• Archives of Plastic Surgery
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• v.39 no.4
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• pp.376-383
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• 2012

Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction. Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed. Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276). Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.13-19
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• 2013

Purpose : The purpose of this research was to develop a proposal by investigating the work habits associated with exercise programs for the prevention of chronic back pain. Methods : The symptoms, areas and causes of musculoskeletal patients were analyzed during a three-month period in order to develop and apply prevention programs that stimulate lumbar deep layer muscle movement. Results : The results of this study show that the lumbar and shoulders are primary areas of pain. According to the literature, lumbar and shoulder pain is caused due to long periods in the standing position and unhealthy posture during work. A preliminary program was conducted for one month to study lower back pain prevention. Preliminary results of the program showed a lumbar stabilizing effect caused by the strengthening of abdominal muscles. In addition, the alignment of the spine often leads to effective action. Therefore, action-oriented programs should be implemented in order to induce contractions of the transverse abdominis muscle. Conclusion : The completed program should consider habit and practices of workers within their working environment. The promotion of health through exercise for both employers and workers is expected to bring physical and psychological benefits that will positively affect economic results.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.140-146
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• 2019

Background Thoracodorsal vessels (TDVs) and internal mammary vessels (IMVs) have both been widely employed as recipient vessels for use in free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flaps. However, whether TDVs or IMVs are preferable as recipient vessels for autologous breast reconstruction with a free MS-TRAM flap remains controversial. The purpose of this study was to compare the clinical outcomes when TDVs were used as recipient vessels to those obtained when IMVs were used as recipient vessels for autologous breast reconstruction with a free MS-TRAM flap. Methods A retrospective matched-cohort study was performed. We retrospectively reviewed data collected from patients who underwent a free MS-TRAM flap for autologous breast reconstructions after mastectomy between March 2003 and June 2013. After a one-to-one matching using age, 100 autologous breast reconstructions were selected in this study. Of the 100 breast reconstructions, 50 flaps were anastomosed to TDVs and 50 to IMVs. Patient demographics and clinical outcomes including operation time, length of hospital stay, postoperative complications, and aesthetic score were compared between the two groups. Results No statistically significant differences were found between the two groups in patient demographics and clinical outcomes, including the complication rates and aesthetic scores. There were no major complications such as total or partial flap loss in either group. Conclusions The results of our study demonstrate that both TDVs and IMVs were safe and efficient as recipient vessels in terms of the complication rates and aesthetic outcomes.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.183-190
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• 2021

Purpose : The purpose of this study was to investigate the effect of side planks on the muscle thickness of the core muscles, external oblique, internal oblique, and transverse abdominis, and this study was conducted to compare whether side plank exercise according to the application of various unstable support surfaces increases the thickness by activating the action of the muscles. Methods : The subjects of this study were 30 healthy adults and were randomly and equally assigned to three groups by a random number table. All subjects were divided into three groups according to the application of an unstable support surface during the side plank(Group A = stable support, Group B = one unstable support, Group C = two unstable supports). The side plank exercise was performed 30 minutes a day, 3 times a week for a total of 4 weeks. The muscle thickness of the core muscle was measured before the intervention, 2 weeks, 4 weeks, and 3 times in total. All measured data were comparatively analyzed by repeated measures ANOVA and one-way ANOVA. The statistical significance level was set to .05. Results : The results of this study were as follows : 1. All muscles showed an interaction between training period and group. 2. There was a significant difference between the groups at the 2 weeks and 4 weeks of the internal oblique and transverse abdominis muscle measurements. Conclusion : The thickness of the abdominal muscle increased during the side plank exercise according to the support surface, and the thickness of the abdominal muscle increased the most during the side plank exercise on the unstable support surface. Therefore, it is thought that the addition of an unstable support surface will provide a more effective therapeutic effect on the thickness change of the abdominal muscle during side plank exercise.

• PNF and Movement
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• v.19 no.1
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• pp.127-135
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• 2021

Purpose: The purpose of this study was to determine the effect of the side-bridge exercise on the thicknesses of the external and internal obliques, the transverse abdominis, and the erector spinae, which are some of the trunk muscles of healthy adult males and females. Methods: There were 30 subjects divided into two groups with 15 subjects in the modified side-bridge exercise group and 15 subjects in the bridge exercise group. The changes in each variable were analyzed before the exercise, after three weeks, and after six weeks of exercise using a two-way repeated analysis of variance. The significance level was set at 0.05. When there was any interaction between the time of measurement and each group, a paired t-test was conducted to find the difference within groups and an independent-sample t-test was conducted to find the difference between groups. The significance level for both tests was set at 0.01. Results: There was a significant difference in the external and internal obliques and the erector spinae according to changes over time and the interactions between the time and groups (p < 0.05). However, there was a significant difference in the transverse abdominis only according to the interaction between the length of times (p < 0.05). Conclusion: The study results indicated that the modified side-bridge exercise significantly increased the thickness of the external and internal obliques and the erector spinae. This suggests the usability of the exercise in lumbar stabilization exercises in future studies and clinical fields.

• Archives of Plastic Surgery
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• v.50 no.4
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• pp.354-360
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• 2023

Background The Island transverse rectus abdominis musculocutaneous (TRAM) flap is well vascularized with very reliable blood flow, because all perforators of the zone I are included when it is harvested. The number of perforators, topographic mapping, and their relationship with reconstructed outcomes were investigated. Methods Fifty patients with Island TRAM breast reconstruction from September 2021 to August 2022 were investigated. The zone I was divided into a total of eight sections. Under the loupe magnification, all perforators larger than 0.5 mm in zone I were counted with fine dissection, and photographs were taken in background of vessel loops. Complications like flap necrosis, seroma, and hematoma were also investigated. Result There are 12 ideal perforators on average in zone I such as one perforator in section I, II, IV, V, VI, VIII, and three perforators in section III and VII. However, two perforators (M6 and L6) below arcuate line were sacrificed in the time of flap harvest to prevent hernia. Island TRAM included 10 perforators on average (5 perforators in each side) above arcuate line to be transferred to the recipient site. Only minor complications were identified. Conclusion The Island TRAM flap includes 10 perforators to get the vigorous blood flow. The periumbilical to upper medial perforators become more dominant in the perfusion of the flap after deep inferior epigastric artery division. Well preserved perforators will guarantee the satisfactory breast reconstruction with the least complication.

• Physical Therapy Korea
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• v.21 no.1
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• pp.63-69
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• 2014

Cross knee curl-up is an ideal variation of abdominal curl up exercise to strengthen abdominal musculature without excessive lumbar flexion which can increase the loads on the disc and ligaments. In addition, slowly forced expiration can facilitate the activation of the abdominal musculature. The purpose of this study was to determine the effects of slowly forced expiration on activity of abdominal muscles, such as rectus abdominis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO), while cross knee curl-up. Eleven young and healthy subjects (6 males and 5 females) participated. All subjects performed the cross knee curl-up slowly forced expiration and natural breathing. Paired t-test was performed in normalized electromyogram (EMG) muscle activity of the bilateral RA, EO, and TrA/IO to compare the differences between the cross curl-up with slowly forced expiration and natural breathing. Statistical significance was set at .05. There were no significant differences in normalized EMG muscle activity of the bilateral RA, EO, and TrA/IO between the cross curl-up with slowly forced expiration and natural breathing. The finding of this study designates that slowly forced expiration does not induce increasing activity of abdominal muscle in cross knee curl-up; hence, learning step of breathing control might not be necessary to strengthen abdominal muscle in cross knee curl-up.

• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.201-206
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• 2017

Purpose: The aim of this study was to identify the effects of Pilates mat exercise may improve trunk muscle thickness and balance in healthy adults. Methods: Eighteen healthy adults participated in this study. They were randomly assigned to one of two groups: Pilates mat exercise group (n=9) and the control group (n=9). Subjects in Pilates mat exercise group performed the exercises three days per week for 6 weeks, which consisted of warm up, main workout, and cool down. Trunk muscle thickness of the rectus abdominis (RA), internal oblique (IO), external oblique (EO), transverse abdominis (TrA), multifidus (MF), and erector spine (ES) were measured using an ultrasonography. Balance ability was evaluated using Romberg test and limits of stability (LOS). Measurements were performed before training, 3 weeks after training, and 6 weeks after training. Results: There was a significant difference of RA, EO, IO, MF, and ES according to the main effect of time (p<0.05). There was a significant difference of EO, MF, ES, Romberg, and LOS according to interaction effect between the time and group (p<0.05). There was a significant difference only for LOS according to the main effect of the group (p<0.05). Conclusion: Pilates mat exercise did increase trunk muscle thickness and balance. However, the effect with respect to trunk thickness was limited. Pilates mat exercise appears to be more effective in improving muscles related to trunk extension and balance.

• Journal of Korean Physical Therapy Science
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• v.19 no.2
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• pp.63-71
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• 2012

Purpose : This study aimed to acquire a basic knowledge about lumbar stability and inquire into exercise approach of pressure biofeedback unit for lumbar stability. Methods : This study was composed with reviewed theory of lumbar stability and several books and articles for exercise using pressure biofeedback unit. Results : The stability of lumbar should work symmetrical with passive, active, control subsystem in neutral zone, and local muscles should be using for stability. Especially, selective using of transverse abdominis work for lumbar stability importantly. The control of using pressure biofeedback unit may important not only examination but treatment. Conclusion : The stability of lumbar need co-contraction of specific local muscle and training for timing as well as using pressure biofeedback unit for accurate control may use for examination and therapedic approach.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.398-405
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• 2021

Objective: The interest of clinicians is increasing due to the newly established medical insurance for pulmonary rehabilitation. Improvement of respiratory muscle strength and pulmonary function is an important factor in pulmonary rehabilitation, and this study aims to investigate the correlation between changes in respiratory muscle contraction thickness that can affect respiratory muscle strength and pulmonary function. Design: Cross-sectional observational study. Methods: Thirty-one subjects (male=13, female=18) participated in this study. The respiratory muscle strength was measured by dividing it into inspiratory/forced expiratory muscles, and the pulmonary function was measured by forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. To evaluate the respiratory muscle length increase, in resting and concentric contraction thickness of diaphragm, external/internal oblique, transverse abdominis, and rectus abdominis were measured by using ultrasonography. Results: Inspiratory muscle strength showed a significant correlation with the length increase of the inspiratory muscle (r=0.368~0.521, p<0.05), and forced expiratory muscle strength showed a significant correlation with length increase of forced expiratory muscle (r=0.356~0.455, p<0.05). However, pulmonary function was not correlated with the length increase of the respiratory muscle. Conclusions: In this study, a correlation between respiratory muscle strength and respiratory muscle length increase was confirmed, but no correlation with the pulmonary function was found. It is considered that the respiratory muscle strength can be improved by increasing the respiratory muscle thickness through appropriate respiratory muscle training.