• 제목/요약/키워드: lateral branch

검색결과 199건 처리시간 0.026초

고주파열응고술을 이용한 척수신경 후내측지 신경절제술에서 후내측지를 확인하는 새로운 기준 -증례 보고- (A New More Reliable Indicator for Confirmation of the Medial Branch in Radiofrequency Neurotomy -Case report-)

  • 신근만;최상은;윤선혜;임소영;정배희;이기헌;홍순용;최영룡
    • The Korean Journal of Pain
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    • 제13권2호
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    • pp.242-246
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    • 2000
  • Radiofrequency medial branch neurotomy is an effective way of controlling pain in the posterior compartment of the spine such as the facet joint, and the interspinous ligament. However, it is difficult to determine the exact location of the medial branch. Up until now we have relied on sensory response provoked by 50 Hz stimulation. The responses elicited using this method are quite subjective and can originate from sources other than the medial branch such as the periosteum, the intermediate or lateral branch. We need a confirmed indicator to locate the medial branch reliably. We applied 2 Hz stimulation under 0.4 volts to locate the medial branch and elicited a motor response. Twitching of multifidus and muscles around the SI joint was observed. The observation of these muscles provides a much more reliable method for confirmation of the medial branch. We have treated 45 chronic nonspecific low back pain patients using radiofrequency medial branch neurotomy with this method of confirming the medial branch.

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역혈류성 전외측대퇴 혈관경피판을 이용한 무릎 주위 결손의 재건 (Distally Based Anterolateral thigh Pedicled Flap in the Reconstruction of Defect Around Knee)

  • 박상순;심정수
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.769-774
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    • 2010
  • Purpose: As the soft tissue defect around the knee is difficult to reconstruct, local flap or free flap is used. Distally based anterolateral thigh pedicled flap introduced by Zhang uses sufficient reverse flow supplied from the vascular network around the knee. We report successful reconstruction of defect around knee by this method. Methods: Four patients with skin & soft tissue defect around knee have been treated for reconstruction using the distally based anterolateral thigh pedicled flap. First, the doppler was used to check the perforator flap of the descending branch of the lateral circumflex femoral artery and to draw and dissect the perforator flap as much as needed. After the dissection, the proximal of the descending branch was clamped and checked for sufficient supply of blood flow from the reverse flow and then ligated. It was dissected along the descending branch and in order to prevent damage to the joined parts of the descending branch and the lateral superior geniculate artery, a more careful ligation was done starting from 10 cm superior to the knee. The defect was reconstructed after securing enough vascular pedicle to cover all the damaged parts. Results: Not all patients suffered from flap necrosis. In case of the patient with chronic osteomyelitis, slight venous congestion was observed right after the surgery but it disappeared the following day. All three patients had no occurences of additional complications. Conclusion: Distally based anterolateral thigh pedicled flap was enough to provide large flap for knee reconstruction. It had sufficient blood flow and vascular pedicle. It also had taken short operation time compared to the free flap operation. The distally based anterolateral thigh pedicled flap used by the authors is a very useful way of reconstructing the area around knee.

Computed tomographic anatomy of hepatic artery in normal beagle dogs

  • Kim, Soochan;Jeong, Seongmok;Lee, Heechun;Lee, Youngwon;Choi, Hojung
    • 대한수의학회지
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    • 제59권2호
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    • pp.55-58
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    • 2019
  • This study was performed to examine the visualization and anatomical variants of the hepatic artery with dual-phase computed tomography (CT) angiography and three-dimensional volume rendering imaging analysis in clinically normal dogs. Seven healthy beagle dogs were enrolled and underwent dual CT angiography. Arterial phase images could be obtained with multi-detector CT angiography using the fixed-scan method in these dogs. Contrast enhancement of the hepatic parenchyma was quite minimal because of the unique blood supply system of the liver. In most dogs, the main hepatic arterial branches were the right lateral branch, left branch, and right medial branch. Although hepatic arterial variation appears to be common in dogs, only one dog in this study had the caudate lobar branch as the first branch of the hepatic artery. Further study on a larger number of dogs with CT images will be needed to identify and classify the pattern of hepatic arterial variations.

Prognostic Factor Analysis for Management of Chronic Neck Pain : Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

  • Seong, Han Yu;Lee, Moon Kyu;Jeon, Sang Ryong;Roh, Sung Woo;Rhim, Seung Chul;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • 제60권4호
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    • pp.456-464
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    • 2017
  • Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

Lateral Brow Lift: A Multi-Point Suture Fixation Technique

  • Foustanos, Andreas;Drimouras, Georgios;Panagiotopoulos, Konstantinos
    • Archives of Plastic Surgery
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    • 제42권5호
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    • pp.580-587
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    • 2015
  • Background Descent of the lateral aspect of the brow is one of the earliest signs of aging. The purpose of this study was to describe an open surgical technique for lateral brow lifts, with the goal of achieving reliable, predictable, and long-lasting results. Methods An incision was made behind and parallel to the temporal hairline, and then extended deeper through the temporoparietal fascia to the level of the deep temporal fascia. Dissection was continued anteriorly on the surface of the deep temporal fascia and subperiosteally beyond the temporal crest, to the level of the superolateral orbital rim. Fixation of the lateral brow and tightening of the orbicularis oculi muscle was achieved with the placement of sutures that secured the tissue directly to the galea aponeurotica on the lateral aspect of the incision. An additional fixation was made between the temporoparietal fascia and the deep temporal fascia, as well as between the temporoparietal fascia and the galea aponeurotica. The excess skin in the temporal area was excised and the incision was closed. Results A total of 519 patients were included in the study. Satisfactory lateral brow elevation was obtained in most of the patients (94.41%). The following complications were observed: total relapse (n=8), partial relapse (n=21), neurapraxia of the frontal branch of the facial nerve (n=5), and limited alopecia in the temporal incision (n=9). Conclusions We consider this approach to be a safe and effective procedure, with long-lasting results.

Early Stages in Morphogenesis of the Shell of Crenella decussata (Bivalvia: Mytilidae)

  • Kolotukhina, N.K.;Kulikova, V.A.;Evseev, G.A.
    • 한국패류학회지
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    • 제27권2호
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    • pp.91-97
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    • 2011
  • This study examines the morphological features of larval and postlarval shells of the paedomorphic bivalve Crenella decussata Montagu, 1808 from the Sea of Japan. During the early morphogenesis of the shell of C. decussata the following characteristics appear: prodissoconch I -the anterior and posterior provincular teeth, a broad primary ligament pit located on the chondrophore; nepioconch - the anterior and posterior juvenile teeth,primary lateral teeth, fine commarginal and radial sculpture. Larvae of C. decussata distinctly differ from other mytilid larvae by a D-shaped shell, absence of umbo, astraight hinge margin, and homogeneous fine-grained sculpture without co-marginal lines of growth. These shell characters indicate lecithotrophic development of this species. Some morphostructures are revealed which might be used in crenellin taxonomy.

The Use of Arteriovenous Bundle Interposition Grafts in Microsurgical Reconstruction: A Systematic Review of the Literature

  • Kareh, Aurora M.;Tadisina, Kashyap Komarraju;Chun, Magnus;Kaswan, Sumesh;Xu, Kyle Y.
    • Archives of Plastic Surgery
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    • 제49권4호
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    • pp.543-548
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    • 2022
  • Microvascular reconstruction frequently requires anastomosis outside of the zone of injury for successful reconstruction. Multiple options exist for pedicle lengthening including vein grafts, arteriovenous loops, and arteriovenous bundle interposition grafts. The authors performed a systematic review of arteriovenous bundle interposition grafts to elucidate indications and outcomes of arteriovenous grafts in microvascular reconstruction. A systematic review of the literature was performed using targeted keywords. Data extraction was performed by two independent authors, and descriptive statistics were used to analyze pooled data. Forty-four patients underwent pedicle lengthening with an arteriovenous graft from the descending branch of the lateral circumflex femoral artery. Most common indications for flap reconstruction were malignancy (n = 12), trauma (n = 7), and diabetic ulceration (n = 4). The most commonly used free flap was the anterolateral thigh flap (n = 18). There were five complications, with one resulting in flap loss. Arteriovenous bundle interposition grafts are a viable option for pedicle lengthening when free flap distant anastomosis is required. The descending branch of the lateral circumflex femoral artery may be used for a variety of defects and can be used in conjunction with fasciocutaneous, osteocutaneous, muscle, and chimeric free flaps.

외측연수증후군(外側延髓症候群)(wallenberg syndrome)으로 진단받은 태음인환자를 치료한 1예(例)에 대한 증예보고(症例報告) (A Case Study about Treatment of Taeumin Patient diagnosed as Lateral medullary syndrome(wallenberg syndrome))

  • 이시우;박혜선;김경요;김형순
    • 사상체질의학회지
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    • 제13권2호
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    • pp.182-189
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    • 2001
  • If the proximal portion of the fourth segment of the vertebral onery is occluded before the posterior inferior cerebellar artery branch, ischemia usually affects the lateral medulla oblongata or the ipsilateral side of the cerebellum. The lateral medullary syndrome(wallenberg syndrome) resulting from occlusion in this area is common. 62 years old male who has swallowing difficulty, dizziness and diagnosed as the lateral medullary syndrome(wallenberg syndrome) is admitted in Wonkwang university oriental medical hospital Kwangju. We have diagnosed him as Taeumin and treated by east integrated therapy. We classified this as Taenmin-liyoiljung(太陰人 裏熱症) and prescribed chungsimyoinjatang(淸心蓮子湯) to the principle of cheongganjoyoil(淸肝燥熱). In the result, we had the improvement of the symptoms. This report described the process and contents about the way the patient was cured.

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Growth of Salix gracilistyla Miq. Originated from Provenance in Gangwon-do, Korea for Bioenergy Resource

  • Hyunseok Lee
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2020년도 추계국제학술대회
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    • pp.59-59
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    • 2020
  • Salix gracilistyla has a characteristic of fast growth especially in the river side or infertile soil, showing a lot of lateral branches and a strong root system among the Salix. spp. On the basis of results observed, we provide several growth characteristics of S. gracilistyla among some selected provenances. In two-year results, root collar diameter ranged from 33.5 mm to 56.7 mm. Taeback showed the lowest value, and Jeongseon and Hoengseong were higher than the other areas in the traits above. Height growth was the lowest in Samcheok and the highest in Wonju. To examine growth and development of lateral branches is important because S. gracilistyla has a lot of lateral branches which account for high biomass production. Length of lateral branch showed high variation, in which the highest number was observed in Yeongwol and the lowest in Samcheok. Many lateral branches were shown in Wonju. Preliminary study on biomass resources evaluation, we analyzed correlation between volume and length, and volume and root diameter. High correlation was observed between root diameter and plant volume. And we compared the observed volume with the caculated volume by regression formula. To evaluate Salix species as biomass resources, it is needed to survey growth characteristics continuously and adopt selection of individuals or families of high biomass and caloric values by reliable data. In addition, Salix spp. can be also applicable to selection breeding regime because of feasible propagation and fast growth.

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대퇴직근 기능성 유리 피판술을 위한 신경 및 혈관에 대한 해부학적 고찰 (Anatomic Analysis of Rectus Femoris Functional Flap in Korean)

  • 한경진;이영길;김준용;한승환;이두형;조재호
    • Archives of Reconstructive Microsurgery
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    • 제16권1호
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    • pp.1-5
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    • 2007
  • The purpose of this article to evaluate the availability of the rectus femoris flap in Korean subjects. Material and Methods is that Cadaveric dissections were done on 51 femoral triangles of 26 cadevers. We measured the length of the direct head of rectus femoris from anterior superior iliac spine to patella upper pole, ASIS to lateral border of femoral nerve, and entry point of femoral nerve and vessel branches to rectus. Usually, there were three terminal branches to rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal $17.5{\sim}31.4%$ portion of the rectus femoris. The second and the third branch entered at the proximal $22.5{\sim}40.7%$ and $26.3{\sim}42.3%$, respectively. The vessel entry was at $20.2{\sim}37.3%$. The length from ASIS to femoral nerve was $3.5{\sim}8.5\;cm$. Among the 51 rectus femoris muscles, 44 had one nutrient artery, and 7 had 2 nutrient arteries. The nutrient artery originated from the descending branch of the lateral femoral circumflex artery in 18(40.9%) cases, directly from the lateral femoral circumflex artery in 8(18.0%) cases, and from proximal(6 cases, 13.6%) and distal(12 cases, 27.3%) portion of the deep femoral artery. The average length of the nutrient artery was 29.8 mm and the width was 2.14 mm. The point where it meets the main feeding artery of the rectus femoris was $9.0{\sim}15.0\;cm$ from the ASIS. In all cases, the main artery's entrance was proximal to the first nerve branch. Conclusion is that rectus femoris has available data for functional flap.

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