• Title/Summary/Keyword: Deep Muscle

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Repair of Large Spinal Soft Tissue Defect Resulting from Spinal Tuberculosis Using Bilateral Latissimus Dorsi Musculocutaneous Advancement Flap: A Case Report (척추결핵으로 인한 광범위한 결손에 대해 양측 넓은등근전진피판술을 이용한 치험례)

  • Kim, Yeon-Soo;Kim, Jae-Keun
    • 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.

Effect of Pilates Breathing on the Activity of Trunk Stabilizer Muscles during the Movements of Pilates Chair Exercise (필라테스 호흡이 체어 동작에서 몸통 안정화 근육의 활성도에 미치는 영향)

  • Baek, Kyung-Min;Lee, Su-Been;Jeon, Mi-Na;Cho, Eun-Byeol;Jin, Hee-Soo;Han, Ji-Soo;Lee, Na-Kyung
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.4
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    • pp.187-197
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    • 2022
  • Purpose: This study aimed to investigate the changes in the muscle activity of the trunk stabilizer muscles before and after incorporating Pilates breathing during three types of Pilates chair exercises. Methods: This study included 33 healthy men and women in their 20's; they were recruited according to the inclusion and exclusion criteria. sEMG was used to measure the changes in the muscle activity in the internal oblique/transverse abdominis, rectus abdominis, and erector spinae during the three types of Pilates chair movements (footwork, twist footwork, and bridging) without and with the Pilates breathing integration. The muscle activities of the trunk stabilizers between without and with Pilates breathing were statistically analyzed and compared. Results: The internal oblique/transverse abdominis showed an increase and a significant difference in the muscle activity in all three movements of footwork, twist footwork, and bridging after the Pilates breathing integration (p<.001). The muscle activity of the rectus abdominis (p<.05) and the erector spinae (p<.05) also increased and showed a significant difference after the Pilates breathing incorporation, except in the bridging movement for the erector spinae. The increase in the rate after integrating Pilates breathing was relatively greater in internal oblique/transverse abdominis than in other muscles. Conclusion: When Pilates breathing was applied, the activities of the trunk stabilizer muscles increased significantly and immediately in all three movements of Pilates chair footwork, twist footwork, and bridging. This means that the use of breathing is expected to have a positive and immediate effect on the activation of trunk stabilizers, thus indicating that it can possibly be an effective re-enforcing tool to promote trunk stability when it is integrated to the Pilates chair exercise. Incorporating Pilates breathing also seemed to have a tendency to activate the deep trunk stabilizer muscles more than the superficial stabilizer muscles.

Differential Proteome Expression of In vitro Proliferating Bovine Satellite Cells from Longissimus Dorsi, Deep Pectoral and Semitendinosus Muscle Depots in Response to Hormone Deprivation and Addition

  • Rajesh, Ramanna Valmiki;Kim, Seong-Kon;Park, Mi-Rim;Park, Min-Ah;Jang, Eun-Joung;Hong, Seung-Gu;Chang, Jong-Soo;Yoon, Du-Hak;Kim, Tae-Hun;Lee, Hyun-Jeong
    • Journal of Animal Science and Technology
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    • v.51 no.6
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    • pp.459-470
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    • 2009
  • The aim of this study was to analyze the proteome of proliferating bovine satellite cells from longissimus dorsi, deep pectoral and semitendinosus muscle depots which had been subjected to hormonal deprivation or addition in culture. For hormone deprivation or addition studies, the cells were either grown in 10% charcoal-dextran stripped fetal bovine serum (CD-FBS) or in 10% FBS supplemented medium. Further to analyze the effect of insulin like growth factor (IGF-1) and testosterone (TS), the cells were grown in 10% CD-FBS containing IGF-1 (10 ng/ml) or TS (10 nM). Results have shown that hormone deprivation had a negative impact on proliferation of the cells from each of the muscle depots. In case of IGF-1 and TS addition, the proliferation levels were low compared with that of the cells grown in 10% FBS. Hence, to gain the insights of the proteins that are involved in such divergent levels of proliferation, the proteome of such satellite cells proliferating under the above mentioned conditions were analyzed using 2D-DIGE and MALDI-ToF/ToF. Thirteen proteins during hormone deprivation and nine proteins from hormone addition were found to be differentially expressed in all the cultures of the cells from the three depots. Moreover, the results highlighted in this study offer a role for each differentially expressed protein with respect to its effect on positive or negative regulation of cell proliferation.

TREATMENT OF HEAVY MANDIBULAR BUCCAL FRENUM USING APICALLY POSITIONED FLAP UNDER DEEP SEDATION IN CHILDREN (소아환자의 깊은 진정요법 하에서 근단변위 판막술을 이용한 거대협소대의 치료)

  • Kim, Jong-Bin;Yoon, Hyung-Bae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.69-76
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    • 1999
  • The mandibular buccal frenum is defined as a fold of mucous membrane at the posterior labial vestibule and attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem when its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourage plaque formation and interfere with tooth brushing. Especially, heavy buccal frenum mucogingivally results in insufficent attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular premolar. Frenotomy, frenectomy and mucogingival surgery are used in treating heavy buccal frenum. Frenotomy with autogenous free gingival graft has been used popularly because of its stable result. But, it is difficult in younger children because of inadequate donor site, difficulty in making recipient site and behavior management. Frenotomy with apically positioned flap is considered as more efficient way for a very young child with heavy buccal frenum. Additionally, modified deep sedation with $N_2O-O_2$ can be used as an adjunct for the effective treatment outcome. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment approach.

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Unusual Presentation of Traumatic Neuroma of the Medial Plantar Nerve after Deep Laceration Mimicking a Foreign Body Granuloma: A Case Report (이물 육아종으로 오인된 심부 열상 이후 발생한 비정상적인 내측 족저 신경의 외상성 신경종: 증례 보고)

  • Woo, Seung Hun;Kim, Tae Woo;Bae, Jung Yun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.174-178
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    • 2017
  • Traumatic neuromas are rare benign tumors that are common after trauma or surgery and are usually accompanied by obvious symptoms of pain. Most reports show neuromas in the face, neck, and limbs, and the traumatic neuroma of the medial plantar nerve has rarely been reported. We encountered a traumatic neuroma of the medial plantar nerve after a deep laceration mimicking a foreign body granuloma. A small mass lesion was found around plantar aponeurosis with heterogeneous high signal intensity in the T2 fat suppression view and slightly enhanced intensity in the magnetic resonance imaging that suggested a foreign body granuloma. The lesion was diagnosed pathologically as a traumatic neuroma. A satisfactory clinical result was obtained after excision of the traumatic neuroma and burial of the proximal and distal stumps to the adjacent muscle at the secondary operation.

Deep circumflex iliac artery free flap in the mandibular reconstruction (DCIA를 이용한 하악골 재건술)

  • Won, Ji-Hoon;Kim, Bong-Chul;Kim, Hyung-Jun
    • The Journal of the Korean dental association
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    • v.49 no.9
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    • pp.520-526
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    • 2011
  • Vascularized iliac crest flap include bone tissue of good quality and quantity for mandible segmental defect. Even if fibular flap can contain longer bone tissue, iliac crest has esthetic shape for mandible body reconstruction and large height for implant. Conventional vascularized iliac crest osteomyocutaneous flap is too bulky for reconstruction of intraoral soft tissue defect. But modified flap can reduce soft tissue volume, so is good for functional reconstruction of oral mucosa. It takes only one month for completely replace oral mucosa. The final mucosal texture is much better than other skin paddle flap, especially for implant prosthesis. Donor site morbidity of this method looks same level or less with other modalities functionally and socially. In case of oral mucosa-mandible combined defect, vascularized iliac crest with internal oblique muscle flap shows good outcomes for hard and soft tissue.

Changes of Thickness in Abdominal Muscles between Crook Lying and Wall Support Standing during Abdominal Hollowing in Healthy Men

  • Park, Du-Jin
    • The Journal of Korean Physical Therapy
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    • v.22 no.6
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    • pp.7-12
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    • 2010
  • Purpose: This study investigated changes in the thickness of the transversus abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) muscles between crook lying and wall support standing positions during abdominal hollowing (AH), using ultrasound imaging. Methods: Experiments were conducted on 20 healthy male adults (mean age=$22.45{\pm}4.08$ years) who voluntarily agreed to participate in the experiments. The changes in the thickness of the subjects' abdominal muscles were measured during AH in crook lying and wall support standing positions. Results: The difference in the thickness of TrA between the two positions during AH was statistically significant, but the differences in the thicknesses of IO and EO were not significant. Conclusion: Activity of the TrA, which is a deep muscle, was stimulated in the standing position, which is, therefore, more functional than the crook position, but the activities of IO and EO muscles did not decrease. Therefore, various methods to induce the activity of TrA while decreasing the activities of IO and EO, in the functional standing position that can stimulate deep muscles, need to be designed.

RECONSTRUCTION OF MIDFACIAL DEFECTS UTILIZING RECTUS ABDOMINIS FREE FLAP : REPORT OF 2 CASES (유리 복직근 피판을 이용한 중안모 결손부 재건의 2 치험례)

  • Lee, Seong-Geun;Sung, Iel-Yong;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.98-104
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    • 2000
  • Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

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Definitions of groove and hollowness of the infraorbital region and clinical treatment using soft-tissue filler

  • Lee, Ji-Hyun;Hong, Giwoong
    • Archives of Plastic Surgery
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    • v.45 no.3
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    • pp.214-221
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    • 2018
  • Clarification is needed regarding the definitions and classification of groove and hollowness of the infraorbital region depending on the cause, anatomical characteristics, and appearance. Grooves in the infraorbital region can be classified as nasojugal grooves (or folds), tear trough deformities, and palpebromalar grooves; these can be differentiated based on anatomical characteristics. They are caused by the herniation of intraorbital fat, atrophy of the skin and subcutaneous fat, contraction of the orbital part of the orbicularis oculi muscle or squinting, and malar bone resorption. Safe and successful treatment requires an optimal choice of filler and treatment method. The choice between a cannula and needle depends on various factors; a needle is better for injections into a subdermal area in a relatively safe plane, while a cannula is recommended for avoiding vascular compromise when injecting filler into a deep fat layer and releasing fibrotic ligamentous structures. The injection of a soft-tissue filler into the subcutaneous fat tissue is recommended for treating mild indentations around the orbital rim and nasojugal region. Reducing the tethering effect of ligamentous structures by undermining using a cannula prior to the filler injection is recommended for treating relatively deep and fine indentations. The treatment of mild prolapse of the intraorbital septal fat or broad flattening of the infraorbital region can be improved by restoring the volume deficiency using a relatively firm filler.

Peroneal Artery Perforator Free Flap on the Palm and Removal of Back Foreign Body in High Voltage Electrical Burn Patient: A Case Report (고압전기화상 환자에서 손바닥에 비골동맥천공지유리피판수술과 등의 이물질제거수술: 증례 보고)

  • Jung, Sung Won;Lee, Seung Je
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.58-65
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    • 2019
  • Wound caused by high-tension electrical burns is difficult to manage because the wound is deep and complex. The wound is progressively necrotic due to microvascular injury resulting in deep tissue exposure. So, coverage of the wound at the entry point and the exit point is cumbersome, often requiring flap coverage. We experienced a case of one patient for peroneal artery perforator free flap coverage on the palm of the right hand of the entry point of electrical burn. The left foot wound of electrical exit point was covered by full thickness skin graft. Also a small wound was on the left side of the lower back was the exit point of electrical burn. The lower back wound was healed and recurred repeatedly after burn. On postburn day 6 month, through the radiologic exam, metal shadow was identified in the left gluteus muscle forming chronic sinus. We explored the wound of sinus and a foreign body was identified in the sac as multi braid wires thin as hair. According to the patient's past history, we suspected that the back wound was caused by electrical burn injury through the wires.