• Journal of Chest Surgery
• /
• v.40 no.10
• /
• pp.722-725
• /
• 2007

Morgagni's hernia constitutes about 3% of all the congenital diaphragm hernias. It is usually asymptomatic and it is frequently found coincidentally during routine diagnostic testing in adulthood. It is usually diagnosed by simple chest X-ray, but when this condition is without intestinal herniation, then chest CT or other modalities are necessary. Operative repair is desirable when there is the risk of strangulation of the intestine. The trans-thoracic or trans-abdominal approaches are possible to treat this malady. We report here on one case for which we successfully used a laparoscopic approach to treat this problem.

• Advances in Computational Design
• /
• v.5 no.1
• /
• pp.35-54
• /
• 2020

One of the prevailing structural systems in high-rise buildings is the core-wall system. On the other hand, the existence of one or more underground stories causes the perimeter below-grade walls with the diaphragm of grade level to constitute of a very stiff box. In this case or a similar situation, during the lateral response of a tall building, underground perimeter walls and diaphragms that provide an increased lateral resistance relative to the core wall may introduce a prying action in the core that is called backstay effect. In this case, a rather great force is generated at the diaphragm of the grade-level, acting in a reverse direction to the lateral force on the core-wall system, and thus typically causes a reverse internal shear. In this research, in addition to review of the results of the preceding studies, an improved relationship is proposed for prediction of backstay force. The new proposed relationship takes into account the effect of foundation flexibility and is presented in a non-dimensional form. Furthermore, a specific range of the backstay force to lateral load ratio has been determined. And finally, it is shown that although all suggested formulas are valid in the elastic domain, yet with some changes in the initial considerations, they can be applied to some certain non-linear problems as well.

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.4
• /
• pp.415-419
• /
• 2004

Meigs' syndrome is defined as presence of pleural effusion, with ovarian tumor associated ascites, which spontaneously resolve soon after the removal of the tumor. The pathogenesis of the pleural effusion, in patients with Meigs' syndrome, is thought to be the passage of fluid from the peritoneal cavity into the pleural cavity, through small holes in the diaphragm. A case of Meigs' syndrome, in a 63-year-old woman, who had been referred for control of pleural effusion is reported.

• Steel and Composite Structures
• /
• v.18 no.5
• /
• pp.1083-1101
• /
• 2015

Previous theoretical equations for the shear capacity of steel beam to concrete filled steel tube (CFT) column connections vary in the assumptions for the shear deformation mechanisms and adopt different equations for calculating shear strength of each component (steel tube webs, steel tube flanges, diaphragms, and concrete etc.); thus result in different equations for calculating shear strength of the joint. Besides, shear force-deformation relations of the joint, needed for estimating building drift, are not well developed at the present. This paper compares previously proposed equations for joint shear capacity, discusses the shear deformation mechanism of the joint, and suggests recommendations for obtaining more accurate predictions. Finite element analyses of internal diaphragm connections to CFT columns were carried out in ABAQUS. ABAQUS results and theoretical estimations of the shear capacities were then used to calibrate rotational springs in joint elements in OpenSEES simulating the shear deformation behavior of the joint. The ABAQUS and OpenSEES results were validated with experimental results available. Results show that: (1) shear deformation of the steel tube dominates the deformation of the joint; while the thickness of the diaphragms has a negligible effect; (2) in OpenSEES simulation, the joint behavior is highly dependent on the yielding strength given to the rotational spring; and (3) axial force ratio has a significant effect on the joint deformation of the specimen analyzed. Finally, modified joint shear force-deformation relations are proposed based on previous theory.

• The Journal of Internal Korean Medicine
• /
• v.26 no.1
• /
• pp.244-251
• /
• 2005

Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. It causes various symptoms(heart bum, chest pain, dysphagia, vomiting etc.) when it is associated with a condition called gastroesophageal reflux disease(GERD). In this occasion, complications included bleeding because of the erosion, ulceration and inflammation of the mucosa. For treatment, there are $H_2$ blockers and proton pump inhibitors, but they have many side effects. In Oriental Medicine effectively treated cases are rare. Therefore, it is essential to seek radical agents and effective treatments for these disorders. In this case report, these disorders are approached by focusing on the deficit of 'yin(陰)'especially 'pi-yin(脾陰)'. Desired results were seen with herbal medications which enhance the 'yin(陰)', especially through 'wuyin-jian(五陰煎)' which enhances the 'pi-yin(脾陰)'. This is reported to contribute to development of future treatments.

• Tuberculosis and Respiratory Diseases
• /
• v.62 no.2
• /
• pp.149-153
• /
• 2007

A pulmonary blastoma is a rare malignant tumor of the lung that is composed of epithelial and mesenchymal elements and resembles the structure of an embryonic lung. Pulmonary blastomas have a very poor prognosis and make up 0.25 to 0.5 percent of all primary malignant lung tumors. A pulmonary blastoma usually manifests as a solitary parenchymal mass or nodule and multiple subpleural mass with effusion on chest X-ray and computed tomography. We encountered a very rare case of pulmonary blastoma in a 52 years old male. He complained of abdominal pain, fullness, and dyspnea. The radiology examination revealed a huge lung mass invading the mediastinum, heart, diaphragm, and liver. The percutaneous needle biopsies were performed, and this tumor was diagnosed as a pulmonary blastoma. We report a biopsy confirmed case of a huge pulmonary blastoma invading multiple organs.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.3
• /
• pp.261-265
• /
• 2011

Cholethorax is a bilious pleural effusion caused by a pleurobiliary fistula or leakage of bile into the pleural space. Most cases of cholethorax arise from a complication of abdominal trauma, hepatobiliary infection, or invasive procedures or surgery of hepatobiliary system. However, we experienced a case of a patient with cholethorax of unknown origin. There was no evidence of pleurobiliary fistula or leakage of bile from the hepatobiliary system although we examined the patient with various diagnostic tools including chest and abdominal computed tomography, endoscopic retrograde cholangiopancreatography, tubography, bronchofiberscopy, hepatobiliary scintigraphy and video-assisted thoracoscopic surgery. Herein we report a case of cholethorax for which the specific cause was not identified. The patient was improved by percutaneous drainage of pleural bile.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.3
• /
• pp.241-245
• /
• 2009

Traumatic diaphragmatic rupture is uncommon, but requires a prompt diagnosis and repair. Diaphragmatic injury is most commonly associated with automobile accidents. The diagnosis is difficult and may be delayed because there are no specific symptoms, signs, or radiographic studies that are pathognomic for diaphragmatic injury. The most important factor in the diagnosis is a high suspicion and the use of proper diagnostic studies. We report a case involving the delayed presentation of diaphragmatic rupture in a 54 year old man, requiring surgical repair 12 days following multiple blunt trauma. It should be noted that early recognition for diaphragmatic injury is important in patients with multiple trauma to avoid the potential fatal complications.

• Radiation Oncology Journal
• /
• v.19 no.4
• /
• pp.319-326
• /
• 2001

Purpose : Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. Depending on the location of the tumor, the magnitude of PTV margin extends from 10 mm to 30 mm, which increases substantial volume of the irradiated normal tissue hence, resulting in increase of normal tissue complication probability (NTCP). We developed a simple and handy method which can reduce PTV margins in patients with liver tumors, respiratory motion reduction device (RRD). Materials and methods : For 10 liver cancer patients, the data of internal organ motion were obtained by examining the diaphragm motion under fluoroscope. It was tested for both supine and prone position. A RRD was made using MeV-Green and Styrofoam panels and then applied to the patients. By analyzing the diaphragm movement from patients with RRD, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using AcQ-Plan, a treatment planning software. Dose to normal tissue between patients with RRD and without RRD was analyzed by comparing the fraction of the normal liver receiving to $50\%$ of the isocenter dose. DVH and NTCP for normal liver and adjacent organs were also evaluated. Results : When patients breathed freely, average movement of diaphragm was $12{\pm}1.9\;mm$ in prone position in contrast to $16{\pm}1.9\;mm$ in supine position. In prone position, difference in diaphragm movement with and without RRD was $3{\pm}0.9\;mm$ and 12 mm, respectively, showing that PTV margins could be reduced to as much as 9 mm. With RRD, volume of the irradiated normal liver reduced up to $22.7\%$ in DVH analysis. Conclusion : Internal organ motion due to breathing can be reduced using RRD, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.

• Wind and Structures
• /
• v.16 no.1
• /
• pp.93-115
• /
• 2013

This paper describes a study of the influence of a dynamically flexible building structure on pressures inside and net pressures on the roof of low-rise buildings with a dominant opening. It is shown that dynamic interaction between the flexible roof and the internal pressure results in a coupled system that is similar to a two-degree-of-freedom mechanical system consisting of two mass-spring-damper systems with excitation forces acting on both the masses. Two resonant modes are present, the natural frequencies of which can readily be obtained from the model. As observed with quasi-static building flexibility, the effect of increased dynamic flexibility is to reduce the first natural frequency as well as the corresponding peak value of the admittance, the latter being the result of increased damping effects. Consequently, it is found that the internal and net roof pressure fluctuations (RMS coefficients) are also reduced with dynamic flexibility. This model has been validated from experiments conducted using a cylindrical model with a leeward end flexible diaphragm, whereby good match between predicted and measured natural frequencies, and trends in peak admittances and RMS responses with flexibility, were obtained. Furthermore, since significant differences exist between internal and net roof pressure responses obtained from the dynamic flexibility model and those obtained from the quasi-static flexibility model, it is concluded that the quasi-static flexibility assumption may not be applicable to dynamically flexible buildings. Additionally, since sensitivity analyses reveal that the responses are sensitive to both the opening loss coefficient and the roof damping ratio, careful estimates should therefore be made to these parameters first, if predictions from such models are to have significance to real buildings.