  • Kim, Kyoung
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.59-66
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    • 2006
  • Purpose : The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of lumbar paraspinal muscles of normal healthy people. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Methods : Sixty male college students ranging 19 to 34 years were screened and % maximal voluntary contraction(% MVC) of trunk muscles on the four positions of back extension exercise was compared during the pre and post of inspiration of diaphragmatic breathing. Results : 1. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic right arm and left leg extension position(p<0.05). 2. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic left arm and right leg extension position(p<0.05). 3. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying prone extension position(p<0.05). 4. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying on prone position(p<0.05). Conclusion : This study will be used as the purpose of data collection of lumbar paraspinal muscles on diaphragmatic breathing and be introduced as the new therapeutic intervention for management of patients with back pain.

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Role of Bedside Ultrasonography in Assessment of Diaphragm Function as a Predictor of Success of Weaning in Mechanically Ventilated Patients

  • Elshazly, Mostafa Ibrahim;Kamel, Khaled Mahmoud;Elkorashy, Reem Ibrahim;Ismail, Mohamed Said;Ismail, Jumana Hesham;Assal, Hebatallah Hany
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.4
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    • pp.295-302
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    • 2020
  • Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cut-off value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cut-off value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.

A Case of Radiographic and Ultrasonographic Diagnosis of Congenital Peritoneopericardial Diaphragmatic Hernia in a Dog (개에서 선천성 복막 심낭 횡격막 탈장의 방사선학적 및 초음파학적 진단례)

  • 이정민;엄기동;이해운
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.255-258
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    • 2003
  • A 2.5 kg, three-month-old. intact male Shih-tzu was referred to the Veterinary Teaching Hospital of Kyungpook National University to examine the postoperative inflammation and suspected diaphragmatic defect which had been found during the surgical correction of umbilical hernia by the referral veterinarian. An umbilical hernia had been surgically repaired one month earlier at the time. Radiographic findings were enlarged cardiac silhouette containing soft tissue and gas densities and overlapping of cardiac and diaphragmatic borders. Ultrasonographic findings revealed the discontinuity of the diaphragm and the partial herniation of the liver into the pericardial sac. According to these findings, it was diagnosed as congenital peritoneopericardial diaphragmatic hernia(PPDH). Because the dog showed no serious clinical signs of PPDH and the owner didn't want a surgery to correct it, the dog was discharged the day of the examination after treatment of the inflammatory surgical site. On the follow-up after three months, the dog showed no distinct clinical signs of PPDH and was in good physical condition.