Kim, Do Yup;Choi, Hyun Nam;Park, Jin Hyung;Kim, Sin Rak;Kim, Hyun;Han, Yea Sik
Archives of Plastic Surgery
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v.41
no.2
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pp.133-139
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2014
Background Various shapes and designs of the gluteal artery perforator flap have been used for treating sacral pressure sores and reconstructing breasts. To establish the ideal fasciocutaneous flap design for use in the gluteal area, the soft tissue thickness distribution was measured. Methods Twenty-one buttocks of adult Korean cadavers were analyzed through rectangular subfascial dissection. Each buttock was divided horizontally into 10 sections and vertically into 10 sections, and then, the thickness at the corners of the sections was measured. For the sake of comparison and statistical verification with living bodies, computed tomography (CT) images of 120 buttocks of patients were randomly selected. Five horizontal sections and 4 vertical sections were made, and the thickness at each corner was recorded. Results According to the dissection and the CT images, the area with the thinnest soft tissues in the buttock was around the posterior superior iliac spine, close to the sacral area. The thickest area was the superolateral area of the buttock, which was 3.24 times and 2.15 times thicker than the thinnest area in the studies on cadaver anatomy and the CT images, respectively. Conclusions The thickness of the soft tissues in the buttocks differed by area. The superolateral area had the thickest soft tissues, and the superomedial area had the thinnest. This study includes information on the distribution of the thickness of the gluteal soft tissues of Koreans. The outcome of this study may contribute to the design of effective local flaps for pressure sore reconstruction and free flaps for breast reconstruction.
Author studied the changes of experimental bite marks using a special apparatus which was equipped with adults human resin dental model(in accordance with the time elapsed). The experimental bite marks were made in the forearm of 20 healthy men and in the buttock of 10 Durac pigs with various pressure. In making the experimental bite marks, the left forearm was pressed with a load of 70kgs and 130kgs for 3 seconds, and 5 of the 10 pigs were sacrigiced immediately after making the bite marks. Through visual examinations, photographs and rubber base impressions of bite marks, following results were obtained : 1. The durations of measurable indentation of the experimental bite marks in the forearm of living human subject were depended upon the degree of the pressure and the length of the pressure time applied in making the bite marks. 2. As a physiological responds to a physical stimulus of biting, indentation, bruising, edema and subepithelial bleeding were observed in the experimental bite marks in the forearm of living human. And the experimental bite marks in the buttok of pigs which were sacrificed immediately after making the bite showed only indentation and subepithelial bleeding in addition to postmortem changes. 3. The duration of measurable indentation of the experimental bite marks in the buttock of pigs which were sacrificed immediatly after making the bite were much longer than those of the living pigs. 4. All of the measurements of the experimental bite marks were not matched completly with those of the model which was used in making the bite marks.
Min, Seung Nam;Park, Se Jin;Subramaniyam, Murali;Lee, Heeran
Journal of the Ergonomics Society of Korea
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v.33
no.4
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pp.255-265
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2014
Objective: The purpose of this study was to evaluate comfort levels of functional and non-functional chairs using subjective comfort rating, interface pressure measurement, muscle activity measurement, and skin temperature measurement. Background: Chairs are used for a prolonged period of time for sitting in many places such as the office, at university, at school, in industry, and so on. Almost all people use chairs in their everyday life. The functional properties of the chair are associated with comfort. Method: The subjective evaluation contains questions regarding chair comfort which can be rated with five point scale. The body-seat interface pressure was measured using a pressure mat system. The symmetry of sitting was measured using electromyography. The change in body part (thigh and buttock) temperature before and after sitting on a chair was measured with an infrared camera. Results: Participants rated significantly (p < 0.05) higher comfort scores for the functional chair in relation to the buttock and thigh region. Also, the participants felt a better cushion effect in the functional chair. When using the functional chair, lower interface pressure, better thermal comfort, and better symmetry of erector spinae muscle activity were observed. Conclusion: Overall, interface pressure measurement, muscle activity measurement, thermal imaging and subjective comfort score results showed that the functional chair was more comfortable than the non-functional chair. Application: The adopted methodologies could be used to measure the seating comfort of train seats.
Purpose: Recurrent ischial pressure sore is troublesome for adequate soft tissue coverage, because usually its pocket has a very large deep space and adjacent donor tissue have been scarred in the previous surgery. However, the conventional reconstructive methods are very difficult to overcome them. Modified gluteus maximus myocutaneous V - Y advancement flap from buttock can be successfully used in these circumstances. Methods: From February 2007 to October 2008, modified gluteus maximus myocutaneous V - Y advancement flaps were perfomed in 10 paraplegic patients with recurrent ischial pressure sore. The myocutaneous flap based on the inferior gluteal artery was designed in V - shaped pattern toward the superolateral aspect of buttock and was elevated from adjacent tissue. Furthermore, when additional muscular bulk was required to obliterate dead space, the flap dissection was extended to the inferolateral aspect which can included the adequate amount of the gluteal muscle. After the advanced flap was located in sore pocket, donor defect was repaired primarily. Results: The patients' mean age was 46.9 and the average follow - up period was 12.4 months. The immediate postoperative course was uneventful. But, two patients were treated through readvancement of previous flap due to wound dehiscence or recurrence after 6 months. The long - term results were satisfied in proper soft tissue bulk and low recurrence rate. Conclusions: The modified gluteus maximus myocutaneous V - Y advancement flap may be a reliable method in reconstruction of recurrent ischial pressure sore, which were surrounded by scarred tissue because of its repetitive surgeries and were required to provide sufficient volume of soft tissue to fill the large pocket.
Pressure ulcers are serious complications of tissue damage that can develop in patients with diminished pain sensation and diminished mobility. Pressure ulcers can result in irreversible tissue damage caused by ischemia resulting from external loading. There are many intrinsic and extrinsic contributors to the problem, including interface tissue pressure, shear, temperature, moisture, hygiene, nutrition, tissue tolerance, sensory and motor dysfunction, disease and infection, posture, and body support systems. The purposes of this study were to investigate the relationship between buttock interface pressure and seating position, wheelchair propulsion speed. Seated-interface pressure was measured using the Force Sensing Array pressure mapping system. Twenty subjects propelled wheelchair handrim on a motor-driven treadmill at different velocities (40, 60, 80 m/min) and seating position used recline ($100^{\circ}$, $110^{\circ}$, $120^{\circ}$) with a wheelchair simulator. Interface pressure consists of average (mean of the pressure sensor values) and maximum pressure (highest individual sensor value). The results of this study were as follows; No significant correlation in maximum/average pressure was found between a static position and a 40 m/min wheelchair propulsion (p>.05). However, a significant increase in maximum/average pressure were identified between conditions of a static position and 60 m/min, and 80 m/min wheelchair propulsion (p<.05). No significant correlation in maximum pressure were found between a $90^{\circ}$ recline (neutral position) and a $100^{\circ}$, $110^{\circ}$, or $120^{\circ}$ recline of the wheelchair back (p>.05). No significant difference in average pressure was found between conditions of a $90^{\circ}$ recline and both a $100^{\circ}$ and $110^{\circ}$ recline of wheelchair back. However, a significant reduction in average pressure was identified between conditions of a $90^{\circ}$ and $120^{\circ}$ recline of wheelchair back (p<.05). This study has shown some interesting results that reclining the seat by $120^{\circ}$ reduced average interface pressure, including the reduction or prevention in edema. And interface pressure was greater during dynamic wheelchair propulsion compared with static seating. Therefore, the optimal seating position and seating system ought to provide postural control and pressure relief. We need an education on optimal seating position and a suitable propulsion speeds for wheelchair users.
The purpose of this study is to examine quantitatively the relations between the girdle pressures operated on the abdomen and buttock of body according to the increase of time and the displacement or the deformation of thorax, diaphragm, heart and stomark caused. In an erect position, the roentgen photographs of thorax and abdomen were taken on three female subjects (20~21 years old) with eutonic stomach under four different time sequence (0, 3, 6, 9 hours) of the girdle pressure. The displacement and deformation of each viscera were examined by X-ray films thus obtained. The results are as follows: 1. Thorax was not statistically significant according to the increase of time in the girdle pressure. 2. Diaphrame greatly ascended under the increase of time in the girdle pressure after 9 hours, put pressure upon the lung and heart. 3. Heart increased in the height of maximum transverse-diameter, of the left side because of ascending of diaphragm.
A Morel-Lavallée lesion is a post-traumatic closed degloving soft tissue injury after blunt trauma. Infection and skin necrosis frequently occur if it is not treated properly in the early stages. However, there is no clearly established treatment algorithm. In the acute stage, it is mainly treated with aspiration, simple compression, and incisional drainage. In the chronic stage, sclerotherapy is usually performed. If skin necrosis develops, the necrotic tissue is resected and a skin graft is needed. We describe a case of acute Morel-Lavallée lesion in the buttock region that was treated with limited incisional drainage and negative-pressure wound therapy, and also present a review of the literature.
Park, Se Jin;Min, Seung Nam;Lee, Heeran;Subramaniyam, Murali;Suh, Woo Sung
Journal of the Ergonomics Society of Korea
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v.33
no.3
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pp.215-227
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2014
Objective: The purpose of this study was to evaluate Korea's Honam express train's first- and second-class seat discomfort by using pressure measurement, subjective discomfort rating, and physical compatibility. Background: Over the years, the demand for an express train service is continually increasing. A comfortable ride is important to achieving passenger satisfaction. A train seat plays a significant role in fulfilling passenger seating comfort. With this in view, a field survey and pressure measurements were performed on the selected train seat. Method: The pressure ratio at the body-seat interface (thigh and buttock regions) was measured by the pressure mat system. The interface pressure ratio was calculated and compared. The subjective discomfort rating scale was used to evaluate the subjects' overall feeling. The dimensions of train seats were analysed according to the anthropometric and demographic characteristics of the population data from Size Korea. Results: The results highlighted that the interface pressure ratio was greater while participants sat on the second-class seat than the first-class seat in the left- and right-side thigh regions. Also the pressure ratio was greater for the participants in the 1st~25th percentile height groups (149.8~160.8cm). The subjects rated higher discomfort for the second-class seat than the first-class seat. The physical compatibility results showed that the second-class seat's breadth was inadequate for the 95th and 99th percentile male. Conclusion: Overall, interface pressure measurement, subjective discomfort score and physical compatibility results showed that the second-class seat was more uncomfortable for the passengers than the first-class seat. Application: The adopted methodologies could be used to measure the seating comfort of the train seats.
Purpose: Perforator flaps have been widely used for reconstruction of pressure sores because they have many benefits, especially reducing tension. Otherwise in order to prevent recurrence of a pressure sore, sufficient thickness of a flap is desirable, so a musculocutaneous flap is also useful for reconstruction of a pressure sore. Therefore, the authors considered about the postoperative results of reconstruction of pressure sores between using perforator flaps and musculocutaneous flaps. Methods: In this study, 33 patients (46 flaps) who underwent reconstructive operation of pressure sores from January 2007 to February 2011 were reviewed. Patients operated by using perforator flaps were 18 (18 flaps), and musculocutaneous flaps were 17 (28 flaps). We studied postoperative complications and recurrence. Results: We experienced five patients (10 flaps) with complications or recurrences who were operated using musculocutaneous flaps and one patient using a perforator flap. One case using a perforator flap stemmed from dehiscence caused by a urinary fistula occurring in two months after the surgery. Among ten cases using musculocutaneous flaps, one case was caused by total necrosis of flap, five cases by partial necrosis of flap and dehiscence, and four cases by recurrences during follow-up period. Conclusion: Even if more cases were required, it can be more considerable to operate using the perforator flap rather than the musculocutaneous flap to reduce the complication or recurrence of pressure sore.
In a turn a century, the skepticism, mysticism and eroticism used to prevail, the people becoming anxious, expectative and doubtful about an oncoming age. The costumes tend to become more exciting and erotic in the fashion. This thesis is on understanding “What would 21 century's clothes be\ulcorner” after analyzing the specific points in an end of the century. The characteristics found from 16th century to 20th century are going to the extremes in the shapes, consistent appearance of bustle style costumes and excessive ornaments which are closely interrelated with one another. I expect the fashion in 21st century would be changed in two ways. Firstly, going to the extremes and stressing on the buttock would be going down in the end of 1999. Secondly, the comfortable clothes highest in function and technology, and also friendly to the environment, might be the main stream, rather then outwardly good looking clothes, because spirit and environment is much more emphasized than the mode by the social impact or pressure in the next era. (Korean J Human Ecology 2(1) : 114~128, 1999)
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