• Archives of Plastic Surgery
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• v.48 no.6
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• pp.646-650
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• 2021

Head and neck reconstruction poses unique challenges in rehabilitating surgical defects in terms of integrity, function, and form. The radial forearm free flap (RFFF) has been widely used for defect coverage, especially in the head and neck area, but its versatility allows it to be used for soft-tissue reconstruction in various parts of the body. The vascular features of the flap are quite constant and reliable. Nevertheless, abnormalities of the forearm vascular tree have been described over the decades. We report a case of intraoral reconstruction after verrucous carcinoma recurrence in a 74-year-old woman with an unusual forearm flap, which we called the median forearm free flap, based on a median branch of the radial artery that was preoperatively detected using handheld Doppler ultrasonography. The distally located skin paddle was predominantly supplied by the aberrant median vessel with its perforators. The flap was thus safely harvested with this atypical pedicle. Successful reconstruction of the intraoral defect was achieved, with an uneventful postoperative course.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.16 no.5
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• pp.338-346
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• 2023

During isometric elbow flexion, forearm length should be an important factor to determine not only joint torque but also maximum endurance time (MET), when the forearm is perpendicular to the direction of the force. The purpose of this paper is to examine the effect of forearm length as an additional factor on empirical models of MET such as an exponential model and a power model during isometric elbow flexion. Thirty volunteers participated in our experiment to measure factor variables such as circumferences and lengths of their upper and lower arms. Their METs were measured according to the percent of maximum voluntary contraction intensity (%MVC). For the multiple linear regression model of ln(MET) using these measurements, significant variables could be observed in %MVC and forearm lengths (P<0.05). The empirical models were assessed by these models using forearm length as the additional factor. Mean absolute deviations (MAD) between the measured METs amd the two empirical models were about 19.4 [s], but MAD using models applied forearm lengths were reduced to about 16.2 [s]. The correlation coefficients and intraclass correlation coefficients were about 0.87, but those applied forearm lengths were increased to about 0.91. These results demonstrated that forearm length was a significant additional factor to the empirical model.

• PNF and Movement
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• v.21 no.1
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• pp.139-146
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• 2023

Purpose: The aim of this study is to provide basic information to create an efficient training program to improve shoulder stability and function in patients with injuries and in patients having undergone surgery of the supraspinatus and infraspinatus muscles, which have a relatively high incidence of injury in shoulder joint disease. Further, independent activities of the supraspinatus and infraspinatus muscles were investigated according to forearm rotation and the neutral and lateral rotation postures. Methods: The activities of the supraspinatus and infraspinatus muscles were measured using surface electromyography in 22 healthy adults in Busan, and isokinetic muscle strength measurement equipment was used to measure muscle strength during shoulder lateral rotation. The subjects performed lateral rotation of the shoulder in three different forearm postures (neutral, supine, prone) to measure shoulder muscle activity and lateral rotation strength. Results: The independent activity ratio (% Isolation) of the supraspinatus and infraspinatus muscles during lateral rotation of the shoulder joint demonstrated a significant difference (p<0.05) according to the change in forearm posture. Conclusion: The supraspinatus muscle showed independent activity ranging from highest to lowest in the order of pronation, neutral, and supination of the forearm, while the independent activity of the infraspinatus muscle ranged from highest to lowest in the order of neutral, supination, and pronation of the forearm. Therefore, the most active forearm positions for the supraspinatus and infraspinatus muscles are pronation and neutral, respectively.

• Clinics in Shoulder and Elbow
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• v.17 no.1
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• pp.25-30
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• 2014

Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.7 no.1
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• pp.7-10
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• 2009

Purpose : The purpose of this study was to investigate the effect of electrical stimulation applied in dominant forearm on autonomic nervous system response of both hands. Methods : Fourteen healthy subjects (women) received low frequency-high intensity electrical stimulation to one forearm. The subjects assigned to two groups; a ipsilateral stimulation group (n=7) and a contralateral stimulation group (n=7). The electrode attachment was arranged on the forearm of the dominant arm and the electricity stimulus time was set as 15 minutes. Measuring items were the skin conduction velocity, the blood flow, and the pulse rate, which were measured total 3 times (pre, post, and post 10 min.). Results : The skin conduction velocity showed a significant difference according to the change of the time in both hands, but there was no significant difference according to time in the blood flow, and the change of the pulse frequency regardless of stimulus side. Conclusion : These results demonstrate that the low frequency-high intensity electrical stimulation applied dominant forearm can increase selectively only with the skin conduction velocity, which may be helpful for the activation of the sudomotor function of both hands by the activation of sympathetic nerve.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.55-59
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• 2001

The hand is a frequently affected area in high voltage electrical burn injury as an input or output sites. Therefore, early debridement and synchronous flap coverage are generally accepted as a primary treatment of several electrical burns complicated by exposure of tendons, neurovascular structures, and bones. So, in order to establish convenient, promising methods for the reconstruction of hand defects in electrical burn patients, we performed various reverse forearm flaps. From March 1997 to February 2000, we reconstructed 12 cases of hand defects in high voltage electrical burn wounds with reverse forearm flaps. Reverse radial fasciocutaneous flap were 3 cases, reverse ulnar fasciocutaneous flap were 3 cases, reverse ulnar fasciocutaneous flap and STSG were 4 cases, reverse ulnar fascial flap and STSG were 2 cases. We successfully reconstructed hand defects in all 12 cases, and obtained following conclusions. 1 Various reverse forearm flaps provide well vascularized, profitable tissues and they require short operative time with relatively easy procedures. 2. Reverse fascial flap and STSG, reverse fasciocutaneous flap and STSG provide thin flaps with good aesthetics and minor donor site morbidity.

• Journal of Fashion Business
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• v.7 no.1
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• pp.27-37
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• 2003

This study is the first part of the research to reveal the effects of somatotype characteristics on body temperature control reaction as well as thermal sensation. Nine healthy female collegians (classified into 3 body types of thin, normal, and obese according to Rohrer index) living in Busan were chosen as the subjects. The following are the results: Significant differences of skin temperature appeared in the parts of epigastrium (thin/normal>obese), anterior forearm (normal>thin/obese), and anterior leg (obese > thin/normal) as well as mean skin temperature. Mean skin temperature temporarily dropped owing to the exercise but tended to recover as time went by. Skin temperature of normal/thin shows higher than obese type. The change of skin temperature was noticed in the order of forehead > epigastrium > anterior forearm > anterior leg > anterior thigh (obese type) ; epigastrium > forehead > anterior forearm > anterior thigh > anterior leg (normal type) ; epigastrium > forehead > anterior forearm > anterior thigh > anterior leg (thin type, before and after exercise); epigastrium > forehead > anterior forearm > anterior leg > anterior thigh (thin type, during exercise). Significant differences were shown in the temperature change inside clothes according to somatotypes. No significant differences were revealed in thermal sensation, moisture sensation, and comfortable sensation according to body types and time.

• Archives of Reconstructive Microsurgery
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• v.11 no.2
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• pp.179-185
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• 2002

The wrist and forearm are a frequently damaged area in high tension electrical injury as an input or output of the current. Electrical burns affecting the wrist and forearm may produce full thickness necrosis of the skin and damage deep vital structures beneath the eschar, affecting the local tendons, nerves, even bones and joints which result in serious dysfunction of the hand. From January 1997 to December 2001, we had treated 20 patients with high tension electrical burn in the wrist and forearm using anterolateral thigh free flap. Average follow up period were 24 months and we get satisfactory results both in functional and aesthetic aspects. This flap is considered useful in one-stage reconstruction of wide and large soft tissue defect combined with arterial injuries.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.225-228
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• 2009

Purpose: Urethral reconstruction following failed hypospadias repair is difficult because of a severe shortage of the skin on ventral surface of the penis. We experienced a successful reconstruction of a failed hypospadias repair using the radial forearm free flap. So we present our case. Methods: A 16 - year - old boy had a proximal shaft hypospadias and had been taken a transverse preputial island flap but it completely broke down. There was no spare skin on the shaft of the penis. So we reconstructed a neo - urethra and the ventral skin of the penis with the radial forearm free flap. Results: Postoperatively he made relatively good process. The urethral catheter was maintained for 10 days and self - voiding was started. The suprapubic catheter was removed at the postoperative 30th day after control of cystitis. The postoperative appearance of the penis is acceptable and a straight erection is achieved. Conclusion: In the scarred penis with hypospadias, the radial forearm free flap transfer is a reliable reconstructive method for the neo - urethra and the ventral skin of the penis.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.185-188
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• 2000

The goals of lip reconstruction are to provide oral competence, adequate support for the lower lip, contour restoration, adequate lip sulcus, and adequate oral aperture. The composite radial forearm palmaris longus free flap is thin enough that it can be folded onto itself without a significant increase in bulk. The flap is easy to dissect, the pedicle contains long vessels of large diameter, and the skin is a good color and texture match for the perioral region. Moreover, the vascularized tendon can be used for lower lip reconstruction. This makes the flap ideally suited for total lower lip reconstruction. We experienced the case of total lower lip excision and reconstruction with the radial forearm free flap including palmaris longus tendon, so we reported that case with literature. The patient has a lower lip squamous carcinoma(T3NIM0), and performed a total lower lip excision with right modified radical neck dissection and left extended supraomohyoid neck dissection, and a reconstruction with radial forearm free flap includng palmaris longus tendon. The oral competence and masticatory function were nearly normalized and cosmetical result was very acceptable.