• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.35-45
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• 2011

목적: 본 연구의 목적은 고해상도 자기공명영상 장치를 이용하여 젊은 성인에서 병변이 없는 견갑하근의 건 부분의 구조적 특성에 대하여 알아보고자 하였다. 대상 및 방법: 2007년 4월부터 2010년 5월까지 상완-관절와 불안정성 및 비특이적 견관절 통증을 평가하기 위해 본원 정형외과 외래를 방문한 20대의 젊은 성인들에서 시행한 총 88예 (88견관절)의 고해상도 자기공명영상을 대상으로 하였다. 모든 예에서 견갑하근의 근-건 단위에서의 병변은 관찰되지 않았다. 자기공명영상에서 견갑하근의 근-건 단위에 대한 횡적 길이를 측정하였으며, 각 근육 내 건가닥의 수를 측정하였다. 결과: 자기공명영상에서 설정된 축상 기준면 상 측정된 견갑하근의 건대의 횡적 길이는 평균 15.0 mm (범위: 8~20 mm)였고, 전체 건 부분의 횡적 길이는 48.9 mm (범위: 40~60 mm)였다. 또한 관상사면을 기준으로 관절와의 가장 내측 면을 지나는 영상에서 측정한 근육 내 건가닥의 수는 20예에서는 3개 (22.72%), 45예에서는 4개 (51.14%) 그리고 23예에서는 5개(26.14%)였다. 또한 관상사면을 따라 견갑하근의 근-건 단위를 추적하였을 때, 외측으로 갈수록 건가닥의 형태가 점진적으로 둥글어지고 두꺼워지는 것을 관찰할 수 있었으며, 상방으로 수렴되는 방향성을 가지는 것이 관찰되었다. 결론: 자기공명영상을 이용하여 견갑하근의 건 부분에 대한 구조와 형태적 특성을 관찰할 수 있었다. 이러한 자기공명영상의 분석과 이해는 견갑하근에 대한 연구의 생역학적 기초를 제공하게 될 것으로 생각하며, 견갑하근의 파열과 정상적인 생역학적 기능을 회복하기 위한 수술적 접근의 근거로 제시될 수 있을 것으로 생각한다.

• 대한영상의학회지
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• 제85권1호
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• pp.171-183
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• 2024

목적 본 연구의 목적은 수술 전 MRI의 다양한 간접 소견 중 어떤 소견이 외과적 치료가 필요한 견갑하건 파열을 예측하는 데 가장 주요한 것인지 조사하는 것이다. 대상과 방법 총 86명의 환자를 대상으로 수술 전 MRI 영상을 후향적으로 분석하였다. 견갑하건 파열의 직접평가, 이두박근 장두의 병리, 상완골두의 후방위, 상완골 회전, 견갑하근의 지방변성과 위축을 평가하였다. En-face 보기에서 부리돌기의 끝과 관절오목의 기저를 연결한 base-to-tip line (이하 BTL)을 이용한 육안 등급 및 두께 측정을 통해서 위축을 평가하였다. 결과 관절경 시술에서 31명(36%)의 환자가 Lafosse type III 또는 IV의 견갑하건 파열을 보여, 재건수술을 받았다. 이두박근 장두의 병리(p = 0.002), 상완골두의 후방위(p = 0.012), 견갑하근의 지방 변성(p < 0.001), BTL 등급(p = 0.003)은 견갑하건 파열과 유의한 상관관계가 있었다. 다변량 분석에서 상완골두의 후방위(p = 0.011, odds ratio [이하 OR] = 5.14)와 견갑하근의 지방변성(p = 0.046, OR = 2.81)은 견갑하건 파열의 독립적인 예측인자였다. 결론 상완골두의 후방위와 지방변성은 견갑하건 파열 진단에 도움이 될 수 있다. 이러한 결과를 판독하는 것은 최적의 수술 전략을 계획하는 데 기여할 수 있다.

• 한국축산식품학회지
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• 제41권1호
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• pp.71-84
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• 2021

This study aimed to determine the effects of breed on meat quality characteristics of porcine Boston butt muscles (M. subscapularis) from three different pig breeds: Landrace×Yorkshire×Duroc (LYD), Berkshire, and Ibérico available in Korean market. Ibérico showed significantly higher fat content, yellowness (CIE b⁎), cooking loss, and lower shear force values than LYD and Berkshire. Moreover, the contents of oleic acid (18:1) and palmitic acid (16:0) were significantly higher in Ibérico breed, but stearic acid (18:0) was higher in LYD. As linoleic acid (18:2) and arachidonic acid (20:4) were higher in Berkshire sows as compared to the other breeds, atherogenicity and thrombogenicity indexes were significantly lower in Berkshire sow. Ibérico had lower the ω-6/ω-3 fatty acids ratio, and higher taurine and free amino acids compared with the others. Ibérico also showed significantly greater lipid oxidation, lower antioxidant capacity, and higher hypoxanthine contents, whereas the Berkshire had higher inosine-5'-monophosphate and lower K-index value as compared to the Ibérico. The breed did not impart any significant effect on the size and density of muscle fibers. Thus, quality characteristics of Boston butt varied from breed to breed, and certain consumer preferences for Ibérico can be explained, in part, by the unique quality characteristics imparted by higher contents of intramuscular fat, oleic acid, and free amino acids.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.265-273
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• 2022

Background: Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. Methods: This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. Results: The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. -1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. Conclusions: In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.

• Investigative Magnetic Resonance Imaging
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• 제25권1호
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• pp.1-9
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• 2021

The aim of this study was to provide a new assessment of rotator cuff muscle activity. Eight male subjects (24.7 ± 3.2 years old,171.2 ± 9.8 cm tall, and weighing 63.8 ± 11.9 kg) performed the study exercises. The subjects performed 10 sets of the exercise while fixing the elbow at 90 degrees flexure and lying supine on a bed. One exercise set consisted of the subject performing external shoulder rotation 50 times using training equipment. Two imaging protocols were employed: (a) true fast imaging with steady precession (TrueFISP) at an acquisition time of 12 seconds and (b) multi-shot spin-echo echo-planar imaging (MSSE-EPI) at an acquisition time of 30 seconds for one echo. The main method of assessing rotator cuff muscle activity was functional T2 mapping using ultrafast imaging (fast-acquired muscle functional MRI [fast-mfMRI]). Fast-mfMRI enabled real-time imaging for the identification and evaluation of the degree of muscle activity induced by the exercise. Regions of interest were set at several places in the musculus subscapularis (sub), musculus supraspinatus (sup), musculus teres minor (ter), and deltoid muscle (del). We used the MR signal of the images and transverse relaxation time (T2) for comparison. Most of the TrueFISP signal was not changed by exercise and there was no significant difference from the resting values. Only the T2 in the musculus teres minor was increased after one set and the change were seen on the T2 images. Additionally, except for those after one and two sets, the changes in T2 were significant compared to those at rest (P < 0.01). We also demonstrated identify and visualize the extent to which muscles involved in muscle activity by exercise. In addition, we showed that muscle activity in a region such as a shoulder, which is susceptible to B0 inhomogeneity, could be easily detected using this technique.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.89-98
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• 2010

This study was performed to investigate the effectiveness of trigger point needling and oriental medical treatment to shoulder pain patients in stroke sequelae with three aspects of pain and range of motion, muscle strength. Trigger point needling was applied to 3 patients on supraspinatus, infraspinatus, deltoid, subscapularis muscle. For evaluating treatment, visual analog scale(VAS), passive range of motion(PROM), muscle strength evaluation(MSE) were checked. After treatment, VAS score of 1 cases were decreased. PROM of 1 case was improved and MSE of 2 cases were improved slightly. These results suggest that trigger point needling and oriental medical treatment were effective on shoulder pain patients in stroke sequelae and it is necessary to research more case with shoulder pain in stroke sequelae.

• 한국축산식품학회지
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• 제35권5호
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• pp.646-652
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• 2015

The beef forequarter muscle comprises approximately 52% of carcass weight. The objective of this study was to evaluate the physiochemical characteristics and meat color from forequarter muscle of Holstein steers. Fifteen forequarter muscles were trimmed of external connective tissue and fat. An experimental group of eight Holstein steers was assessed using meat color, water-holding capacity, drip loss, and Warner-Bratzler shear force value at the same quality grade. The M. omotransversarius (0.45 kg) had the highest (p<0.05) lightness (L*) value, whereas the M. teres major (0.4 kg) and M. triceps brachii (caput laterale) (0.52 kg) had the lowest (p<0.05) values. The M. semispanitus capitus (1.48 kg), which is a neck muscle, had the highest values for both redness (a*) and yellowness (b*), whereas the lowest (p<0.05) values were for the M. teres major. The M. omotransversarius, M. latissimus dorsi (1.68 kg), and M. rhomboideus (1.2 kg) were ranked high (p<0.05) in water-holding capacity. The drip loss value was the highest for the M. longissimus dorsi thoracis (p<0.05; 1.86 kg), while the M. infraspinatus (2.28 kg), M. supraspinatus (1.38 kg), M. brachiocephalicus (1.01 kg), and M. pectoralis superficialis (1.18 kg) had the lowest (p<0.05). The Warner-Bratzler shear force value indicated that the M. pectoralis profundus (3.39 kg), M. omotransversarius, and M. brachiocephalicus were the toughest (p<0.05), whereas the M. subscapularis (0.86 kg), M. longissimus dorsi thoracis, M. teres major, and M. infraspinatus were the most tender cuts (p<0.05). Here, muscle type explained most of the variability in the forequarter physiochemical characteristics. Thus, our findings suggest that these muscle profile data will allow for more informed decisions when selecting individual muscles to produce value-added products from Holstein steers.

• 대한관절경학회지
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• 제8권2호
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• pp.124-131
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• 2004

목적: 관절경으로 견갑하건을 봉합하여 비교적 좋은 결과를 얻었으므로 그 수기를 소개하고 그 적용범 위를 알아보고자 하였다. 대상 및 방법: 2003년 4월부터 2004년 4월까지 관절경하 견갑하건 봉합술을 시행했던 8예를 대상으로 하였다. 평균 추시기간은 ll개월이였다. 견갑하건의 단독 손상이 2예, 후상방회전근개의 소범위 단순파열과 동반된 손상이 4예, 후상방 회전근개의 광범위 파열과의 동반이 2예이었다. 견갑하근의 파열형태로서 상방부의 전층파열이 6예, 관절면에 국한된 부분파열이 1예 그리고 완전파열이 1예이었다. 결과판정은 최종 추시시점에서의 환자의 주관적 만족도, 상방 전위된 상완골두의 하방이동 여부 그리고 임상적 평가로서 Constant - Murley 기능평가법 이용하였다(Table 1) 결과: 술 후 평균 11개월에서의 견관절 기능평가는 술 전 55점에서 술후 75점으로 증가되었고 광범위 후상방파열이 동반되었던 2예를 제외한다면 술 후 평균 71점으로 비교적 우수한 결과를 보였다. 상완골두의 상방이동은 술 전평균 0.7 cm에서 술 후 0.5 cm로 감소하였으나 상방이동이 오히려 가속된 1 예를 제외한다면 대부분의 경우에서 뚜렷한 하방 이동을 보였다. 최종 추시 시점에서의 술 후 만족도에서는 만족이 5예, 보통이 1예 그리고 불만족이 2예 이었고 불만족인 1예에서는 술 후 6개월에 관혈적 방법으로 견갑하건을 봉합하였다. 결론: 관절경을 이용한 견갑하건의 봉합은 광범위파열과 동반된 견갑하건의 파열이 있을경우 퇴축이 심하지 않다면 피부절개와 삼각근의 절개범위를 줄일 수 있어 술 후 통증이나 삼각근의 약화로 발생할 수 있는 합병증을 줄일수 있으며, PASTA 병변을 포함해서 후상방 파열과 동반되지 않은 견갑하건의 부분 파열은 매우 적합한 관절경하복원술의 적응증이 될 수 있다고 사료된다.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.100-104
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• 2020

Function and strength of the deltoid muscle are important in reverse shoulder arthroplasty (RSA). Moreover, location and shape of the acromion, clavicle, and scapular spine, which are origins of the deltoid muscle, are also important. The frequency of os acromiale is 5% to 15%; however, it is rare in the Asian population, affecting approximately 0.7% of Koreans. RSA has rarely been reported in patients with os acromiale. We present a case series of two patients with cuff tear and arthropathy combined with os acromiale who underwent RSA. From 2016 to 2018, two patients with os acromiale who presented with pain and limited range of motion (ROM) underwent RSA with cuff tear arthropathy using the subscapularis-sparing deltopectoral approach. Their ROM, visual analog scale (VAS), and satisfaction were evaluated before and after surgery. In both patients, VAS decreased, ROM increased, and postoperative satisfaction increased. There were no specific complications due to os acromiale. The VAS, ROM, and satisfaction of patients improved after surgery compared with values before surgery. However, careful attention must be given during surgery to ensure optimal repair and recovery.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.