• Korean Journal of Community Nutrition
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• v.1 no.2
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• pp.201-214
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• 1996

This study was aimed at evaluating the lipid status of 122 pregnant women, who were attending peripheral community clinics in low-income areas and were vulnerable in terms of public health, by anthropometric measurements, estimating dietary intakes and analyzing serum lipids content and fatty acids composition. Regarding the skinfold thickness, it has increased more significantly in suprailliac than in triceps, biceps, subscapular, which means body fat has been accumulated in central parts more than in distal parts of the pregnants. It is found that intakes of energy, protein, lipid and carbohydrate are desirable while calcium, zinc and copper are low and sodium is excessive. Regarding dietary fat intake, the energy $\%$ of fat was within the same range as RDA(20%) for adults, but energy $\%$ intake from each fatty acid was usually low, especially energy % of monoun-saturated fatty acid intake was below RDA for adult women. And intake ratio of $\omega$6$\omega$3 fatty acids was desirable. Accordingly, it is thought that dietary fat intake was balanced in quality. Serum lipids concentrations were increased with the length of pregnancy and were higher as compared with non-pregnant women. Polyunsaturated fatty acids, especially $\omega$6 fatty acids, have gradually decreased with the length of pregnancy. Serum lipids content and fatty acids composition were not greatly influenced by dietary fat but serum free fatty acid level was negatively related to energy, carbohydrate, fatty acids and cholesterol intake. On the basis of the above results, it can be predicted that lipid metabolism for mother and fetus is changed by pregnant status and multilateral research on maternal nutrition in terms of areas and income levels will have to be made. (Korean J Community Nutrition 1(2) : 201-214, 1996)

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.73-79
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• 1997

Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.