• Title/Summary/Keyword: Transverse abdominal

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The Effect of Ultrasound-guided TAPB on Pain Management after Total Abdominal Hysterectomy

  • Gharaei, Helen;Imani, Farnad;Almasi, Fariba;Solimani, Massoud
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.374-378
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    • 2013
  • Background: Incisional pain is particularly troublesome after hysterectomy. A method called transversus abdominis plane block (TAPB) has shown promise in managing postoperative pain. In this study, we evaluated the analgesic efficacy of ultrasound-guided TAPB after hysterectomy at different time points and at each time point separately for 48 hours. Methods: Forty-two patients (ASA I, II) who were electively chosen to undergo total abdominal hysterectomy were divided into 2 groups, control (group C) and intervention (group I). Twenty-one patients underwent TAPB (group I) and 21 patients received only the standard treatment with a fentanyl pump (group C). Both groups received standard general anesthesia. For patients in group I, following the surgery and before emergence from anesthesia, 0.5 mg/kg of ropivacaine 0.2% (about 20 cc) was injected bilaterally between the internal oblique and transverse abdominis muscles using sonography. Pain scores using the Visual Analogue Scale (VAS) and drug consumption were measured at 2, 6, 12, 24, and 48 hours after TAPB. Results: There were no significant differences in demographics between the two groups. VAS scores appeared to be lower in group I, although there was no interaction with time when we compared mean VAS measurements at different time points between group I and group C (P > 0.05). The amount of fentanyl flow was consistently higher in group C, but when we compared the two groups at each time point separately, the observed difference was not statistically significant (P < 0.053). The incidence of vomiting was 10% in group I and 28% in group C. There were no complaints of itching, and sedation score was 0 to 3. There were no complications. Conclusions: This study showed that TAPB did not result in a statistically significant decrease in VAS scores at different time points. TAPB did lead to decreased fentanyl flow, but when we compared the two groups at each time point separately, the observed difference was not statistically significant.

Colon Perforation in Hyperimmunoglobulin E Syndrome - A Case Report - (Hyperimmunoglobulin E 증후군에서의 결장천공 - 증례보고 -)

  • Oh, Jung-Tak;Kim, In-Gyu;Han, Seok-Joo;Kim, Ho-Guen;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.151-155
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    • 1996
  • Hyperimmunoglobulin E syndrome is a relatively rare primary immunodeficiency syndrome characterized by recurrent infection, abscess formation and marked elevation of serum IgE level. The common infectious organism is Staphylococcus aureus and recurrent infection indicates some defects in the immunologic system. Although the infection can affect various organs, gastrointestinal tract involvement is rare and only one case of colon perforation has been previously reproted. Herein we report another one case of colon perforation which ocurred in an 8-year-old girl with hyper immunoglobulin E syndrome. The patient was admitted to the hospital due to an abscess on right neck. The diagnosis of hyper immunoglobulin E syndrome was made because she had eczematoid dermatitis on the face, pneumatocele on left upper lung field and markedly elevated serum IgE level(>15,000 IU/ml) with a past histories of frequent scalp abscesses and otitis media. Abdominal pain developed on the 13th day of admission and abdominal plain X-ray revealed free air. An exploratory laparatomy was performed and two free perforations of the transverse colon were noted. Segmental resection and double barrel colostomy were performed. Colostomy closure was done 4 month later and she had no gastrointestinal problem during a follow up period of 15 months.

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Comparison of Abdominal Muscle Thickness Using Ultrasound Imaging During Bridging Exercises With a Sling and Ball in Healthy Young Adults

  • Moon, Young;Choi, Jong-duk
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.87-92
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    • 2020
  • Background: Bridging exercises are used to enhance the functional stability of the lumbopelvic region in clinical settings. Although most of the studies on bridging exercises have compared the complete activation of the trunk muscles, some recent studies have examined the functional stability of the trunk and the lumbopelvic region and assessed the appropriate recruitment of the local and global muscles during different task levels. Objects: The purpose of this study was to investigate the changes in muscle thickness in the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles during a common bridging exercise on an unstable surface and to determine whether these changes differ based on the surface used. Methods: Twenty-five healthy young adults (8 males, 17 females) were recruited. The subjects were randomly assigned to either the exercise progression with a sling bridge group or the ball bridging exercise progression group, each with three stages of increasing difficulty. Each position was measured three times with an ultrasonic diagnostic imaging system, and the mean values were recorded for analysis. Results: No significant differences were observed between the TrA, IO, or EO muscle thickness ratios between the sling and ball exercise groups (p > 0.05). There were also no significant differences in the EO muscle thickness ratios between the tasks irrespective of whether the sling or ball was used. However, the TrA and IO thickness ratios in both groups were significantly greater during stages 2 and 3 compared to stage 1. Conclusion: The results suggest that the use of slings and balls during bridging exercises is effective in activating the deep abdominal muscles.

The Effect of Application of a Non-Elastic Fixation Belt on the Balance Ability and Fall Prevention in Elderly Women (비탄력 고정식 벨트가 노인 여성의 균형능력과 낙상예방에 미치는 영향)

  • Lee, Jang-Tae;Chon, Seung-Chul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.2
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    • pp.398-404
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    • 2017
  • The aim of this study was to determine the effect of a non-elastic fixation belt on the balance ability and fall prevention in elderly women. Elderly women experience reduced balance ability and an increased risk of falls due to a weakening of the surrounding sacroiliac joint and pelvic muscles during childbirth and menopause. On the other hand, specific studies are still needed. The subjects were allocated randomly to two groups: control (n=20) and experimental (n=20). The experimental group used a non-elastic fixation belt, whereas the control group had no fixation belt. The balance ability and the fall index were measured in all subjects using a balance measurement device, and the low abdominal muscle thickness was determined in the experimental group using ultrasound imaging for the exact application of the non-elastic fixation belt. The following statistical analysis was performed: an independent t-test for the general characteristics of the subjects, $2{\times}2$ analysis of variance with repeated measures for the balance and fall index score, and a paired t-test for the abdominal muscle thickness. The group ${\times}$ time interaction effect showed significant improvement in the General Stability Index (F1,38=47.24, p=0.001), Fourier Harmony Index (F1,38=88.83, p=0.001), Weight Distribution Index (F1,38=50.21, p=0.001), and Fall Index (F1,38=21.59, p=0.001). The thicknesses of the transverse abdominal (p=0.001) and internal oblique (p=0.001) muscles were increased significantly in the experimental group after using the non-elastic fixation belt. Overall, the application of a non-elastic fixation belt could be effective in improving the balance ability and fall prevention in elderly women.

Radiographic Measurements of Normal Spleen Size in Dogs (개에서 정상 비장크기의 방사선학적 계측)

  • Choi, Ho-Jung;Lee, Young-Won;Lee, Kyung-Woo;Wang, Ji-Hwan;Jung, In-Jo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.584-587
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    • 2007
  • The purpose of this study was to estimate the standard of normal spleen size and its variations in relation to age, body weight(BW) and 1st lumbar vertebra($L_1$) length using radiographs. The Maximum transverse length (MTL) and maximum vertical length(MVL) of the spleen were obtained from ventrodorsal abdominal radiographs of 134 dogs which underwent radiography for indications unrelated to splenic disease. Splenic size did not significantly correlated with the age. MTL and MVL increased with BW according to the nonlinear correlation. Also, MTL and MVL increased with $L_1$ length according to the linear correlation.

Correlations of Symmetry of the Trunk Muscle Thickness by Gender with the Spinal Alignment in Healthy Adults

  • Lim, Jae-Heon
    • The Journal of Korean Physical Therapy
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    • v.25 no.6
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    • pp.405-410
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    • 2013
  • Purpose: Most studies have reported that the abdominal muscle thickness differs according to gender but none of these studies reported a gender difference in the thickness of the multifidus and erector spine. The spinal alignment is affected by the left and right balance in the trunk muscle. The aim of this study was to identify the trunk muscle symmetry according to gender and the correlations of the trunk muscle thickness with spinal alignment. Methods: Forty three subjects(27 males and 16 females) were enrolled in this study. The trunk muscle thickness was measured by ultrasonography. The trunk muscle, which consisted of the rectus abdominis (RA), external oblique abdominis (EOA), internal oblique abdominis (IOA), transverse abdominis (TrA), erector spine (ES), and multifidus (MF), was measured. The spinal alignment was measured by Formetric-III 3D analysis. The dependent variables of the spinal alignment were the trunk imbalance, trunk inclination, lateral deviation, and surface rotation. Results: The muscle thickness of the EOA muscle increased more significantly in the right side than the left side (p<0.05). Each left and right difference in the muscle thickness between the male and female group showed a significant difference (p<0.05) except for the TrA thickness. Significant positive correlations were observed between the ES and lateral deviation and between the TrA with trunk imbalance. Conclusion: These results suggest that asymptomatic men have a greater trunk muscle thickness than women but there was no difference between the left and right in healthy adults. The trunk muscle thickness of ES, TrA is related by the spinal alignment.

Changes in Abdominal Muscle Thickness and Balance Ability on Plank Exercises with Various Surfaces

  • Kang, Kyung-Woo;Son, Sung-Min;Ko, Yu-Min
    • The Journal of Korean Physical Therapy
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    • v.28 no.5
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    • pp.264-268
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    • 2016
  • Purpose: This study was conducted to investigate the effects on muscle thickness and balance ability after performing plank exercise on various surface types. Methods: In this study, there were thirty healthy participants. Participants were randomly distributed into three groups, a control group (n=10), sling group (n=10), and ball group (n=10). All participants performed plank exercises three times a week for four weeks. Plank exercises consisted of five sets of 30 seconds each with a one minute break between each set. Muscle thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) was measured using an ultrasound diagnostic apparatus and balance was measured using I-balance. Results: Evaluation of muscle thickness revealed that the IO and EO muscle of the ball group changed significantly relative to the control group (p<0.05). However, there were no significant changes in balance. Conclusion: The results revealed that performing plank exercise on a ball is more effective among various types of surfaces.

Microstructural Organization of the Central Nervous System in the Orb-Web Spider Araneus ventricosus (Araneae: Araneidae)

  • Park, Yong-Ki;Moon, Myung-Jin
    • Applied Microscopy
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    • v.43 no.2
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    • pp.65-74
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    • 2013
  • Although the geometrical difference in body position between web-building and wandering spiders could affect the organization of their central nervous system (CNS), however most of our informations about spider's CNS are dependent on those revealed from the wandering spiders. Therefore, this paper describes microstructural organizations of the CNS in the geometric orb-web spider Araneus ventricosus. Similarly to other wandering spiders, the CNS of A. ventricosus is also consisted of a dorsal supraesophageal ganglion and a ventral subesophageal mass. The supraesophageal ganglia are fused together and made up of a large sized nerve cell clusters, whereas the subesophageal ganglia are made up of the foremost part of the ventral nerve cord. It has been revealed that the only nerve arising from the supraesophageal mass was the optic nerve which connected with four pairs of eyes, whereas a pair of pedipalpal and four pairs of appendage nerves including abdominal nerve pairs were arisen from the subesophageal nerve mass. Fibrous masses are highly organized into longitudinal and transverse tracts, and are only consisted of processes of neurons and the terminal ramnifications of peripheral sensory neurons. In addition, central fibrous mass of both the brain and the subesophageal mass are totally devoid of nerve cell bodies.

Transabdominal Augmentation of Contralateral Breast in TRAM Breast Reconstruction (횡복직근 피판을 이용한 유방 재건시 복부 절개선을 통한 반대측 유방 확대술)

  • Kim, Eun Key;Lee, Taik Jong
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.29-32
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    • 2009
  • Purpose: Introduction of the mammary implant through the abdominal route has been well known since late 1960s, but the use of transabdominal route for contralateral breast augmentation in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction patients has not been reported in Korean literature. The authors report their experience with technical points as well as the selection of the appropriate patients. Methods: Simultaneous contralateral augmentation mammaplasty through transabdominal route was performed in 11 patients who underwent TRAM breast reconstruction from August 2003 to May 2008 with a mean follow up of 27 months. The pocket was created under direct vision: 3 subglandular, 7 subpectoral, and 1 dual plane was dissected. Eight saline and 3 silicone gel implants were used with an average volume of 165 cc. Results: There were no complications such as infection, hematoma, implant displacement, and capsular contracture. The result was well maintained throughout the follow up period. Conclusion: Transabdominal route could be recommended in selected patients for contralateral augmentation in TRAM breast reconstruction.

Colon Cancer with Appendiceal Perforation in a 13-year-old Boy (충수염으로 오인된 소아의 대장암)

  • Choi, Myung-Min;Lee, Un-Gi;Jeon, In-Sang;Kim, Hyun-Young
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.189-195
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    • 2008
  • Colorectal cancer is extremely rare in children. Unlike adult colorectal cancer, the overall prognosis of colorectal cancer in children is poor. Delayed diagnosis, advanced stages of the disease at presentation, and mucinous type of histology are the major determinants of poor outcome in childhood. A 13-year-old boy with abdominal pain visited our hospital. Physical examination andabdominal ultrasonography identified acute appendicitis with perforation. He underwent appendectomy and then the pathologic findings revealed mucinous adenocarcinoma. The cancer was located at the transverse colon and had metastases on peritoneal wall at $2^{nd}$ laparotomy. Extended right hemicolectomy was performed. He underwent palliative chemotherapy. After 4 months later, hepatic metastasis and aggravated peritoneal seedings developed. He died of renal failure and pneumonia 13 months after operation. We need to have a high index of suspicion for the possibility of a malignant colorectal tumor in any childhood case with nonspecific signs and symptoms.

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