• 한국응용과학기술학회지
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• 제40권2호
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• pp.342-347
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• 2023

본 연구의 목적은 무중력 운동기구를 활용한 하이플랭크 운동 동작 차이에 따른 상완, 체간 및 코어근육의 근활성도를 비교하는 것이었다. 본 연구의 대상자는 20대 남성 6명을 대상으로 진행하였고(연령, 23.00±0.73 세; 신장, 172.95±2.05 cm; 체중, 66.83±2.75 kg; 신체질량지수, 22.33±0.72 kg/m²), 4가지(HP, HPAW, HPSB 및 HPWT)의 하이플랭크 동작을 수행하였으며, 근활성도 분석을 위하여 구체적인 표면전극의 부착 부위는 신체 근육의 우측 삼각근, 상완삼두근, 광배근 및 외복사근으로 설정하였다. 본 실험 결과, 삼각근, 상완삼두근, 광배근 및 외복사근의 근활성도는 HPSB 동작 시 가장 높게 나타났다(p=.000). 따라서 본 연구의 결과는 추후 무중력 운동기구를 활용한 하이플랭크 동작 시 효과적인 운동 프로그램의 기초자료가 될 것으로 기대된다.

• 한국응용과학기술학회지
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• 제39권2호
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• pp.335-339
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• 2022

본 연구의 목적은 정적 플랭크 운동의 동작 차이에 따른 코어근육의 근활성도를 비교하는 것이었다. 본 연구의 대상자는 "J"대학교 20대 남성 10명을 대상으로 진행하였고(연령, 23.20±0.65 세; 신장, 174.54±1.51 cm; 체중, 70.00±2.24 kg; 신체질량지수, 22.94±0.51 kg/m²), 4가지의 풀, 엘보우, 사이드 및 리버스 정적 플랭크 동작을 수행하였으며, 근전도 분석을 위한 표면전극 부착 부위는 신체 근육의 우측복직근, 외복사근, 광배근 및 척추기립근으로 설정하였다. 본 실험 결과, 광배근과 척추기립근의 근활성도는 리버스 플랭크 동작 시 가장 높게 나타났고(p<.001), 복직근과 외복사근의 근활성도는 엘보우 플랭크 동작 시 가장 높게 나타났다(p<.001). 따라서 본 연구의 결과는 추후 정적 플랭크 동작 시 효과적인 운동 프로그램의 자료가 될 것으로 기대된다.

• 대한두개안면성형외과학회지
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• 제25권1호
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• pp.22-26
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• 2024

Background: This study analyzed the demographic characteristics of patients with facial palsy who were treated using either dynamic or static procedures. This study aimed to compare the frequency of procedure implementation and age distribution between the two groups. Methods: This study retrospectively analyzed the medical records of patients treated for facial palsy at a single institution from 2014 to 2022. Among cases included in our study, dynamic procedures involved cross-facial nerve graft and latissimus dorsi or gracilis muscle flap transfer. Static procedures included gold weight insertion, canthopexy, browlift, and thread lift/static slings. Results: Among the 31 patients included in our study, eight (25.8%) incorporated dynamic techniques, and the average age of patients was 44.75 years (range, 24-68 years) with a male to female ratio of 1:4. The remaining 23 patients (74.2%) underwent a static procedure, of which the average age was 59.17 years (range, 23-81 years) which was statistically significantly higher than the average age of 44.75 of dynamic patients (p= 0.013). Regarding the timing of treatment after diagnosis, no patient underwent dynamic procedures more than 20 years after initial diagnosis. A greater diversity in the timing of treatment was observed in the static group. All patients who underwent dynamic procedures were treated using static procedures during the study period. Conclusion: Because aesthetics-based static techniques are typically quick outpatient procedures that can be performed under local anesthesia, our study shows that these are often preferred treatments for all age groups, especially for debilitated or older patients. Further research is required to investigate the long-term functional outcomes of these surgical techniques in a wider population of patients.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.24-34
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• 1996

There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

• 대한족부족관절학회지
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• 제1권1호
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• pp.59-64
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• 1997

전북대학교병원 정형외과에서 1992년 6월부터 1996년 5월까지 족부 손상 13례에 대하여 유리조직 이식술울 시행하고 만 1년이상 추시하여 다음과 같은 결과를 얻었다. 1 손상 족부의 원인별로는 압궤손상이 9례, 족부 골수염 3례, 그리고 전기화상 1례 등 13례이었다. 2. 유리조직 이식술은 족배피판이 5례(38.5%), 박근 4례(30.7%), 복직근(15.4%), 고아배근피 이식술과 상환 피부판 이식술 각 1례 등 13례를 시행하였는데 부위별로는 족배부에 족배피판 4례와 박근 4례를 시행하였고, 발뒤꿈치의 후방에 광배근 피판 1례, 후외측에 족배피판 및 상완 피판 각 1례, 족부 후방과 족장부 동시 손상에 복직근 1례, 긔록 내측부 손상에 복직근 1례를 시행하였다. 2. 6례의 유리 근 이식술후 평균 20일만에 피부 이식술을 시행하였으며 괴사없이 도포되었다. 4. 유리조직 이시술을 시행한 13례 전례에서 생존하여, 6례에서 시행하였던 피부 이식술을 제외한 2차 술식없이 손상되었던 족부를 재건할 수 있었으며 유리조직의 신발신기 평가에서도 양호 이상의 좋은 결과를 얻었다.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.29-35
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• 2002

Free flap reconstruction of the foot has become one of the standard procedures at the present time, but choice of a free flap for the soft tissue defect of the foot according to location and size remains controversial. We evaluated the results of free flap reconstruction for the soft tissue defects of the foot. Twenty seven free flaps to the foot were performed between May 1986 and December 2000 in the department of Orthopedic Surgery. Patient age ranged from 3 to 60 years. Male to female distribution was 20:7. Mean follow-up period was 30.5 months which ranged from 12 months to 60 months. The indications for a specific flap depended on the location and extension of the foot defect. In weight-bearing area and amputation stump, the authors chose the sensate (reinnervated) dorsalis pedis flaps (n=7) and sensate radial forearm flaps (n=2). In nonweight-bearing area including dorsum of the foot and area around Achilles tendon, we performed nonsensate (non-reinnervated) free flap reconstructions which included dorsalis pedis flaps (n=5), groin flap (n=1), radial forearm flaps (n=6), scapular flaps (n=4), latissimus dorsi flaps (n=2). Twenty-six flaps transferred successfully (96.3%). The sensate flaps which were performed in weight-bearing area and amputation stumps survived in all cases and recovered protective sensation. Mean two-point discrimination was 26 mm at the last follow up. As a conclusion, the selection of a proper flap depends on the location and extension of the foot defect and patient's age. Fasciocutaneous flap including radial forearm flaps and dorsalis pedis flaps were the best choice in nonweight-bearing area. The sensate free flaps which are performed in the weight-bearing area and amputation stumps can produce better outcome than nonsensate free flap.

• Journal of Chest Surgery
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• 제32권5호
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• pp.428-432
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• 1999

배경: 전기적인 자극에 의하여 골격근의 피로현상이 극복됨으로써 골격근을 심장보조장치에 이용할 수 있게 되었다. 인공심장이나 심실보조기구는 에너지원의 전원장치가 크고 거추장스러운 단점이 있어 아직 해결해야될 문제이다. 반면 골격근을 이용한 심실보조장치는 에너지원으로 환자 자신의 골격근 수축력을 이용할 수 있는 장점이 있어 이의 임상응용 가능성을 제시하고자 한다. 대상 및 방법: 8예의 광배근을 이용하여 골격근 심실의 모형을 만들었다. 물이 담긴 라텍스 주머니를 골격근이 한바퀴 반 감싸도록 고안하였고 골격근의 수축압력은 연결된 관을 통하여 변환기에 기록되도록 하였다. 전극은 흉배신경 주위에 설치한 후 Itrel 7420 박동기에 연결하였다. 프로그래머로 박동기를 조절하였으며 3.0Volt, cyclic burst, 0.31초 on time, 6.0초 off time의 자극을 주었다. 라텍스 주머니 내에 액체의 양을 25cc 씩 증가시키면서 전부하의 변화에 따른 골격근 심실의 박출량과 압력 및 수축력을 측정하였다. 결과: 골격근 심실의 전부하가 0인 경우 일회박출량은 76.3ml 이고, 전부하가 점차 증가함에 따라 일회박출량이 감소하는 경향을 보였다. 전부하가 75cc 이상이 되면 일회박출량은 70ml 이하로 감소하는 양상을 볼 수 있었다. 압력을 측정한 결과도 전부하가 75cc 이하인 경우 정상의 혈압과 비슷한 107mmHg 이상의 혈압을 보이고 있으나 전부하가 100cc 이상 증가하는 경우 혈압이 100mmHg 이하로 감소하는 것을 볼 수 있었다. 또한 최대의 골격근 수축력은 50cc의 전부하에서 16.6 W/kg의 힘을 분출하였다. 결론: 골격근 심실은 전부하의 변화에 따라 정상 심장보다도 강한 박출량과 압력의 변화를 관찰할 수 있었으며 임상 응용의 가능성을 볼 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권6호
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• pp.478-482
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• 2011

Purpose: Free flap reconstruction is performed on defects including benign and malignant tumors as well as trauma in the department of oral and maxillofacial surgery, but there are few reports of free flap reconstruction cases for oral cancer in patients in Korea. Methods: This study was designed to retrospectively analyze surgical outcomes and complications of 164 free-flap reconstructions performed at the Oral Oncology Clinic, National Cancer Center, during 2002~2011. A total of 164 free flaps were performed for reconstruction of oral and maxillofacial defects which were caused by oral cancer and osteoradionecrosis in 155 patients. Results: The present study had 162 successful cases and 2 failed cases for a total of 164 cases. The study had a success rate of 98.8% for free-flap reconstructions. Flap donor sites included radial forearm free flap (n=93), fibula osteocutaneous free flap (n=25), anterolateral thigh flap (n=18), latissimus dorsi myocutaneous flap (n=16) and other locations (n=12). Postoperative medical complications were generally pneumonia and delirium. Postoperative local complications occurred including partial flap necrosis, delayed wound healing of the donor site, infection of the recipient site and salivary fistula. The incidence of postoperative complications and patient-related characteristics including age, sex, smoking, history of radiotherapy, hypertension (HTN) and diabetes Mellitus (DM) were retrospectively analyzed. Patient age ($P$=0.003) and DM ($P$=0.000) and HTN ($P$=0.021) were significant risk factors for complications overall. Conclusion: The present study had no mortality and confirms that free-flap reconstructions are extremely reliable in achieving successful results.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.27-34
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• 2011

Purpose: Anterolateral thigh (ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. Methods: 84 patients who were treated with ALT perforator free flap from December 2004 to 2008, and February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from $3{\times}4$ to $12{\times}18$ cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. Results: Among the 84 patients, partial necrosis of flaps occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And total flap necrosis in 5 patients because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. Conclusion: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time need to consider to prevent flap necrosis. And operators should need careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.1-5
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• 2000

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.