• 대한통합의학회지
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• 제10권3호
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• pp.221-232
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• 2022

Purpose : In this study, rectus abdominis relaxation intervention was administered to office workers who were experiencing low back pain due to sitting for extended periods of time in an incorrect posture. This study aimed to develop an effective treatment program for individuals who experience low back pain. This was done by verifying changes using the Korean Oswestry Disability Index (K-ODI) and considering kyphosis. Both factors are related to low back pain. Methods : This study included 39 office workers with low back pain. The participants were randomly assigned to three groups. 1) The functional massage and self-stretching (FAS) group (n=14). 2) The diaphragmatic breathing and self-stretching (DAS) group (n=13). 3) The self-stretching (S) group (n=12). All groups applied the intervention for 30 minutes a day, thrice a week for four weeks. All participants were evaluated using the K-ODI and thoracic kyphosis measurements before and after the intervention. Results : The findings of this study are as follows. All three groups had improved K-ODI scores after the intervention. The FAS and DAS groups showed a greater effect than the S group. However, there was no difference in effect between the FAS and DAS groups. Kyphosis was not improved in any of groups after the intervention, and there was no difference between the three groups. Conclusion : This study showed that the FAS, DAS, and S programs were effective relaxation interventions that improved the K-ODI for office workers with low back pain. The FAS and DAS programs were more effective than the S program. Therefore, it is recommended to combine relaxation and stretching of the rectus abdominis muscle for office workers who experience low back pain. Clinically, a relaxation intervention that is most appropriate for the patient, depending on his or her condition, should be.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.535-540
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• 2023

Background Abdominoplasty with abdominal plication increases intra-abdominal pressure (IAP) and has been previously associated with limited diaphragmatic excursion and respiratory dysfunctions. Many factors found in abdominoplasties and among postbariatric patients predispose them to a higher occurrence. This study aims to evaluate the impact of abdominal plication among postbariatric patients, assess whether the plication increases their IAP, and analyze how these IAP correlate to their postoperative outcome. Methods This prospective study was performed on all patients who underwent circumferential Fleur-De-Lis abdominoplasty. For this intended study, the IAP was measured by an intravesical minimally invasive approach in three stages: after the initiation of general anesthesia, after a 10-cm abdominal wall plication and skin closure, and 24 hours after the procedure. Results We included 46 patients, of which 41 were female and 5 were male. Before the bariatric procedure, these patients had an average maximum weight of 121.4 kg and an average maximum body mass index of 45.78 kg/m²; 7 were grade I obese patients, 10 were grade II, and 29 were grade III. Only three patients were operated on with a gastric sleeve and 43 with gastric bypass. We presented six patients with transitory intra-abdominal hypertension in the first 24 hours, all of them from the grade I obesity group, the highest presented was 14.3 mm Hg. We presented 15% (7/46) of complication rates, which were only four seroma and five dehiscence; two patients presented both seroma and wound dehiscence. Conclusion Performing a 10-cm abdominal wall plication or greater represents a higher risk for intra-abdominal hypertension, slower general recovery, and possibly higher complication rate in patients who presented a lower degree of obesity (grade I) at the moment of the bariatric surgery.

• Korean Journal of Radiology
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• 제22권9호
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• pp.1481-1489
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• 2021

Objective: To construct a CT-based Fagotti scoring system by analyzing the correlations between laparoscopic findings and CT features in patients with advanced ovarian cancer. Materials and Methods: This retrospective cohort study included patients diagnosed with stage III/IV ovarian cancer who underwent diagnostic laparoscopy and debulking surgery between January 2010 and June 2018. Two radiologists independently reviewed preoperative CT scans and assessed ten CT features known as predictors of suboptimal cytoreduction. Correlation analysis between ten CT features and seven laparoscopic parameters based on the Fagotti scoring system was performed using Spearman's correlation. Variable selection and model construction were performed by logistic regression with the least absolute shrinkage and selection operator method using a predictive index value (PIV) ≥ 8 as an indicator of suboptimal cytoreduction. The final CT-based scoring system was internally validated using 5-fold cross-validation. Results: A total of 157 patients (median age, 56 years; range, 27-79 years) were evaluated. Among 120 (76.4%) patients with a PIV ≥ 8, 105 patients received neoadjuvant chemotherapy followed by interval debulking surgery, and the optimal cytoreduction rate was 90.5% (95 of 105). Among 37 (23.6%) patients with PIV < 8, 29 patients underwent primary debulking surgery, and the optimal cytoreduction rate was 93.1% (27 of 29). CT features showing significant correlations with PIV ≥ 8 were mesenteric involvement, gastro-transverse mesocolon-splenic space involvement, diaphragmatic involvement, and para-aortic lymphadenopathy. The area under the receiver operating curve of the final model for prediction of PIV ≥ 8 was 0.72 (95% confidence interval: 0.62-0.82). Conclusion: Central tumor burden and upper abdominal spread features on preoperative CT were identified as distinct predictive factors for high PIV on diagnostic laparoscopy. The CT-based PIV prediction model might be useful for patient stratification before cytoreduction surgery for advanced ovarian cancer.

• Advances in pediatric surgery
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• 제20권1호
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• pp.1-6
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• 2014

Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).

• Journal of Chest Surgery
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• 제38권7호
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• pp.461-467
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• 2005

기관 또는 기관지의 이식이나 기관문합술 후 그리고 폐절제술 후 기관지의 봉합면에 빠른 재혈관화를 통해 감염이나 허혈성 괴사를 막기위해 흉막, 심외막, 심외지방, 횡격막, 장막, 늑간 근육 등을 이용하여 보강해 주는 경우가 많다. 이 연구는 실험동물에서 자가기관을 흉막, 장막 및 횡경막에 이식했을 때 생존에 미치는 영향을 알아보고자 하였다. 대상 및 방법 : 실험동물로 무게는 $250\~350g$ 정도의 Sprague-Dawley rats가 사용되었다. 장막, 횡격막, 흉막 세 군으로 나누어서 각 군별로 5마리씩 실험하였다. 복막 내 마취 후 기관 삽관을 시행하였고 기관을 노출시켜 세마디의 기관이식편을 잘라내었다 잘라낸 기관을 장막, 횡격막, 흉막에 각각 이식하였고 2주 후 쥐를 희생시켜 얻은 조직으로 병리조직학적 검사를 하였다. 병리조직학적으로 절단기관편의 생존능력을 비교하기 위하여 각각의 상피조직, 점막하조직, 연골조직의 괴사정도를 점수화하여($0\~3$점) 그 결과의 평균값을 표시하였다. 결과 : 병리 조직학적 검사상 장막군이 가장 좋은 보존 상태를 보였다. 괴사 점수는 흉막이식군에서 상피층서 $2.17\pm0.983$, 점막하층 $1.67\pm0.516$, 연골층 $2.17\pm0.753$으로 나타났고 장막이식군의 경우 각각 1.00\pm0.00,\;1.60\pm0.548,\;1.8\m0.447$, 횡격막이식군은 $1.40\pm0.894,\;2.40\pm0.547,\;2.2\pm0.447$으로 관찰되었다. 전체 괴사 점수는 흉막이식군에서 $6.00\pm1.789$, 장막이식군에서 $4.40\pm0.894$, 횡격막이식군에서 $6.00\pm1.414$보였다. 걸론: 세 그룹간의 비교시 통계적 유의성은 없었으나 장막에 이식한 기관에서 가장 낮은 괴사점수가 나와 장막이 횡격막이나 흉막보다 기간 봉합면을 보호하고 신혈관 생성에 더 좋은 역할을 하는 경향을 보였다.

• 기본간호학회지
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• 제1권1호
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• pp.51-68
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• 1994

One aim of this study was to find out the difference of indirect blood pressure between the types of instruments. The difference of indirect blood pressure was measured with mercury sphygomomanometer and electronic blood pressuremeter. Another was to determine the difference of indirect blood pressure according to width of cuff and site of cuff. Indirect blood pressures were measured with the diaphragmatic side of sphygomomanometer. The subjects were 40 female volunteers, whose arm circumferences were from 22 to 34cm. The data were analyzed by SPSS-PC program and pared t-test was used. The results are summarized as follows ; 1. Mercury sphygomomanometer systolic pressure was higher(average 2.20mmhg) than electronic blood pressuremeter. It was statistically significant(p=0.026). 2. The value of Mercury sphygomomanometer diastolic pressure was lower(2.00mmhg) than electronic's. It was statistically significant(p=0.03) 3. In the mercury sphygomomanometer systolic pressure, the value of standard cuff($12{\times}23cm$) was higher(2.40mmhg) than large one's($14{\times}45cm$). It was statistically significant(p=0.007). 4. In diastolic pressure(K4), the value of standard cuff was higher(0.65mmhg) than large cuff's. It was not statistically significant(p=0.481). In K5, the value of standard cuff($12{\times}23cm$) was higher(0.55mmhg) than large cuff's. It was not statistically significant(p=0.541). 5. Difference according to site of showed that the values of systolic pressure over elbow joint were higher(20.00mmhg, 26.45mmhg) than ones at site of elbow joint. It was significant statistically(p=0.000) and clinically. 6. The values of diastolic pressure(K4) over elbow joint were higher(17.10mmhg, 21.60mmhg) than ones at site of elbow joint. It was significant statistically (p=0.000) and clinically. The values of K5 over elbow joint were higher(17.25mmhg, 22.15mmhg) than ones at site of elbow joint. It was significant statistically(p=0.000) and clinically. I think similar studies about indirect blood pressure according to diseases and positions are necessary. In addition, similar studies, are required about accuracy of method electronic blood pressuremeter according to site of mesurement.

• Tuberculosis and Respiratory Diseases
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• 제44권1호
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• pp.197-202
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• 1997

저자들은 반복적인 월경성 객혈을 주소로 내원한 35세 여자 환자에서 흉부 전산화 단층촬영으로 병소를 확인한 후 부분폐엽절제술로 치유한 우측 폐실질내의 자궁내막증식증을 경험하였기에 보고하는 바이다.

• 대한수의학회지
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• 제29권2호
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• pp.1-9
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• 1989

The distribution of portal veins within the liver in 30 Korean native cattle were observed. Vinylite solution was injected into portal veins of eighteen specimens for cast preparation. The angiography was prepared in twelve specimens by injecting 30% barium sulfate solution into portal veins, and then radiographed on a X-ray apparatus(Shimadzu 800MA 120Kvp). The results were summarized as follow: 1. The Vena portae was divided immediately upon entering the liver into a very short Truncus dexter venae portae($14.75{\pm}4.86$ : 6.9~23.1mm) and a long Truncus sinister venae portae($94.16{\pm}9.62$ : 110~150mm). 2. The Truncus sinister venae portae runs of first in the long axis of the liver from the Porta hepatis toward the left lobe. At the boundary between the quadrate and left lobes it bends sharply 50 to 80 degrees toward the Incisura ligamentum teretis, and after a course of 36. 5 to 54.mm between the quadrate and left lobes, ends abruptly. The Truncus sinister venae portae is divided for description into the Pars transversa, from the Porta hepatis to the flexure, and the Pars umbilicalis, from the flexure to the end. 3. The branches of Venae portae were Ramus ventralis lobi sinistri, Ramus intermedius lobi sinistri, Ramus dorsalis lobi sinistri, Ramus lobi quadratii, Ramus ventralis lobi dextri, Ramus intermedius lobi dextri, Ramus dorsalis lobi dextri, Rami processus caudatorum and Rami processus papillarum. 4. The Ramus intermedius lobi sinistri was arised from the left surface of the Pars umbilicalis, and was origined on the common trunk with Ramus dorsalis lobi sinistri(3 cases, 10%) or Ramus ventralis lobi sinistri(3 cases, 10%). 5. The Rami lobi quadratii consisted of the vein(15 cases, 50%) or two veins(15 cases, 50%), and was observed on the arched-shaped at 2 cases (6.6%) of the liver. 6. The Rami processus caudatorum consisted of one vein(28 cases, 93.3%) or two veins(2 cases, 6.6%). The former were formed common trunk with R, dorsalis lobi dextri(7 cases, 23.3%) or R. ventralis lobi dextri (2 cases, 6.6%). 7. The Rami processus papillarum were arised from the dorsal border of Pars transversa, and also gave off many small branches supplied papillary process of the caudate lobe. 8. The anastomosis on the branches of Vena portae was observed in the intralobar and interlobar areas. 9. The Truncus dexter venae portae and Truncus sinister venae were ramified many secondary branches that were radiated within the liver. 10. On the diaphragmatic surface, small vessels of the portal veins were observed, while there were big ones on the visceral surface. 11. The ramified angles at Ramus dorsalis lobi dextri, Rami processus papillarum, Ramus dorsalis lobi sinistri, Ramus intermedius lobi sinistri, Ramus ventralis lobi sinistri, Rami lobi quadratii, Rami processus caudatorum, Ramus ventralis lobi dextri and Ramus intermedius were 10~50, 70~110, 100~150, 140~170, 185~220, 270~330, 240~300, 270~320 and 340~10 degrees, respectively.

• 한국방사선학회논문지
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• 제7권3호
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• pp.233-238
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• 2013

Chest lateral decubitus 촬영은 일반적으로 PA 검사를 시행하여 왔으나, 응급환자나 몸이 불편한 환자의 검사에 있어 많은 불편이 있었다. 이에 본 연구에서는 AP 검사와 PA 검사를 비교하여 영상의 질, 환자의 안전성, 검사 효율성을 분석하고 두 검사간의 유용성을 알아보고자 하였다. 본원에서 2011.10.1 ~ 2012.7.30까지 늑막염 또는 기흉으로 의심되거나 진단된 환자들 중 chest lateral decubitus 촬영을 시행한 30명(남자 20명, 여자 10명)을 대상으로 하였다. 영상 화질 평가방법은 폐야의 미세구조, 진단영역의 넓음, air-fluid 경계면의 명확 유무, 환자 회전유무, 심장음영과 횡격막의 선명유무를 기준으로 하였으며, 영상의학과 전문의 2명, 호흡기내과 전공의 2명이 blind test로 평가하였다. 환자 안정성 및 방사선 검사의 효율성 평가는 환자 position의 안정성, 환자 상태 확인 등의 기준으로 일반촬영 5년 이상 경력의 방사선사 15명이 5점 척도로 평가를 하였고, 통계 분석은 Paired T-test로 분석하였다. Chest decubitus 촬영 시 AP와 PA자세에 따른 검사의 유용성을 비교 분석한 결과 영상의 화질에서 AP와 PA자세는 큰 차이가 없었던 반면, 환자의 안정성 및 방사선사의 검사 효율성에 있어 PA자세에 비해 AP자세의 평가 점수가 높게 나타났다. 이에 특별히 PA자세가 요구되지 않는다면 AP자세로 검사하여도 무방할 것으로 사료된다.

• Journal of Chest Surgery
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• 제31권10호
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• pp.1017-1021
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• 1998

중피낭종은 심막체벽낭종, 스프링워터낭종, 장막낭종 등 여러 가지 이름으로 명명되고 있다. 대부분의 중피낭종은 심낭의 기형으로 부터 발생 된다고 하나, 본 증례는 늑막기형에서 발생된 아주 희귀한 중피낭종이므로 조직학적으로 특수 염색을 통하여 확진하게 되었다. 본 증례는 64세 여자 환자로서 입원 당시 우측 목 부위에 통증 없는 낭성 종괴가 만져져 외래를 통하여 내원케 되었다. 컴퓨터 단층촬영상 종격동 림프관종이라는 진단하에 수술을 시행하여 낭성종괴를 완전 절 제 하였다. 수술후 절제된 조직소견 결과 종격동 중피낭종이 확진 되었으며 수술후 환자는 큰 후유증 없이 완치되어 퇴원 하였다.