• Archives of Plastic Surgery
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• 제37권6호
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• pp.736-741
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• 2010

Purpose: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap. Methods: From August 2008 to June 2009, 4 cases of thoraco-abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly. Results: Their mean age, 55.7 years and the average follow-up interval was 9 months. Patients' oncologic status ranged from stage IIIc to stage IV, it was classified according to the TNM staging system. Flap dimensions ranged between $15{\times}15$ and $25{\times}25\;cm$. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap. Conclusion: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single-stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.

• 대한정형도수물리치료학회지
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• 제29권1호
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• pp.1-9
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• 2023

BACKGROUND: The purpose of this study was to find out which exercise is more effective for the activation of the trunk, when the suspension plank and modified bridge exercise are performed. Weakening of the trunk muscles can lead to secondary injuries such as back injuries. In order to prevent injury, trunk muscles must be strengthened, and representative trunk strengthening exercises include planks and bridges. Each has been developed with a modified method, but since there is no paper comparing which exercise is more effective for trunk muscle strength, it was written to compare the two exercises. METHODS: The subjects were a random sample of 30 healthy men who agreed to participate in the study. The subjects were divided into two groups of 15 people each, and the suspension plank and the modified bridge exercise were performed for six weeks. The thickness of the transverse abdominis (TrA), internal abdominal oblique (IO), external abdominal oblique (EO), rectus abdominis (RA), multifidus (MF) was measured before and after the exercise. The two groups were analyzed using an independent t-test and paired t-test to compare the muscle thickness and the difference before and after exercise. RESULTS: The trunk muscle thickness was increased in both groups with suspension plank and modified bridge exercise, and there was a statistically significant difference. When comparing the two groups, the suspension plank group also showed a significant difference in RA (p<.05). CONCLUSION: As a result of this study, suspension plank exercise can have a positive effect on activating the trunk muscles and strengthening the strength of RA. Therefore, it is considered that suspension plank exercise is a more effective intervention to strengthen trunk muscle than modified bridge exercise.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.16-25
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• 2010

The aim of this study was to determine the muscle activity of the abdominalis and erector spinae during bridging and unilateral bridging exercises on the firm surface, the sir-fit, and the foam roll. Eighteen healthy young subjects were recruited for this study. Surface electromyographic (EMG) activities were recorded from the both sides of the rectus abdominalis, external obliques, internal obliques, and erector spinae muscles during bridging and unilateral bridging-exercises. A one-way repeated analysis of variance was used to compare the EMG activity of each muscle according to the support surface condition. Differences in the EMG activities between the bridging and unilateral bridging exercises, and between the right and left side were assessed using a paired t-test. The study showed that the EMG activities of all of the muscles were significantly higher when the bridging exercise was performed using the foam roll or sit-fit than on the firm surface. The EMG activities of the right rectus abdominis, right external obliques, the right internal oblique, and both erector spinae were significantly higher during unilateral bridging ex exercise using the foam roll or the sit-fit than on the firm surface. The EMG activities of all of the muscles were significantly higher during the unilateral bridging exercise than during the bridging exercise. Based on these finding, performing the unilateral bridging exercise using the sit-fit or the foam roll is a useful method for facilitating trunk muscle strength and lumbar stability.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.375-378
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• 2018

In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasound-guided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.22-30
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• 2018

Background: Improvement of lumbo-pelvic stability can reduce the compensatory action of the quadratus lumborum (QL) and selectively strengthen the gluteus medius (GM) during side-lying hip abduction (SHA). There are abdominal draw-in maneuver (ADIM) and abdominal bracing (AB) as active ways, and pelvic compression belt (PCB) as a passive way to increase of lumbo-pelvic stability. It is necessary to compare how these stabilization methods affect the selective strengthening of the GM. Objects: To investigate the effects of ADIM, AB, and PCB during SHA on the electromyography (EMG) activity of the GM, QL, external oblique (EO) and internal oblique (IO), and the GM/QL EMG activity ratio. Methods: A total of 20 healthy male adults participated in the study. The subjects performed three conditions in side-lying in random order: SHA with ADIM (SHA-ADIM), SHA with AB (SHA-AB), and SHA with PCB (SHA-PCB). To compare the differences among the three conditions, the EMG activities of the GM, QL, EO and IO, and GM/QL EMG activity ratio were analyzed using one-way repeated ANOVA. Results: The EMG activity of the QL was significantly higher in SHA-AB than in SHA-ADIM and SHA-PCB. The GM/QL activity ratio was significantly higher in SHA-PCB than in SHA-ADIM and SHA-AB. In addition, the figure for SHA-ADIM was significantly higher than that for SHA-AB. In the case of the EO, the figure for SHA-AB was significantly higher than corresponding values for the other two conditions. The figure for SHA-ADIM was significantly higher than that for SHA-PCB. The EMG activity of the IO was significantly higher in SHA-AH than in SHA-PCB. Conclusion: It can be suggested that wearing the PCB can more selectively strengthen the GM than to perform ADIM and AB during SHA. In addition, the ADIM can be recommended when there is a need to strengthen abdominal muscles during SHA.

• 디지털융복합연구
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• 제18권2호
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• pp.483-487
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• 2020

본 연구는 지면의 유형에 따른 서스펜션 트레이닝의 효과를 분석하기 위해 14명의 건강한 남자 대학생을 대상으로 2종류의 다른 지면 편평한 지면, 짐볼을 이용한 불안정한 지면에 따른 서스펜션 트레이닝의 주목적인 코어 근육의 활성 특성을 연구하였다. 지면의 유형에 따른 코어 근육의 활성도를 측정하기 위해 EMG(Electromyography)를 활용하였고 측정부위는 복직근, 외복사근, 내복사근, 하부요추 기립근의 근활성도를 측정하였다. 측정변인은 각각의 코어 근육 별로 지면의 유형에 따라 근전도 신호를 표준화하기 위해 %MVC방법으로 측정하였다. 지면의 유형에 따른 코어 근육의 차이를 검증하기 위해 paired t-test를 실시하였으며 유의수준은 p<. 05로 설정하였다. 다양한 유형의 지면에 따른 코어 근육의 활성도에 관한 특성을 측정한 결과 두 지면 사이의 근육 별, 지면 별 차이점은 통계적으로 유의하게 나타나지 않았다. 하지만 이는 코어 근육의 트레이닝의 적용 시 반드시 불안정한 형태의 지면에서의 트레이닝 효과가 안정된 지면에서의 효과보다 우월하다는 통념을 다시 한 번 생각하게 하는 중요한 결과라 사료된다. 본 연구의 의미는 불안정한 지면이나 안정된 지면이 코어 근육 활성화에 큰 영향을 미치지 않으므로 어떠한 운동프로그램이던지 정규화된 코어근육 강화프로그램을 실시해도 근육의 활성화에 차이가 없음을 의미한다.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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• pp.214-221
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• 2023

Objective: This study aimed to assess the impact of using the LED light electromyographyfeedback system (EMG-light) during Pilates exercises in women to maintain consistent muscle contraction in the abdominal external oblique muscles and reduce muscle contraction in the upper trapezius muscles. This study compared Pilates training using the EMG-light with Pilates training only in healthy women for 4 weeks. Design: This study was conducted as a cross-sectional study. Methods: A total of 17 healthy women were divided into an experimental group (n=9) and a control group (n=8). Both groups performed Pilates exercises as assigned, twice per week for four weeks, with each session lasting fifty minutes. The experimental group were used the EMG-light feedback system during pilates exercise while the control group did not use EMG-light. We used cervical vertebral angle (CVA), shoulder tilt angle to evaluate neck posture and standing balance with closed eye for 30s before and after exercise. Results: The control group exhibited a significant change in CVA (p<0.05). Both groups showed significant changes in shoulder tilt, center of pressure (COP) path-length, and COP velocity during eyes-closed conditions (p<0.05). However, there were significant differences between the experimental and control groups in terms of CVA, shoulder tilt, COP path-length, and COP velocity. Conclusions: This study demonstrated that Pilates exercises had positive effects on shoulder posture and balance. The use of EMG-light provided real-time visual feedback on muscle contraction during Pilates exercise. However, the experimental group did not show significant improvements compared to the control group, which performed Pilates exercises without feedback.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.410-417
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• 2006

The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권2호
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• pp.114-120
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• 2007

The augmentation of soft tissue defects is one of the critical problems in the oral and maxillofacial surgery. Various types of graft materials, both autologous and non-autologous, have been used for the augmentation of soft tissue in the facial region. However, it is not easy to choose an ideal material for soft tissue augmentation because each has its advantages and disadvantages. An ideal graft material should meet the following criteria : it should not leave a scar at the area from which it was taken; should have less likelihood of causing infection; should feel natural after implanted; and should be not absorbed. Among the materials meeting these criteria, human dermis and artificial dermis are commonly used for clinical purposes. The present study was aimed to investigate and compare the resorption rate and the histological change following the use of the autologous dermis, the human homogenous dermis $Alloderm^{(R)}$, and the artificial dermis $Terudermis^{(R)}$ to reconstruct the soft tissue defect. Twenty mature rabbits of either sex, weighing about 2 ㎏, were used. Each rabbit was transplanted with the autologous dermis, $Alloderm^{(R)}$, and $Terudermis^{(R)}$ size $1{\times}1-cm$ at the space between the external abdominal oblique muscle and the external abdominal oblique fascia. They were then divided into 4 groups (n=5 each) according to the time elapsed after the surgery: 1, 2, 4, and 8 weeks. The resorption rate was calculated by measuring the volume change before and after the transplantation, and H-E stain was preformed to observe the histological changes. The resorption rate after 8 weeks was 21.5% for the autologous dermis, 16.0% $Alloderm^{(R)}$, and 36.4% $Terudermis^{(R)}$, suggesting that $Alloderm^{(R)}$ is the most stable while $Terudermis^{(R)}$ is the most unstable. In microscopic examinations, the autologous dermis graft was surrounded by inflammatory cells and showed foreign body reactions. The epidermal inclusion cyst was observed in the autologous dermis graft. $Terudermis^{(R)}$ and $Alloderm^{(R)}$ demonstrated neovascularization and the progressive growth of new fibroblast. The results suggest that $Terudermis^{(R)}$ and $Alloderm^{(R)}$ can be availably for substituting the autologous dermis.

• 한국응용과학기술학회지
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• 제38권3호
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• pp.720-726
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• 2021

본 연구의 목적은 필라테스 브릿지 동작 시 소도구의 적용과 발의 불안정성 차이에 따른 신체근육의 근전도를 비교·분석하는데 있었다. 본 연구의 대상자는 20대 남성 18명을 대상으로 실시하였고(연령, 22.3±2.1세; 신장, 173.89±4.51cm; 체중, 72.61±4.13kg; 신체질량지수, 24.03±1.31kg/m²), 필라테스 브릿지는 소도구 적용(도구 없음, 링, 짐볼)과 발의 불안정성(기본 바닥, 폼롤러, 보수볼) 차이에 따른 9가지 동작을 수행하였으며, 표면전극 부착 부위는 신체 우측의 상복직근, 하복직근, 외복사근, 장내전근, 대퇴직근, 외측광근, 전경골근, 및 대퇴이두근으로 설정하였다. 본 연구의 결과는 다음과 같다. 필라테스 브릿지 동작 시 짐볼의 적용이 신체 근육의 근활성도에 효과적인 소도구로 검증되었고, 보수볼의 적용이 신체근육의 근활성도에 가장 높은 발의 불안정성으로 검증되었다. 이상의 결과를 종합해보면, 필라테스 브릿지 동작 시 짐볼과 보수볼의 적용이 신체 근육의 근활성도에 지대한 영향력을 미친 것으로 나타났다. 따라서 본 연구의 결과는 신체 근력 강화를 위한 효율적인 필라테스 브릿지 운동을 제시할 수 있을 것으로 기대된다.