• Journal of Chest Surgery
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• 제34권12호
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• pp.968-971
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• 2001

유경 대망이식술은 흉부 수술시에 효과적으로 사용되지만 수술 후 몇 가지 합병증을 일으킬 수 있다. 본 교실에서는 65세 남자 환자에서 유경 대망이식술 후 합병증으로 발생한 횡격막탈장 1례를 경험하여 보고한다. 환자는 진균성 하행흉부대동맥류의 대동맥 이식편성형술 시행 3개월 후 발생한 대동맥식도누공으로 흉부동맥류는 절제하고 상행흉부대동맥과 복부대동맥간에 우회술을 시행받고 식도누공을 봉합한 후 유경 대망판을 식도의 봉합부와 대동맥 단락부에 이식하였다. 수술 3년 뒤에 위가 횡격막으로 탈장된 것이 발견되었고 개흉술 실시하에 유경 대망판을 결찰하고 분리한 뒤 횡격막의 결손부위를 봉합하였다.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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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.

• 한국임상수의학회지
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• 제33권4호
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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.

• 대한수의사회지
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• 제41권5호
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• pp.400-412
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• 2005

• Journal of Chest Surgery
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• 제22권2호
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• pp.290-296
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• 1989

• Journal of Chest Surgery
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• 제50권6호
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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.

• 한국임상수의학회지
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• 제18권1호
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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.

• 대한방사선기술학회지:방사선기술과학
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• 제22권1호
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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.

• Journal of Chest Surgery
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• 제19권2호
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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.

• Journal of Chest Surgery
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• 제24권2호
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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.