• 제목/요약/키워드: diaphragmatic

검색결과 306건 처리시간 0.022초

소아 장루의 합병증 (Stomal Complications in Children)

  • 박중재;이주홍;정종도;최영철;정우식;전시열
    • Advances in pediatric surgery
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    • 제8권1호
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    • pp.11-15
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    • 2002
  • This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation, Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required, Sigmoid loop colostomy is preferred whenever possible.

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선천성 질환시 산전 초음파 진단의 의의 (Efficacy of Prenatal Ultrasonographic Diagnosis of Congenital Anomalies)

  • 유수영;김승기;최승훈;이국
    • Advances in pediatric surgery
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    • 제3권1호
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    • pp.15-23
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    • 1997
  • During a 6-year period, from January 1990 to December 1995, 101 neonates with congenital anomalies were admitted to the division of Pediatric Surgery of Youngdong Severance Hospital. All of them had prenatal screening more than once with ultrasound. Fifty eight of them had prenatally detectable anomalies by ultrasonography. However abnormalities were prenatally detected in 24 neonates(41%). The detection rate was 70% in patientws who had the prenatal screening at our hospital, whereas, the rate was 24% when it was performed at other medical facilities. Duodenal and jejuno-ileal atresia showed the highest detection rate(86%) followed by abdominal mass. Esophageal atresia was suggested by maternal polyhydramnios in 3 patients (25%). Only one patient with diaphragmatic hernia(1.75%) was prenatally detected and none with gastroschisis. The mean interval from birth to operation was 32 hours in the prenatally detected patients and 50 hours in the non detected. The complication rate and the mortality after emergency operation were 20% and 7% in the detected group, and 58% and 23% in the nondetected, respectively. The average period of the hospitalization was 20 days in the detected group and 39 days in the nondetected. We conclude that the prenatal detection of anomalies is necessary to ensure adequate care for the mothers and the babies with congenital anomalies. This includes early transfer, timing of optimal delivery and operation.

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십이지장 폐쇄를 동반한 선천성 식도 폐쇄에 대한 고찰 (Clinical Experience with Esophageal Atresia Combined with Duodenal Atresia)

  • 이유미;남소현;김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제14권1호
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    • pp.21-26
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    • 2008
  • There is significant morbidity and mortality associated with the combination of esophageal atresia (EA) and duodenal atresia (DA). Nevertheless, the management protocol for the combined anomalies is not well defined. The aim of this study is to review our experience with the combined anomalies of EA and DA. From May 1989 to August 2006, seven neonates were diagnosed as EA with DA at Asan Medical Center. In all cases, the type of EA was proximal EA and distal tracheoesophageal fistula (TEF). The diagnosis of DA was made in theprenatal period in 1, at birth in 4, 4 days after birth in 1 (2 days after EA repair) and at postmortem autopsy in 1. Except the one case where DA was missed initially, primary simultaneous repair was attempted. DA repair with gastrostomy followed by EA repair in 2, EA repair followed by DA repair without gastrostomy in 2, and TEF ligation followed by DA repair with gastrostomy in 1. There were two deaths. One baby had a large posterolateral diaphragmatic hernia, and operative repair was not attempted. The other infant who had a TEF ligation and DA repair with gastrostomy expired from cardiac failure due to a large patent ductus arteriosus. Simultaneous repair of EA and DA appears to be an acceptable management approach for the combined anomalies, but more experience would be required for the selection of the primary repair of both anomalies.

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태수술에 대한 이해와 구순구개열 환자에서의 적용 (Understanding of Fetal Surgery and Application to the Cleft Lip and Palate Patient)

  • 김성민;박정민;명훈;최진영;이종호;정필훈;김명진
    • 대한구순구개열학회지
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    • 제11권2호
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    • pp.49-58
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    • 2008
  • The development of fetal surgery has led to promising options for many congenital malformations, such as congenital diaphragmatic hernia (CDH), obstructive uropathy, twin-to-twin transfusion syndrome (TTTS), and sacrococcygeal teratoma. However, preterm labor (PTL) and premature rupture of membranes continue to be uniquitous risks for both mother and fetus. To reduce maternal morbidity and the risk of prematurity, minimal access techniques were developed and are increasingly employed recently. Lift-threatening diseases as well as severely disabling but not life-threatening conditions are potentially amenable to treatment. Recently, improvement of video-endoscopic technology has boosted the development of operative techniques for feto-endoscopic surgery, which has been demonstrated to be less invasive than the open approach. Fetal surgery for repair of cleft lip and palate, a congenital anomaly which is not life threatening, is inappropriate until such time that the benefits are shown to outweigh the risks of both the procedure itself and preterm delivery. Further animal studies will be needed before intrauterine surgery for humans should be considered. For the better understanding of recent techniques and complications associated with fetal intervention of congenital facial defect patients, we reviewed recent related articles about the current knowledge and new perspectives of experimental fetal fetal surgery in the cleft lip and palate defects.

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1994년도 한국신생아외과의 현황 - 대한소아외과학회 회원대상 전국조사 - (Current Status(1994) of Neonatal Surgery in Korea -Survey among the members of Korean Association of Pediatric Surgeons-)

  • 김우기;김상윤;김신곤;김인구;김재천;박귀원;박영식;박우현;박주섭;송영택;오수명;이두선;이명덕;이성철;장수일;정을삼;정풍만;주종수;최순옥;허영수;황의호
    • Advances in pediatric surgery
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    • 제2권1호
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    • pp.26-32
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    • 1996
  • To understand the current status of neonatal surgery in Korea, a survey was made among the 27 members of Korean Association of Pediatric Surgeons. Response rate among surgeons was 78 percent, eighteen hospitals participated in this study. Five hundred and three cases of neonatal surgical patients were analyzed. In Korea, about 50% of cases were treated at the hospital in the capital city area. Regional number of patients were closely related to the regional population. Imperforate anus(19%), atresia/stenosis of gut(12%), and Hirschsprung's diseases(12%) were sitting at the top in the list. Majority of operation was done within the first week of life, especially during the first 24 hour period. Eighty per cent was major or so called index cases. Mortality in so-called index cases was 17%. High mortality was observed in patients with diaphragmatic hernia(47%), gastrointestinal perforation(65%) and esophageal atresia(28%). Low birth weight babies showed higher mortality in gastrointestinal perforation, esophageal atresia and abdominal wall defect. These were compared to 1993 survey of Japanese Society of Pediatric Surgeons.

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횡경막에 발생한 악성 섬유종 조직구종 1예 (A case of Primary Malignant Fibrous Histiocytoma of the Diaphragm)

  • 심재준;조용선;김현숙;최혜숙;최천웅;유지홍;강홍모;양문호
    • Tuberculosis and Respiratory Diseases
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    • 제54권6호
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    • pp.645-650
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    • 2003
  • 저자들은 우측 흉부 불편감을 주소로 내원한 25세 여자 환자를 개흉 조직 검사를 시행하여 원발성 횡격막 기원 악성 섬유성 조직구종을 진단하였고 ifosfamide, doxorubicin으로 항암 화학 요법 시행 후 부분 관해가 있었으나 진단 후 12개월째 외래 추적 검사 중 뇌전이로 사망한 젊은 여성 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

한국의 일반 흉부수술 현황 (Current Status of General Thoracic Surgery in Korea)

  • 전영진
    • Journal of Chest Surgery
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    • 제25권5호
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    • pp.504-510
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    • 1992
  • Overall 25,095 cases of general thoracic surgery were analysed, which were performed by 48 institutes in Korea during recent 6 years[242 hospital-years]. The proportions of tumorous disease and infectious disease to be operated were 6,864 cases[27.4%] and 6,775 cases [27.0%], The most common organ involved for operation was lung-bronchus 16,542 cases [69.5%], and remainders were pleura 2,500 [10.0%], esophagus 2,433[9.7%], mediastinum 1,902[7.6%], chest wall 1,297 [5.2%], and diaphragm 421 [1.7%] in order. Among 6,864 cases of tumorous diseases, the most common causes for operation were lung-bronchus tumor 3132 cases [45.6%] and most of them were lung cancer 2,731 cases [88.7%]. In the 2,019 cases of primary lung cancer with known cell type, squamous cell carcinoma 1,296 cases [64.2%] and adenocarcinoma 460 cases [22.8%] were the most. The common types in the 1,207 cases of mediastinal tumor with known cell type were neurogenic tumor 348 cases [28.8%], thymoma 311 [25.8%], and teratoma 252[20.9%]. The annual cases of operation for tumorous disease including malignant tumor were increased steadily. Operation for infectious lung diseases [including bronchiectasis and tuberculosis] were about twice common than infectious pleural disease [i.e. empyema], and operations for tuberculous disease occupied about half cases of infectious lung disease. In 11,456 cases of other disease entities, excluding tumorous and infectious disease, there were bullous lung disease 9,074 cases[79.2%], benign esophageal disease 484[4.2%], myasthenia gravis 356[3.1%], chest wall deformity 483[4.2%], and diaphragmatic lesion 421[3. 7%] in order. We propose that above results for inquiry can be used as the basic data of general thoracic surgery in Korea.

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전북지역 도축돈 호흡기질병 조사 (Seasonal survey on the respiratory diseases of slaughtered pigs in Jeonbuk, Korea)

  • 임미나;김철민;박영민;송주태;진재권;조현웅
    • 한국동물위생학회지
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    • 제39권4호
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    • pp.231-237
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    • 2016
  • The present study was conducted to investigate the lesion of red internal organs in slaughtered pigs and provided assistant data for pig farms. During March to December 2015, a total of 1,160 lung samples out of 58 herds were collected randomly from pigs slaughtered in Jeonbuk province. In addition, 290 hilar lymph nodes from pig with pneumonic lung lesion (5 samples per herd) were screened for selected viral and bacterial pathogens. Gross lesions of lungs such as swine enzootic pneumonia (SEP), pleuritis, pleuropneumonia, pericarditis and liver white spots were examined. The overall prevalence of SEP was 64.3% (746/1,160). In the analysis of seasonal prevalence, there was an increase of occurrence during the spring months (287/400, 71.8%) and decrease during the fall months (93/200, 46.5%) among the whole herds. The mean number of SEP score per pig was $1.20{\pm}1.28$. The prevalence of pleuropneumonia, pleuritis, pericarditis, and milk spot was 25.5% (296/1,160), 44.1% (512/1,160), 3.8% (44/1,160) and 17.6% (204/1,160), respectively. The most frequent region with lung lesion was diaphragmatic lobes (left 17.1%, right 17.3%). In the detection of viral pathogens by PCR, porcine circovirus type2 (PCV2) was positive in 86.9% (252/290), while porcine reproductive and respiratory syndrome virus (PRRSV) was not detected, In the case of bacterial pathogens, 50 microorganisms were isolated by PCR and/or microbiological test. The most frequently isolated bacteria was Streptococcus suis (20, 34.4%), followed by Pasteurella multocida (17, 29.3%), Streptococcus spp. (11, 3.4%), Actinobacillus pleuropneumoniae (2, 8.9%).

Effects of Farinelli Breating Exercise on Respiratory Function and Symptoms in Patients with Chronic Obstructive Pulmonary Disease

  • Ittinirundorn, Supawit;Wongsaita, Naiyana;Somboonviboon, Dujrath;Tongtako, Wannaporn
    • Tuberculosis and Respiratory Diseases
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    • 제85권2호
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    • pp.137-146
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    • 2022
  • Background: Farinelli breathing (FB) exercise is a typical breathing exercise used by singers. This study aimed to compare effects of FB exercise and diaphragmatic breathing (DB) exercise on respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixteen patients aged 51-80 years with mild or moderate COPD were recruited for this study. They were divided into two groups: DB group (n=8) and FB group (n=8). Both groups received complete breathing exercise training five times per week for 8 weeks. Their respiratory functions, COPD symptoms, cytokine levels, and oxidative stress variables were analyzed during pre- and post-tests. Dependent variables were compared between pre- and post-tests using paired t-tests. An independent t-test was used to compare variables between the groups. Differences were considered significant at p<0.05. Results: The maximal expiratory pressure (MEP), maximum oxygen consumption (VO2max), and COPD Assessment Test (CAT) scores changed significantly in the DB group after the 8-week intervention compared to those at pre-test, whereas force vital capacity, forced expiratory volume in the first second, maximum voluntary ventilation, maximal inspiratory pressure (MIP), MEP, VO2max, CAT score, tumor necrosis factor-α, and malondialdehyde level changed significantly in the FB group at post-test compared to those at pre-test. Moreover, both MIP and MEP in the FB group were significantly higher than those in the DB group. Conclusion: FB exercise improved respiratory functions and COPD symptoms of patients with COPD. It might be an alternative breathing exercise in pulmonary rehabilitation programs for patients with COPD.

횡격막에 적용된 테이핑 처치가 30초간의 무산소 운동수행력에 미치는 영향: pilot study (The effect of taping intervention applied to the diaphragm on the performance of anaerobic exercise in 30 seconds: pilot study)

  • 최현석;조일영
    • 디지털정책학회지
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    • 1권1호
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    • pp.7-13
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    • 2022
  • 본 연구는 횡격막에 적용된 테이핑 처치가 30초간의 무산소 운동수행력에 미치는 영향을 알아보고자 실시하였다. 건강한 대학생 18명을 대상으로 실험군(KT)과 대조군(Sham)에 각각 9명씩 무작위 할당되었다. 두 그룹 모두 윙게이트 검사 기반의 사전 측정이 이루어지고 1주일 휴식 후 처치와 함께 사후 측정이 실시되었다. 두 집단간 변인들의 통계는 사전, 사후값의 변화율을 Mann-Whitney U검정으로 실시하였고, 그 결과 대조군의 평균 파워(AP)에서만 통계적으로 유의한 차이가 나타났다. 이는 횡격막 테이핑이 30초 동안의 무산소 운동 수행에 영향을 미치지 않았음을 의미한다. 하지만 30초보다 긴 장기간 무산소 운동에서 유산소 대사가 증가함을 고려할 때 이후 다양한 시간 범위 내 무산소 운동 수행에 대한 추가 연구가 필요할 것으로 생각된다.