• Title/Summary/Keyword: diaphragmatic

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Diaphragmatic Hernia as a Complication of Pedicled Omentoplasty (유경 대망이식술의 합병증으로 발생한 횡격막탈장)

  • 윤찬식;정재일;김재욱;구본일;이홍섭
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.968-971
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    • 2001
  • Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.

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Prefrontal Cortex Activation during Diaphragmatic Breathing in Women with Fibromyalgia: An fNIRS Case Report

  • Hyunjoong Kim;Jihye Jung;Seungwon Lee
    • Physical Therapy Rehabilitation Science
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    • v.12 no.3
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    • pp.334-339
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    • 2023
  • Objective: The present study is designed to delve deeper into the realm of fibromyalgia (FM) symptom management by investigating the effects of diaphragmatic breathing on the prefrontal cortex (PFC) in women diagnosed with FM. Using functional near-infrared spectroscopy (fNIRS), the study aims to capture real-time PFC activation patterns during the practice of diaphragmatic breathing. The overarching objective is to identify and understand the underlying neural mechanisms that may contribute to the observed clinical benefits of this relaxation technique. Design: A case report Methods: To achieve this, a twofold approach was adopted: First, the patient's breathing patterns were meticulously examined to detect any aberrations. Following this, fNIRS was employed, focusing on the activation dynamics within the PFC. Results: Our examination unveiled a notable breathing pattern disorder inherent to the FM patient. More intriguingly, the fNIRS analysis offered compelling insights: the ventrolateral prefrontal cortex (VLPFC) displayed increased activation. In stark contrast, regions of the anterior prefrontal cortex (aPFC) and orbitofrontal cortex (OFC) manifested decreased activity, especially when benchmarked against typical activations seen in healthy adults. Conclusions: These findings, derived from a nuanced examination of FM, underscore the condition's multifaceted nature. They highlight the imperative to look beyond conventional symptomatology and appreciate the profound neurological and physiological intricacies that define FM.

Tension Pneumothorax in a Dog with Diaphragmatic Hernia (횡격막허니아에 병발한 긴장성기흉 1례)

  • Kim, Hyunseok;Yun, Soo-kyung;Son, Won-gyun;Jang, Min;Hwang, Hyeshin;Jo, Sang-min;Shin, Chi Won;Kim, Wan Hee;Yoon, Junghee;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.33 no.4
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    • pp.237-242
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    • 2016
  • A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of Seoul National University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatic hernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During the surgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterial blood ($PaO_2$): 52 mmHg, pulse oximetry ($SpO_2$): 87%, arterial hemoglobin oxygen saturation ($SpO_2$): 85.8%). In addition to hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxia and hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure within the thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tube was placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoring with the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothorax is difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothorax should be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.

Delayed Iatrogenic Diaphragmatic Hernia after Left Lower Lobectomy

  • Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.456-459
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    • 2017
  • A 66-year-old patient undergoing regular follow-up at Samsung Medical Center after left lower lobectomy visited the emergency department around 9 months postoperatively because of nausea and vomiting after routine esophagogastroduodenoscopy at a local clinic. Abdominal computed tomography showed the stomach herniating into the left thoracic cavity. We explored the pleural cavity via video-assisted thoracic surgery (VATS). Adhesiolysis around the herniated stomach and laparotomic reduction under video assistance were successfully performed. The diaphragmatic defect was repaired via VATS. The postoperative course was uneventful, and he was discharged with resolved digestive tract symptoms.

Congenital Esophageal Hiatal Hernia in a Cat (고양이에서의 선천성 식도열공허니아 1예)

  • 정성목;정언승;김순영;최성천;손혜정;이충호;양정환;김완희;서민호
    • Journal of Veterinary Clinics
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    • v.18 no.1
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    • pp.61-64
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    • 2001
  • A 1.2 kg, five-month-old, female domestic short-hair cat was referred to Seoul National University Veterinary Medical Teaching Hospital with a history of vomiting immediatley after eating. Clinical signs were depression, anorexia, severe dehydration and vomiting since weaning. According to history taking, physical examination, complete blood count, serum chemical profile and contrast radiographic study, it was diagnosed as congenital sliding esophageal hiatal hernia. Diaphragmatic plication, esophagopexy and left-sided belt-loop gastropexy were performed. Ranitidine (2 mg/kg, IV, q12h) and sucralfate suspension (20 mg/kg, PO, q6h) were administered with low-fat liquified diet to treat reflux esophagitis. Clinical signs related to esophageal hiatal hernia disappeared immediately after surgical treatment and did not recur for 4 months.

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The Imaging Anatomical Consideration and Application of Vocal Technique (Emphasis on the Resonance of the Oral and Pharyngeal Cavity) (발성기법의 영상 해부학적 고찰과 응용 (구강과 인두강 공명을 중심으로))

  • Lee, Dong-Myoung
    • Journal of radiological science and technology
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    • v.22 no.1
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    • pp.35-42
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    • 1999
  • This study was undertaken to take the correct vocal technique(especially about the resonance of oral cavity). The resonance of oral and pharyngeal cavity is the principle which can vocalize well without any abnormal signs in the throat. Therefore it is important for us to understand how to use the correct resonance of oral and pharyngeal cavity. Shimadzu X-ray remote control TV system and Shimadzu magnet $nex-{\alpha}$ (SMT-50CX/H) were used for checking the movements of T-M joint and diaphragmatic respiration. The results obtained were summerized as follows: 1. While opening T-M joint space like the vowel "A" [a], We should vocalize five fundamental vowel [a,e,i,o,u] with diaphragmatic respiration holded. 2. Diminuendo must be expressed by increasing a breath volume while descending a mandible gradually because we can not ascend maxilla. So we can make a delicate expression. 3. The resonance of oral cavity must be scattered by elevating the soft palatine lightly with relax of throat.

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A case of bochadalek hernia in adult (성인에서 발생한 Bochdalek Hernia 수술치험 1예)

  • 권우석
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.331-334
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    • 1986
  • Bochdalek hernia in adult is relatively uncommon. We experienced a surgical case of Bochdalek hernia in a 29 year old housewife. She was admitted via E-R due to left chest pain and nausea for 1 months. 5 days before admission, she had Cesarean section on private hospital. After delivery, nausea and exertional dyspnea were aggravated. On admission, chest PA showed herniated stomach, colon, small intestine on left thorax. She was diagnosed of diaphragmatic hernia and operated. Operative findings were as follows: 1. hypoplastic: lower lobe of left lung, 2. stomach, colon, small intestine, spleen were herniated, 3. the defect was located on posterolateral portion of diaphragm, measuring 10 x 8 cm in size. Herniated intestines were reduced and diaphragmatic defect was repaired as interrupted sutures with 2-0 Mersilene. Postoperative courses were uneventful and the patient was discharged on POD 10th.

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Traumatic Diaphragmatic Injuries - A report of 23 cases - (외상성 횡격막 손상: 23례 보고)

  • 최세영
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.197-201
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    • 1991
  • Twenty-three patients with traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center from Aug. 1978 to Nov. 1990 were reviewed. There were 19 male and 4 female patients. The age distribution was ranged from 1.5 to 72 years, with a mean age of 34.3 years. Sixteen patients had blunt trauma[traffic accident 14, fall down 2], and 7 had penetrating injuries[stab wound 6, broken glass 1]. Sixteen [70 percent]of the injuries occurred on the left side and 7[30 percent] on the right side. Fifteen patients were operated on during the acute phase, 5 patients during the latent phase, 2 patients during the obstructive phase. The surgical approach in 20 patients was through a thoracotomy; in 2 patients, a thoracoabdominal incision was necessary, and in 1 patient, a laparotomy was performed. Herniated organs in thorax included stomach[10], colon[5], small bowel[5], spleen[4], liver[2]. Postoperative complications included wound infection, empyema, pneumonia, hepatitis and respiratory failure. There were 3 postoperative deaths, 2 with cerebral dysfunction and 1 with sepsis.

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