• Journal of Chest Surgery
• /
• 제16권2호
• /
• pp.221-225
• /
• 1983

Morgagni, in 1760, 1st. described the findings of substernal herniation of abdominal contents into the thoracic cavity, based upon 25 postmortem dissections. Herniation through the foramen of Morgagni is the rarest occurrence of the congenital diaphragmatic hernias and is usually a few symptoms. With the increasing use of routine chest roentgenogram & the need to exclude the possibility of a mediastinal neoplasm, most such cases are brought to the attention of a surgeon. We had experienced 2 cases of Morgagni hernia, which one caused a simple mechanical intestinal obstruction & diagnosed as acute appendicitis with perforation & another one was diagnosed as mediastinal lipoma on routine chest X-ray film at arrival due to traffic accident. We had performed left paramedian abdominal incision as misdiagnosis of acute appendicitis with perforation and repair of the defect and returned transverse colon & stomach into abdominal cavity in one patient. And in another patient, we preferred to approach through right thoracotomy incision and then left upper paramedian abdominal incision and returned the omentum into the abdominal cavity. The post-operative courses were in uneventful and we report these cases and review and discuss the literatures.

• Journal of Chest Surgery
• /
• 제8권1호
• /
• pp.45-50
• /
• 1975

Eleven cases of traumatic diaphragmatic hernia treated at the department of thoracic and cardiovascular surgery, for the period of seven years up to February 1975, from the base of this report. 1. Peak incidence was found in the age group of one to four years and thirty to forty years, four cases in each group respectively, occupying 63.6% of all cases. 2. In all the lesions the left diaphragm was affected and the herniated organs were in order of frequency the small bowel, the large intestine, the stomach, and the spleen. 3. The methods of the adapted treatment were laparatomy in five, thoracoabdominal approach in four, and thoracotomy in two cases. 4. The mortality rate was low, only one out of eleven died It seems that the immediate appropriate treatment can bring forth the excellent outcome.

• Journal of Chest Surgery
• /
• 제3권2호
• /
• pp.113-120
• /
• 1970

Since the turn of the century there has been a constant search for a satisfactory method of controlling a large intrathoracic space following lobectomy. Primarily these methods consist of thoracoplasty, plombage, and phrenic nerve paralysis which are not completely satisfactory for they may result in loss of chest wall motility or diaphragmatic function. Incising the diaphragm at its periphery and resuturing to the chest wall at a level several rib spaces higher is an effective method of reducing intrathoracic space with minimal interference with pulmonary function. It is of particular value when the anticipated space problem is in the lower part of the thoracic cavity. Five cases are presented in which the diaphragm was peripherally detached and advanced to higher levels. Two cases were following lower lobectomy and three cases were following decortication for chronic empyema in which expansion was not good enough to adequately fill the space. Results in these cases were satisfactory.

• Journal of Chest Surgery
• /
• 제32권3호
• /
• pp.330-332
• /
• 1999

좌측 횡격막 거상증을 가진 40세 여자 환자에게 흉강경을 이용하여 횡격막 주름성형술을 시행하였다. 술후 흉부 X선 사진에서 좌측 횡격막의 하강과 좌측폐의 팽창을 확인할 수 있었다. 횡격막 거상증 환자에게 흉강경을 이용하여 수술하면 최소 침습적 수술이 갖는 여러 장점을 환자에게 제공할 수 있다.

• Journal of Trauma and Injury
• /
• 제32권3호
• /
• pp.176-180
• /
• 2019

The growing use of laparoscopy in elective surgery has led to its increase utilization in emergency surgery. However, the employment of laparoscopy in abdominal trauma is still unusual. Here in we report a case of a patient with blunt abdominal trauma that resulted in a combination of exceptional traumatic lesions, diaphragmatic and bladder lacerations. Both injuries were diagnosed and successfully resolved by laparoscopy. The report of this type of lesions and resolution is extremely rare, being this the second case described in the international literature. This article intends to show that laparoscopy may not only be used as a diagnostic tool, but also as a therapeutic instrument in selected cases of blunt abdominal trauma.

• PNF and Movement
• /
• 제10권3호
• /
• pp.39-44
• /
• 2012

Purpose : This study aims to analyze the effect of abdominal respiration on back pain of an Elementary Schoolchild. Methods : The data was collected from April 9 to April 27. We analyzed the descriptive statistics and paired t-test by SPSS 12.0 for windows. Results : The results of the study were as follow : The comparison of change in visual analogue scale showed effective differences before and after diaphragmatic breathing exercise. Conclusion : Thus, this study indicates that have a positive effect on Back Pain of an Elementary Schoolchild. Further trials, which give attention to these parts, are needed before any firm conclusions may be made.

• 한국컴퓨터정보학회:학술대회논문집
• /
• 한국컴퓨터정보학회 2024년도 제69차 동계학술대회논문집 32권1호
• /
• pp.195-198
• /
• 2024

이 연구의 목적은 EMG 바이오피드백을 이용한 가로막 호흡 재교육 운동이 전방머리자세 성인의 들숨 기능의 효과를 알아보고자 하였다. 이연구 결과 EBDBEG에서 최대들숨압(PIP) 유의하게 증가하였다(P<.0.5). 따라서 바이오피트백을 적용한 시각적 되먹임을 통해 가로막호흡운동 시 보다 정확하게 가로막의 수축과 이완의 움직임을 인지하고 호흡 보조근을 억제를 유도할 수 있을 거라 생각되며 좀 더 장시간의 적용은 호흡기능 및 전방머리자세에도 긍정적인 역할을 할 것이다.

• Advances in pediatric surgery
• /
• 제17권2호
• /
• pp.179-187
• /
• 2011

Experimental tracheal ligation (TL) has been shown to reverse the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and to normalize gas exchange. The purpose of this study was to determine whether the TL would correct the surfactant deficiency present in the fetal rabbit model of CDH by using lamellar body count. Lamellar bodies are synthesized and secreted by the type II pneumocytes of fetal lung. The phospholipids present in these bodies constitute the major component of pulmonary surfactant. Twenty-one pregnant New Zealand rabbits underwent hysterotomy and fetal surgery on gestational day 24. Two fetuses of each pregnant rabbit were operated. In the fetus of one end of bicornuate uterus, left DH was created by excision of fetal diaphragm through open thoracotomy (DH Group). In the fetus of the other end of bicornuate uterus, left DH and TL were created (TL Group). The fetuses were delivered by Cesarean section on gestational day 31. Fourteen in control group, 12 in the DH group and 13 in TL group were born alive. En bloc excision of lungs, bronchi and trachea was done in all newborn rabbits. A five Fr catheter was inserted through trachea and repeated irrigations with 10 cc normal saline were done. The irrigated fluid was centrifuged at $280{\times}g$ for 5 minutes and the lamellar bodies were counted with the upper level fluid in platelet channel of electronic cell counter. The average lamellar body counts were $37.1{\pm}14.2{\times}10^3/{\mu}L$ in control group, $11.5{\pm}4.4 {\times}10^3/{\mu}L$ in DH group, and $6.5{\pm}0.9{\times}10^3/{\mu}L$ in TL group. Lamellar body count in DH group was lower than in control group and did not increase after TL. This study shows TL has no therapeutic effect on decreased surfactant level of CDH and the pregnant rabbit is appropriate for the animal model of CDH.

• 한국전문물리치료학회지
• /
• 제24권3호
• /
• pp.10-20
• /
• 2017

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.

• Neonatal Medicine
• /
• 제25권3호
• /
• pp.102-108
• /
• 2018

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.