• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.368-371
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• 2012

The present study evaluated the outcome of use of thoracostomy tube tunneling technique under the latissimus dorsi muscle for the evacuation of postoperative pneumothorax induced by thoracotomy in 11 dogs. A stab incision was made through the skin and the latissimus dorsi muscle over the rib in the fifth intercostal space caudal to a surgical window. The thoracostomy tube with a Kelly hemostat was advanced into the thoracic cavity in a cranioventral direction through the sublatissimal tunnel. After tube placement, a # 1 nylon horizontal mattress suture was placed around the skin incision. The thoracostomy tube was removed after creating a negative pressure in the thoracic cavity. Dogs were monitored after surgery for pneumothorax, subcutaneous emphysema, clinical signs including dyspnea, and tube kinking in a muscle tunnel using physical examination and postoperative radiography. There was no tube kinking in the sublatissimal tunnel in 11 dogs on introducing the tubes into the thoracic cavity. The mean (${\pm}SD$) follow-up period was $19{\pm}10$ months. On postoperative radiography, there was no evidence of pneumothorax in 11 dogs. Subcutaneous emphysema was identified around the stab incision in a dog postoperatively. The subcutaneous emphysema disappeared spontaneously within 3 days. On postoperative physical examination, there was no evidence of dyspnea in 11 dogs. Our results suggest that the sublatissimal tunneling technique for thoracostomy tube placement is effective to prevent air leakage around the thoracostomy tube while the tube remains in the thoracic cavity and along the thoracostomy tunnel after tube removal. Tunneling under the latissimus dorsi muscle should be considered the thoracostomy tube placement technique to prevent iatrogenic pneumothorax with first priority.

• Anatomy & Biological Anthropology
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• v.31 no.4
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• pp.167-170
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• 2018

Axillary arch is relatively common variation of muscle in the axilla. There were several attentions on axillary arch due to its anatomical and surgical importance. During educational dissection, a variant muscle was found in right arm of 68-year-old female cadaver. The variation of muscle originated from the lateral edge of the latissimus dorsi muscle as muscular form. And then, it crossed the axillary artery and median nerve as tendinous form. Finally it became wide as muscular form and inserted into the pectoralis major. We reported this variant muscle and discussed its clinical significances.

• Journal of Korean Physical Therapy Science
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• v.25 no.2
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• pp.47-54
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• 2018

Purpose: The purpose of this study was to investigate the most effective exercise position of Latissimus dorsi's activities during Pull up, Push up and Lat pull down among few positions of hand grips(pronation, Supination and neutral grip) and grip widths(30cm, 60cm) based on EMG activities. Method: 10 healthy adults were participated in this study and the surface EMG activities of the Latissimus dorsi were measured during Pull up, Push up and Lat pull down exercise according to specific hand grip and grip width positions. The maximum and mean value of Latissimus dorsi's EMG activities at all positions were recorded and analysed by ONE-WAY REAPTED ANOVA. Results: The showed that the most Latissimus dorsi's activities is during Pull up exercise. Main results are as follows 1)maximum value: For Pull up, among all studied positions, Rt Latissumus dorsi, position of Supinated grip and 60cm grip width showed strongest muscle activation based on maximum EMG value. Statistical significance was assumed at p<.05. 2)mean value: For Pull up, among all studied positions, Both Latissimus dorsi, position of pronated grip and 60cm grip width showed strongest muscle activation based on mean EMG value. Statistical significance was assumed at p<.05. Conclusion: Therefore, taking the results of this study, Pull up exercise would be the best exercise of Latissimus dorsi's activation. It is recommended to do in pronated grip position and 60cm grip width during Pull up to make body fit.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.75-79
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• 2009

Purpose: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. Method: Case1: A 50 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. Results: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. Conclusion: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstructio.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.695-698
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• 2011

Purpose: Since spinal tuberculosis is increasing in prevalence, it appears that a repair of spinal soft tissue defect as a complication of spinal tuberculosis can be a meaningful work. We report this convenient and practical reconstructive surgery which use bilateral latissimus dorsi musculocutaneous advancement flap. Methods: Before the operation, $13{\times}9.5$ cm sized skin and soft tissue defect was located on the dorsal part of a patient from T11 to L3. And dura was exposed on L2. Under the general endotrachel anesthesia, the patient was placed in prone position. After massive saline irrigation, dissection of the bilateral latissimus dorsi musculocutaneous flaps was begun just upper to the paraspinous muscles (at T11 level) by seperating the paraspinous muscles from overlying latissimus dorsi muscles. The plane between the paraspinous muscles fascia and the posterior edge of the latissimus dorsi muscle was ill-defined in the area of deformity, but it could be identified to find attachment of thoracolumbar fascia. The seperation between latissimus dorsi and external oblique muscle was identified, and submuscular plane of dissection was developed between the two muscles. The detachment from thoracolumbar fascia was done. These dissections was facilitated to advance the flap. The posterior perforating vasculature of the latissimus dorsi muscle was divided when encountered approximately 6 cm lateral to midline. Seperating the origin of the latissimus dorsi muscle from rib was done. The dissection was continued on the deep surface of the latissimus dorsi muscle until bilateral latissimus dorsi musculocutaneous flaps were enough to advance for closure. Once this dissection was completely bilateraly, the bipedicled erector spinae muscle was advanced to the midline and was repaired 3-0 nylon to cover the exposed vertebrae. And two musculocutaneous units were advanced to the midline for closure. Three 400 cc hemovacs were inserted beneath bilateral latissimus dorsi musculocutaneous flaps and above exposed vertebra. The flap was sutured with 3-0 & 4-0 nylon & 4-0 vicryl. Results: The patient was kept in prone and lateral position. Suture site was stitched out on POD14 without wound dehiscence. According to observative findings, suture site was stable on POD55 without wound problem. Conclusion: Bilateral latissimus dorsi musculocutaneous advancement flap was one of the useful methods in repairing of large spinal soft tissue defect resulting from spinal tuberculosis.

• Journal of the Korean Applied Science and Technology
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• v.35 no.3
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• pp.914-924
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• 2018

The purpose of this study is to provide the basic data for the shoulder strengthening exercise by analyzing the% MVIC of the muscle activity in the shoulder rotator cuff by the difference of the stance posture and the anatomical plane. 8male subjects were randomly assigned to perform the shoulder rotation exercise 10 times on the frontal plane, the horizontal plane, the sagittal plane and the two legs stance posture, the one leg stance posture, the lunge posture. Measured muscle activity of supraspinatus, infraspinatus, teres minor, anterior deltoid, rectus abdominis, erector supinea, pectoralis major, lattisimus dorsi during exercise. A repetitive one-way ANOVA was performed using the SPSS 22.0 statistical program. First, during the external rotation on the frontal plane, the erector spinea was higher in the lunge posture than in the two legs stance posture and the one leg stance posture, And during the internal rotation on the frontal plane, the muscle activity of suprapinatus was higher in one leg stance posture than in the two legs stance posture and more so in the lunge posture. Second, during the external rotation on the horizontal plane, the muscle activity of deltoid anterior was higher in the one legs stance posture and in the lunge posture than in the two legs stance posture, and during the internal rotation on the horizontal plane, the muscle activity of infraspinatus was higher in the lunge posture than in the two legs stance posture and one leg posture, and the muscle activity of pectoralis major was higher in two leg stance posture than in the one legs stance posture and more so in the lunge posture. Third, during the external rotation on the sagittal plane, muscle activity of rectus abdominis was higher one leg stance posture in the lunge posture than in two leg stance posture. During the internal rotation on the sagittal plane, muscle activity of supraspinatus was higher one leg stance posture in the lunge posture than in two leg stance posture. And muscle activity of infraspinatus was higher in the lunge posture than in two leg stance posture, one leg stance. And muscle activity of Rectus abdominis was higher in the lunge posture and one leg stance posture than in the two legs stance posture. And muscle activity of Erector spinea was higher in the two legs stance postur and lunge posture than in the one leg stance posture. In conclusion, the differences in stance and shoulder anatomy have different effects on the muscle activity of the shoulder rotator exercises, and this is expected to be a more positive exercise program when applied to the shoulder strengthening exercise program.