• 대한한의학회지
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• 제43권1호
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• pp.1-5
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• 2022

Objectives: Using algometer, measure the pressure pain threshold (PPT) of the epigastric pain(心下痞硬) and calculate the cut-off value, and this can serve as the basis for prognostic diagnosis of functional dyspepsia so we would like to evaluate its diagnostic value. Methods: We investigated 353 patients with functional dyspepsia symptoms who admitted Gangnam Weedahm Oriental Hospital from February 1, 2021 to February 27, 2021. At the time of the patient's visit, an oriental medical doctor measured the pressure at the first pain point on the Algometer of (CV14), twice each, at 1minute intervals. The ROC (receiver operating characteristic) curve and the optimal cut-off value derived through the diagnosis of the (CV14) PPT value for epigastric pain(心下痞硬) and the gold standard of oriental medical doctor, it was evaluated through. Results: In 353 patients, the area under the ROC curve (AUC) was 0.909 (p=0). In addition, the optimal cutting value was 10.05 (kg/cm2), which was statistically significant. Additionally, the sensitivity of the Algometer's PPT measurement was 0.704 and the specificity was 0.884. As a result, if the PPT value of the Algometer exceeds 10.05 (kg/cm²) in terms of the optimal cutting value, it can be seen that epigastric pain(心下痞硬) is lost. Conclusion: Algometer's PPT value measurement can be a reliable test method for quantification of epigastric pain(心下痞硬) diagnosis and can be useful as an objective indicator.

• Journal of Trauma and Injury
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• 제25권1호
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• pp.1-6
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• 2012

Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.

• Journal of Trauma and Injury
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• 제20권1호
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• pp.12-18
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• 2007

Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality. Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test. Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<$50,000/mm^3$), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ. Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.

• Physical Therapy Rehabilitation Science
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• 제8권4호
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• pp.225-233
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• 2019

Objective: The purpose of this study was to examine the possible effects of incorporating short-term slow-abdominal respiration (SAR) into an exercise program, on balance and the cardiac-related autonomic nervous system (ANS). Design: Cross-over repeated measures design. Methods: Fifteen young and healthy adults were randomly assigned into two groups (7 in the C-R group, 8 in the R-C group), each of which carried out both control sequence (C) and respiration-experiment sequence (R) in the inverse order. In the C sequence, the subjects performed passive exercises and a general exercise program (P-GEP). In the R sequence, the subjects received a short-term SAR training session and then performed the respiration incorporated general exercises program (R-RGEP). Before and after both C and R sequences, the length and the area of the displacement of the center of pressure (COP) and heart rate variability parameters were measured. Results: The total length of the COP displacement in the left single-leg-standing condition showed a significantly greater reduction after R-RGEP in the respiration-experiment sequence than after the P-GEP in the control sequence (p<0.05). The mean heart rate was significantly reduced only after R-RGEP in the respiration-experiment sequence (p<0.05) Conclusions: The slow-abdominal-respiration, trained in a simple manner and integrated into the exercise program in a single session, showed partially positive immediate effects on balance stabilization. The decrease in heart rate indicated possible involvement of the parasympathetic ANS activation in the stability, although it is not enough to decide whether it is purely due to the controlled respiration.

• Journal of Yeungnam Medical Science
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• 제31권1호
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• pp.25-27
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• 2014

Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.

• Journal of Chest Surgery
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• 제15권4호
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• pp.432-439
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• 1982

Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

• 한방재활의학과학회지
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• 제26권1호
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• pp.103-111
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• 2016

Objectives The waist circumference has been known as an obesity index reflecting the visceral fat. This study was conducted to investigate the obesity index of what can be predicted visceral fat obesity. Methods 121 test subjects who have $BMI{\geq}30$ or BMI 27~29.9 with having more than one high blood pressure, diabetes, and hyperlipidemia were gathered in the Gachon University Korean medical hospital. The relationship between obesity index, the abdominal fat area, and the metabolic syndrome component analyzed using Pearson correlation analysis. The obesity indices, that are largely used in clinics such as waist circumference (WC), HC (hip circumference), body mass index (BMI), waist-hip ratio (WHR) and waist-height ratio (WHtR). Total fat area (TFA), visceral fat area (VFA), subcutaneous area (SFA) and visceral fat/subcutaneous fat ratio (VSR) that was measured from CT. Results 1. Total fat area (TFA) was positively correlated WC, BMI, HC. 2. The subcutaneous fat area (SFA) was positively correlated HC, WC, BMI. 3. The visceral fat area (VFA) did not show a strong correlation with obesity indicators. Conclusions It was found indices of obesity and visceral fat area is a high correlation. BMI, WC was the obesity index showed a high correlation as the SFA, TFA.

• Safety and Health at Work
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• 제3권4호
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• pp.287-293
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• 2012

Objectives: Metabolic syndrome has received attention as a risk factor for cardiovascular disease, with particular importance attached to visceral fat accumulation, which is associated with lifestyle-related diseases and is strongly correlated with waist circumference. In this study, our aim is to propose waist circumference cut-off values that can be used as a marker for fatty liver based on a sample of workers receiving health checkups in Japan. Methods: This study was conducted in a total of 21,866 workers who underwent periodic health checkups between January 2007 and December 2007. The mean age of the subjects was 47.4 years for men (standard deviation [SD]: 8.0) and 44.7 years for women (SD: 6.9). Evaluation included abdominal ultrasound and measurement of waist circumference, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure. Results: Based on receiver operating characteristic curve analysis, the optimal waist circumference cut-off values were shown as 85.0 cm (sensitivity 0.72, specificity 0.69) for men and 80.0 cm (sensitivity 0.75, specificity 0.78) for women. Conclusion: Abdominal ultrasound is the most efficient means of diagnosing fatty liver, but this examination seldom occurs because the test is not routinely performed at workers' health checkups. In people found to have a high risk of fatty liver, recommendations can be made for abdominal ultrasound based on the waist circumference cut-off values obtained in this study. That is, waist circumference can be used in high risk individuals as an effective marker for early detection of fatty liver.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제5권2호
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• pp.186-191
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• 2002

구토, 심한 보챔, 고열, 복수를 동반한 복부 팽만 등 급성 복막염의 양상을 보인 10개월 된 여아에서 복부 천자 후 담즙성 복막염 의심하에 $^{99m}Tc$ DISIDA 간담도 스캔을 시행하여 진단된 총 담관낭의 자연 천공에 의한 담즙성 복막염 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Veterinary Science
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• 제24권3호
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• pp.23.1-23.16
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• 2023

Background: Irritable bowel syndrome (IBS) is a functional bowel disorder (FBD). Objectives: To assess the therapeutic effects of paeoniflorin (PF) on IBS in rats. Method: Sixty male Sprague-Dawley rats were randomly divided into normal, model, positive drug, low-dose PF, medium-dose PF and high-dose PF groups (n = 10). After gavage for 2 consecutive weeks, the effect of PF on abdominal pain symptoms was assessed based on the abdominal withdrawal reflex (AWR) score, fecal water content and pathological changes in colon tissues. D-lactate, interleukin-1β (IL-1β), transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay, and phosphorylated nuclear factor kappa B (p-NF-κB) p65 was detected by Western blotting. The abundance and diversity changes of intestinal flora were explored using 16S ribosomal RNA sequencing. Result: In PF groups, the mucosal morphology of colon tissues was intact, and the glands were arranged neatly and structured clearly, without obvious inflammatory cell infiltration. Compared with the model group, PF groups had significantly elevated pain threshold, and mRNA and protein levels of zonula occludens-1 (ZO-1) and occludin, decreased AWR score at 20 mmHg pressure, fecal water content, mRNA levels of IL-1β, TGF-β, and TNF-α, protein level of p-NF-κB p65 and level of serum D-lactate, and reduced levels of serum IL-1β, TGF-β, and TNF-α (p < 0.05, p < 0.01). PF groups had higher abundance of Lactobacillus, Akkermansia, Alistipes, and Bacteroides, but lower abundance of Desulfovibrio, Parasutterella, and Enterococcus than those of the model group. Conclusions: PF exerts therapeutic effects on IBS in rats probably by regulating the intestinal flora, and then up-regulating the expressions of ZO-1 and occludin in colon tissue while down-regulating the levels of IL-1β, TGF-β, TNF-α, D-lactate and p-NF-κB p65.