• Physical Therapy Korea
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• v.22 no.1
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• pp.37-48
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• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.581-587
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• 2019

Purpose: Abdominal pain is the most common symptom of patients visiting the emergency department (ED). Abdominal pain is caused by a variety of causes, so it is difficult for a triage nurse to determine the urgency of a patient, but it is still a must. The purpose of this study was to identify the related factors to the urgent diseases of patients with abdominal pain visiting ED. Methods: This study was a retrospective descriptive study. The study setting was an ED in a tertiary hospital in Korea. Data were collected from September 1, 2017 to October 15, 2017. During the study period, of a total of 6,181 patients visiting the ED, 731 complained of abdominal pain. Patients with obvious cause of pain and patients who could not express detailed symptoms were excluded. The 573 patients were included in the final analysis. We collected demographics, clinical characteristics, and final diagnosis. We divided final diagnoses into urgent diseases which were more likely to be life-threatening without treatment and non-urgent diseases. We identified the related factors to the urgent diseases of patients with abdominal pain using the logistic regression. Results: 173 (30.2%) patients had urgent diseases. Age (OR=1.02, 95% CI=1.00~1.03), referral from other clinics (OR=2.92, 95% CI=1.86~4.60), ambulance utilization (OR=2.00, 95% CI=1.27~3.15), diarrhea (OR=0.44, 95% CI=0.25~0.76), and tachycardia (OR=2.27, 95% CI=1.44~3.58) were related to urgent diseases. Conclusion: Triage nurse should take into account the patient's age, mode of visiting, and route of visiting ED; and check the symptom of tachycardia or diarrhea.

• The Journal of Internal Korean Medicine
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• v.37 no.6
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• pp.940-948
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• 2016

Objectives: This exploratory trial evaluated the possibility of quantitatively measuring several aspects during the "abdominal examination" of traditional Korean medicine. The main results of this study will be used to develop a new diagnostic device for abdominal examinations. Methods: Fifteen healthy volunteers were recruited for this study. Three certified Korean medical doctors assessed the existence of pressure pain, the elasticity of the abdominal muscle, and the tonus at CV12 as gold standards. Then, 2 well-trained investigators measured the pressure pain threshold (PPT), the indentation depth of a bar, and repelling force by pressing CV12. Each investigator measured the above 3 variables 2 times at 1 min intervals using a modified digital algometer. Reliability and validity tests of the 3 variables were performed. Results: There were statistically significant coefficients of intraclass correlation on the 3 variables both between and within the investigators (P<0.001). Also, PPT and repelling force showed statistically significant high sensitivity and specificity in a ROC curve. However, the indentation depth of the bar presented relatively low sensitivity. Conclusions: This new diagnostic method using a modified digital algometer could be a useful tool for quantitative measurement in "abdominal examinations". However, future rigorous clinical studies with a large population will be needed for the verification of its usefulness.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.56-60
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• 2010

Purpose: Breast reconstruction with abdominal flap has many advantages. However, it might cause abdominal complications such as bulging or hernia. SIEA (Superficial inferior epigastric artery) flap is the most advanced form of abdominal flap which has no adverse effect on abdominal fascia. We report 2 cases of breast reconstruction with SIEA flap with reference review. Methods: From Jun 2006 to Jan 2009, 110 patients underwent breast reconstruction with free abdominal flap. We tried to find the SIEA in every cases and adopted SIEP flap if the diameter was larger than 1mm and it had visible pulsation. 2 patients underwent breast reconstruction with SIEA flap. After design of abdominal flap SIEA was investigated with portable Doppler. SIEA was usually found 4-5 cm lateral to the midline. Flap was elevated with SIEA and SIEV to their maximal length at hiatus. Results: There were no complications, such as infection, hematoma, and necrosis of flap. In both cases, flaps survived completely with excellent vascularity and breast reconstruction was successful. In one case, there was skin necrosis of mastectomy flap, and it was healed by conservative management. Conclusion: With the SIEA flap, donor site morbidity can be minimized along with reduction of operation time. If there is reliable SIEA, SIEA flap would be the preferred skills. However, the limitation of the SIEA flap is difficulty in identifying the SIEA. The reason for less availability of the flap in Korea might include high prevalence of the Caesarian section scar and relatively higher level of the lower margin of the flap.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.1-9
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• 2016

PURPOSE: The aim of this study was to examine the effects of abdominal breathing and thoracic expansion exercises on craniovertebral and cranial rotation angles in patients with rotator cuff injury. METHODS: This study enrolled 19 patients with rotator cuff injury, and ten and nine of the patients were randomly placed in abdominal breathing and thoracic expansion exercise groups, respectively. After pain treatment in each group, breathing exercise was conducted thrice a week for four weeks. The patients were recorded by using a digital camera and Image J (version 1.46, National Institutes of Health, USA), an angle measurement program, was used to analyze changes in the craniovertebral angle, cranial rotation angle, and sagittal shoulder posture. RESULTS: Statistically significant differences in the craniovertebral angle were found in both the abdominal breathing and thoracic expansion exercise groups (p<.05). A significant difference in cranial rotation angle was found in the thoracic expansion exercise group only (p<.05). No statistically significant differences in sagittal shoulder posture were found in both groups (p>.05). CONCLUSION: Although abdominal breathing and thoracic expansion exercises did not effectively change sagittal shoulder posture, the exercises were effective in improving craniovertebral and cranial rotation angles. Therefore, abdominal breathing and thoracic expansion exercises are suggested as effective exercise programs for forward head posture.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.106-114
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• 2007

Purpose: There is little controversy that a classic indication such as hemodynamic instability or any sign of peritoneal irritation requires an immediate laparotomy in the management of abdominal stab wounds. However, omental herniation or bowel evisceration as an indication for an immediate laparotomy is controversial. The purpose of this study was to evaluate the significance of these factors as indications for an immediate laparotomy. Methods: The medical records of 98 consecutive abdominal stab wounds patients admitted to the Emergency Center of Masan Samsung Hospital from January 2000 to December 2006 were carefully examined retrospectively. Using multivariate logistic regression analysis, thirty-nine factors, including the classic indication and intraabdominal organ evisceration, were evaluated and were found to be associated with a need for a laparotomy. Also, the classic indication was compared with a new indication consisting of components of the classic indication and intra-abdominal organ evisceration by constructing a contingency table according to the need for a laparotomy. Results: Multivariate logistic regression analysis revealed any sign of peritoneal irritation, base deficit, and age to be significant factors associated with the need for a laparotomy (p<0.05). The sensitivity, specificity, and accuracy rates of the classic indication were 98.6%, 72.0%, and 91.8%, respectively, and those of the new indication were 93.2%, 84.0%, and 90.8%, respectively. The differences in those rates between the above two indications were not significant. Conclusion: Intra-abdominal organ evisceration was not a significant factor for an immediate laparotomy. Moreover, the new indication including intra-abdominal organ evisceration was not superior to the classic indication. Therefore, in the management of abdominal stab wounds, the authors suggest that an immediate laparotomy should be performed on patients with hemodynamic instability or with any sign of peritoneal irritation.

• CELLMED
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• v.2 no.2
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• pp.15.1-15.3
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• 2012

Kampo medicine, a Japanese traditional herbal medicine, has been used in clinical practice in Japan. The most appropriate Kampo formula should be chosen for each individual by the four diagnostic procedures. Fuku shin, the abdominal exam, is one of the most important approaches in the procedures. There are several abdominal conformations (signs) when administering Fuku shin. In Kampo medicine, psychiatric illness-marked by depression and anxiety-has been shown to be related with an abdominal conformation, Shin ka hi koh (Epigastric Obstructive Hardness). The aim was to see the occurrence of abdominal conformations in each level of depression and anxiety symptoms. Two hundred fifteen patients were assigned to high-, moderate-, or low-level psychiatric comorbidity based on the Hospital Anxiety and Depression Scale and were studied regarding the occurrence of major abdominal conformations. Moderate and high psychopathological groups showed the higher occurrence of Shin ka hi koh [Low, 21%; Moderate, 67%; High, 74%] ($p$ < 0.0001). In conclusion, moderate and high psychopathological patients showed the higher occurrence of a specific abdominal sign.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.1-9
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• 2020

Purpose : The aim of this study was to compare the effects of the abdominal draw-in exercise (ADIE) and the dead bug exercise (DBE) on the pelvic anterior tilt angle and the activities of the gluteus maximus (GM), erector spinae (ES), and semi tendinosus (ST) during prone hip extension. Methods : A total of 22 female adults with weak abdominal muscles were divided into two groups: ADIE group (n=11) and DBE group (n=11). The muscle activities of the GM, ES, and ST along with the pelvic anterior tilt angle during prone hip extension were measured using a wireless surface electromyograph and gyro sensor before performing the prescribed exercise. Two groups conducted the assigned exercise for 10 minutes. After the exercise, their muscle activities and the pelvic anterior tilt angle were equally re measured. Results : In the DBE group, the muscle activity of GM was significantly increased after the intervention (p<0.05). However, there was no significant difference between the two groups in the amount of increase in the activity of GM (p>0.05). Moreover, in both groups, the activity of ES and the pelvic anterior tilt angle decreased significantly after the intervention (p<0.05) The decreased quantity in the pelvic anterior tilt angle and in the activity of ES showed no difference between the two groups (p>0.05). In the activity of ST, there was no significant difference within and between the two groups (p>0.05). Conclusion : Therefore, we suggest that ADIE and DBE are effective for women with weak abdominal muscles since the ES activity and pelvic anterior tilt angle are reduced during prone hip extension.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.63-73
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• 2020

Purpose: To investigate breathing-related changes in the balance ability of healthy adults. Methods: The participants were 36 healthy adults in their 20s and 30s. All participants were trained in three breathing (neutral, thoracic, and abdominal) methods one week before measurements. We used AccuSway to measure each participant's balance ability, using each breathing technique, in two postures (bipedal and unipedal). Results: During the bipedal balance task, abdominal breathing produced significant increases in path length and sway velocity. Abdominal breathing resulted in significant changes in sample entropy at the anteroposterior location compared with neutral breathing (p<.05). In the normalized anteroposterior location, there were significant changes in backward movement during thoracic and abdominal breathing compared with those during neutral breathing (p<.05). During the unipedal balance task, path length and sway velocity increased significantly during voluntary breathing compared with those during neutral breathing (p<.05). There was a significant change in backward movement when abdominal breathing-compared with neutral breathing-was used in the normalized anteroposterior location (p<.05). In the normalized left-right location, there was a significant shift to the right during thoracic breathing compared with that during neutral breathing (p<.05). Conclusion: Compared with neutral breathing, altered voluntary breathing patterns affect balance in healthy adults. Our results indicated that that static balance was more affected by abdominal breathing than by neutral breathing. Future studies should examine variables such as the breathing volume, rhythm, and method.

• Advances in pediatric surgery
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• v.14 no.2
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• pp.153-163
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• 2008

Inflammatory myofibroblastic tumor (IMT) is a rare reactive lesion characterized by the feature of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. Extrapulmonary IMTs in children have been described involving the mesentery, omentum, retroperitoneum, abdominal soft tissues, liver, bladder, mediastinum, head and neck, extremity, appendix, and kidney. Medical records of children treated with abdominal IMT between 1985 and 2005 were reviewed retrospectively. Seven children were treated for IMT with the mean age of 3 y 2 m (range, 1 y 1 m to 14 y). Tumors were located in transverse mesocolon (n=2), omentum (n=1), porta hepatis (n=2), complex site (antrum, duodenum, common bile duct, porta hepatis) (n=2). The symptoms included abdominal mass, fever, jaundice, abdominal pain and anemia. The masses were excised totally in transverse mesocolon, omentum IMT and there is no evidence of recurrence (follow-up periods: 6 y 8 m, 8 y 9 m, 4 y 10 m). In porta hepatis IMT, liver transplantations were performed and there is no evidence of recurrence (follow period: 6 y 8 m, 8 y 7 m). In one case of complex site IMT, partial excision of mass was performed and he still survived with no change of the residual tumor during follow-up period. The other one of complex site IMT denied further treatment after the biopsy. In conclusion, complete surgical excision including liver transplantation and close follow-up are mandatory for the abdominal IMT in child.