• Title/Summary/Keyword: 아래팔

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Versatility of Radial Forearm Free Flap on Head and Neck Cancer in Old-Aged Patient and its Donor Site Morbidity (노인 두경부 종양환자에서 노쪽아래팔유리피판술의 유용성 및 공여부 결과의 비교)

  • Lee, Ki-Eung;Koh, Sung-Hoon;Eo, Su-Rak
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.92-100
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    • 2006
  • Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

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The Kinetic Analysis of Arabesque Turn Motion in Modern Dance by Upper Extremity Usage (상지이용유무에 따른 현대무용 아라베스크 턴 동작의 운동역학적 분석)

  • Park, Yang-Sun;Kim, Ji-Hye
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.457-466
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    • 2009
  • This study puts the purpose in providing the scientific basis of dance motion as an artistic expression by analyzing the kinematic variable and the distribution factor of power affecting the motion, which is connected to the turn, right after the arabesque motion according to the existence and non existence of using the arm in the arabesque motion of modern dance. As a result of this study, arabesque turn motion, not using the upper limbs, used more turning force of head and body than the arabesque turn motion, using the upper limbs, and arabesque turn using the upper limbs obtained the turning force, using the right shoulder. The range of the hip joint on the left and the position change of left tiptoe in the Arabesque turn motion using the upper limbs is largely ascended to the vertical axis, while, the position of tiptoe in the Arabesque turn motion, not using the upper limbs is dropped to the lower part of each event. In the replacement of body center, Arabesque turn motion using the upper limbs is moved more to the turning axis than arabesque turn motion not using the upper limbs. As a result of maximum vertical ground reaction force, Arabesque turn motion using the upper limbs appeared to be a lower value than the Arabesque turn motion not using the upper limbs.

A Study on the Cheongshimru and Landscape Structure of Yeoju-Palkyung in Old Poems and Map (누정제영시와 고지도에 투영된 청심루와 여주팔경의 경관구조)

  • Rho, Jae-Hyun;Park, Tae-Hie
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.2
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    • pp.73-80
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    • 2011
  • The study reviewed the content and the meaning of the present Yeoju Palkyung(eight scenery) through analyzing and interpreting the Palkyung poems, old maps and paintings, and classic materials transmitted in Yeoju area, and investigated the landscape structure of the area around the Cheongshimru(淸心樓: pavilion). On the other hand, many Palkyung poems and Noojeongjeyong(樓亭) poems illustrating the Cheongshimru as the view point or the objective have clarified the scenic excellence when the Cheongshimru is the view point. The Yeoju Palkyung viewed from the Cheongshimru was described as constructing all around allocation structure, and six scenes are categorized as a distant view of the visual influence while the 7th scene Ireungdogyeon and the 8th scene Pasagwau are a psychologically influencing landscapes. The panoramic composition of the Yeoju Palkyung at the Cheongshimru is interpreted as the Seunggyeong distribution considering Palchaejigyeongsaek(八采之景色), where main viewpoint is the Cheongshimru and the distant landscape is Paldaejangrim. The reputation of the Cheongshimru, the central place of the Yeoju Palkyung, is confirmed by the technique of scene processing describing a various way of illustrating landscapes such as near view, distant view, pulling view and collecting view. The restoration of Cheongshimru and Paldaesup(八大藪) currently undertaken is the essential business for the full recovery of the Yeoju Palkyung, which will be not only for physical restoration but also for the shortcut to revitalize the history and the spirit of Yeoju. Furthermore, the business direction should be reconsidered to truly understand the meaning, the value, and the structure of the Yeoju Palkyung to ensure the pursuit of the sustainability aiming at the project "Local attractions", one of the Namhangnag Four rivers project of the ministry of Land, Transport and Maritime Affairs.

The Effect of Lidocaine Dose and Pretreated Diazepam on Cardiovascular System and Plasma Concentration of Lidocaine in Dogs Ansthetized with Halothane-Nitrous Oxide (Diazepam 전투여와 Lidocaine 투여용량이 혈중농도 및 심혈역학적 변화에 미치는 영향)

  • Lee, Kyeong-Sook;Kim, Sae-Yeon;Park, Dae-Pal;Kim, Jin-Mo;Chung, Chung-Gil
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.451-474
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    • 1993
  • Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels ($3.97{\pm}0.22-4.48{\pm}0.36$ mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels ($7.50{\pm}0.66-11.83{\pm}0.59$ mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and increased pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was associated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVRI). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered, reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level ($7.64{\pm}0.79-13.79{\pm}0.82$ mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After $CaCl_2$ administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, CVP was rather increased than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.

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