• Journal of Chest Surgery
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• v.21 no.1
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• pp.175-183
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• 1988

Congenital diaphragmatic hernia [CDH] is a surgical emergency in the newborn infant because it causes severe cardiorespiratory distress. Congenital diaphragmatic eventration [CDE] may also produce severe cardiorespiratory distress in the newborn infant. CDH is an anatomically simple defect that can be easily repaired by reduction of the displaced viscera from the pleural cavity and closure of the diaphragmatic defect. But these infants mortality has not been reduced and still remains very high. The barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. Between May, 1985 and Oct, 1987, 4 neonates with CDH and 1 neonate with CDE were seen in respiratory distress within 12 hrs of birth at St. Francisco general hospital. Each had severe acidosis and hypoxia. And was transferred from a local clinic. They were surgically repaired within 24 hrs of birth. Three neonates lived and two died. Two of the three neonates with CDH operated in the first 6 hrs died. The remaining two [one with CDH, the other with CDE] operated between 6hrs and 24 hrs lived. One case of mortality was combined with bilateral pulmonary hypoplasia and contralateral pneumothorax. The other one case of mortality was combined with complex syndrome of persistent fetal circulation after honeymoon period.

• Journal of Veterinary Clinics
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• v.25 no.1
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• pp.58-63
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• 2008

Peritoneopericardial diaphragmatic hernia(PPDH) is uncommon and congenital disease in dogs and cats. In PPDH, the peritoneal organs such as liver, small intestine, stomach and omentum are displaced into the congenital defect between pericardial sac and diaphragm and cause the abnormal round and enlarged cardiac silhouette. Abnormal cardiac silhouette contacts with the cranial diaphragmatic border consistently and soft tissue- and/or gas- density structures are summated over the cardiac density in radiography. The contrast medium flows from peritoneal cavity into the pericardial sac and demonstrates the herniated abdominal organs and the abnormal defect in positive peritoneography. In this study, 4 dogs was diagnosed as PPDH using radiography, peritoneography and thoracic ultrasonography and showed various clinical signs according to the kind, amount and clinical state of herniated abdominal organs.

• Tuberculosis and Respiratory Diseases
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• v.61 no.1
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• pp.80-82
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• 2006

Herpes zoster is well-known viral disease in immune compromised that produces inflammatory lesions in the posterior root ganglia and is characterized clinically by pain and skin eruptions along the distribution of the affected ganglia. However, motor involvement after a herpes zoster is an uncommon complication. We report a case of diaphragmatic paralysis that occurred after a herpes zoster in 63-year-old woman. The diaphragmatic paralysis occurred one month after the typical herpes zoster eruptions affecting the C3 and C4 dermatomes in the right neck, shoulder and back area.

• Investigative Magnetic Resonance Imaging
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• v.25 no.4
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• pp.338-344
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• 2021

Solitary fibrous tumors (SFT) are rare mesenchymal tumors that most commonly develop in the pleura; they rarely involve the diaphragm. MRI has not been widely used to evaluate SFTs of the thoracic cavity, though it may be highly useful in assessing local invasion, predicting malignant potential, and helping in the differential diagnosis. However, MRI findings of malignant SFTs of the diaphragmatic pleura have been described in only two cases. We report a rare case of a malignant solitary fibrous tumor of the diaphragmatic pleura in an 82-year-old man. We describe the clinical and characteristic imaging features, including computed tomography, conventional MRI, and diffusion-weighted imaging. Contrast-enhanced MRI is more accurate than is CT in identifying the origin of SFTs, predicting whether they ae benign or malignant, and assessing local invasion. This imaging modality proved helpful in deciding on the treatment strategy for these rare tumors.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.166-170
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• 2023

Diaphragmatic reconstruction is required for extensive diaphragmatic defects associated with tumor resection. Methods using artificial mesh and autologous tissues, such as pedicled flaps, have been reported predominantly for diaphragmatic reconstruction. We present the case of a 61-year-old woman who presented with a 14×13×12 cm tumor in the abdominal cavity of the upper left abdomen on computed tomography. The diaphragm defect measuring 12×7 cm that occurred during excision of the malignant tumor was reconstructed using the rectus abdominis muscle and fascial flap. The flap has vertical and horizontal vascular axes; therefore, blood flow is stable. It also has the advantage of increasing the range of motion and reducing twisting of the vascular pedicles. Fascial flap does not require processing such as thinning and can be used during suture fixation. This procedure, which has rarely been reported so far, has many advantages and may be a useful option for diaphragm reconstruction.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.210-219
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• 2019

Purpose: Traumatic diaphragmatic injury (TDI) is no longer considered to be a rare condition in Korea. This study investigated differences in the prevalence of accompanying injuries and the prognosis in patients with traumatic diaphragmatic damage according to the mechanism of injury. Methods: We retrospectively reviewed the medical records of patients with TDI who were seen at a regional emergency medical center from January 2000 to December 2018. Among severe trauma patients with traumatic diaphragmatic damage, adults older than 18 years of age with a known mechanism of injury were included in this study. Surgery performed within 6 hours after the injury was sustained was defined as emergency surgery. We assessed the survival rate and likelihood of respiratory compromise according to the mechanism of injury. Results: In total, 103 patients were analyzed. The patients were categorized according to whether they had experienced a penetrating injury or a blunt injury. Thirty-five patients had sustained a penetrating injury, and traffic accidents were the most common cause of blunt injuries. The location of the injury did not show a statistically significant difference between these groups. Severity of TDI was more common in the blunt injury group than in the penetrating injury group, and was also more likely in patients with respiratory compromise. However, sex, the extent of damage, and the initial Glasgow coma scale score had no significant relationship with severity. Conclusions: Based on the findings of this study, TDI should be recognized and managed proactively in patients with blunt injury and/or respiratory compromise. Early recognition and implementation of an appropriate management strategy would improve patients' prognosis. Multi-center, prospective studies are needed in the future.

• Advances in pediatric surgery
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• v.6 no.1
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• pp.1-9
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• 2000

Despite of advances in perinatal management and treatment modalities congenital diaphragmatic hernia(CDH) remains a frustrating problem. Although the sheep has proven to be a reliable experimental model for the production of intrauterine CDH, the rabbit may have some advantages. These include lower cost, smaller body size, year-round availability, high number of fetuses per pregnancy, and short gestational period. To evaluate the feasibility of the rabbit model of CDH, twenty-seven pregnant New Zealand rabbits were utilized. Hysterotomy and an operative procedure for creating a diaphragmatic defect on gestational day 24 or 25, in two fetuses of each pregnant rabbit were performed. In one fetus of one cornu of the uterus, the left fetal diaphragm was excised through an open thoracotomy(DH group). In another fetus in the other cornu, CDH was created and the trachea clipped(Surgiclip, USSC, Norwalk, Conn., USA) (TL group). Delivery was by Cesarean section on 30 days of gestation. Among twenty- seven pregnant rabbits, 12 in the DH group and eight in the TL group were born alive. The most common herniated organ was the left lobe of the liver. In thee DH group, the lungs were hypoplastic with decreased lung weight/body weight ratio, reduced numbers of alveoli, thicker media of the pulmonary arteries, and immature alveoli. In TL group, the alveoli were more mature and did not differ from the control animals. In conclusion, (1) pulmonary hypoplasia develops in the fetal rabbit diaphragmatic hernia model and (2) simultaneous tracheal ligation prevents pulmonary hypoplasia.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.203-211
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• 2021

Purpose : It was to compare changes in respiratory function (pulmonary function, inspiratory function) after four weeks of inspiratory muscle strengthening training (diaphragmatic breathing with upper arm exercise, Power-Breathe breathing) for 36 healthy people. Methods : Subjects were randomly assigned to diaphragmatic breathing with upper arm exercise (Group I) and Power-breathe breathing (Group II) was conducted by the protocol for four weeks five times per week. As the main measurement method for comparison between groups For pulmonary function, Forced Vital Capacity (FVC) and Forced Expiratory Volume at One second (FEV1) were used, and for inspiratory function, Maximum Inspiratory Capacity (MIC), Maximum Inspiratory Pressure (MIP), and Maximum Inspiratory Flow Rate (MIFR) were used. Results : In changes in pulmonary function between groups, FVC and FEV₁ showed no significant difference, and in inspiratory function changes, MIC showed no significant difference, but in MIP and MIFR, Group B significantly improved over Group A. Conclusion : The progressive resistance training using the Power-breath device applied to the inspiratory muscle did not show a significant difference in the increase in the amount of air in the lungs and chest cage compared to the diaphragmatic breathing training accompanied by the upper arm exercise. However, by increasing the air inflow rate and pressure, it showed a more excellent effect on improving respiratory function.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.154-157
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• 1980

A twenty three year old, Primigravida and 32 week pregnant woman who has been complained dyspnea, chest pain, nausea and vomiting was admitted to this chest surgical department on Feb. 19, 1979. Physical findings were those of acutely ill appearance, decreased thoracic excursion and absence of breath sounds in the left hemithorax. Roentgen examination of the chest revealed reticular cystic densities in the left, particularly in lower lung field with collapse of the left lung. Correction of the diaphragmatic hernia was carried out with reduction and repair of the hernia through transperitoneal approach. On exploration, the defect of the diaphragm was 12 x 12 cm in size and was located posterolateral area of left diaphragm. Hernia contents were stomach, spleen, omentum and splenic flexure of large bowel. The baby was normal full term spontaneous delivered at 36th POD. Diaphragmatic hernia complicated by pregnancy is a rarity and mortality is extremely high. Therefore, the literatures have reviewed and the case is reported.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.97-101
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• 1978

Primary cyst of the diaphragm is a rather uncommon disease. This is a report of a case of diaphragmatic cyst, located in the tendinous portion of the right diaphragm. The patient had no specific symptoms in the respiratory systems, but suffered from gastrointestinal symptoms [indigestion, epigastralgia, and loss of appetite etc.] for 2 months. Accidentally, on a simple chest x-ray examination, a round homogenous mass density was discovered. Tomography showed a well circumscribed parenchymatous mass. So a coin lesion in the medial segment of the right lower lobe was suspected. A thoracotomy was performed. There were no pathological findings in the lung and pleura. A ping-pong ball sized round mass, which was soft, elastic and fluctuated,was noted in the tendinous portion of the diaphragm. It was enucleated completely without diaphragmatic rupture, and diagnosed as a primary diaphragmatic cyst [fibrous-walled] by the histopathologic examination. Postoperative course was uneventful.