• The Korean Journal of Pain
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• v.32 no.2
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• pp.129-132
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• 2019

Regional anesthesia, including central and plane blocks (serratus anterior plane block and erector spinae block), are used for post-thoracotomy pain. The rhomboid intercostal block (RIB) is mainly performed by injection to the upper intercostal muscle plane below the rhomboid muscle. It has been reported to provide analgesia at the T3-T9 levels. The RIB was performed on 5 patients who had been scheduled for thoracotomy. The catheter was advanced in the area under the rhomboid muscle between the intercostal muscles. Postoperative visual analog scale (VAS) scores were observed and each patient's resting VAS score remained below 3 for 48 hours. The RIB has been observed to be a convenient plane block for post-thoracotomy analgesia. We believe that further information from detailed studies is required.

• Korean Journal of Acupuncture
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• v.20 no.4
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• pp.65-75
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• 2003

This study was carried to identify the component of Spleen Meridian Muscle in human, dividing into outer, middle, and inner part. Lower extremity and trunk were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Spleen Meridian Muscle. We obtained the results as follows; 1. Spleen Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle; ext. hallucis longus tend., flex. hallucis longus tend.(Sp-1), abd. hallucis tend., flex. hallucis brevis tend., flex. hallucis longus tend.(Sp-2, 3), ant. tibial m. tend., abd. hallucis, flex. hallucis longus tend.(Sp-4), flex. retinaculum, ant. tibiotalar lig.(Sp-5), flex. digitorum longus m., tibialis post. m.(Sp-6), soleus m., flex. digitorum longus m., tibialis post. m.(Sp-7, 8), gastrocnemius m., soleus m.(Sp-9), vastus medialis m.(Sp-10), sartorius m., vastus medialis m., add. longus m.(Sp-11), inguinal lig., iliopsoas m.(Sp-12), ext. abdominal oblique m. aponeurosis, int. abd. ob. m., transversus abd. m.(Sp-13, 14, 15, 16), ant. serratus m., intercostalis m.(Sp-17), pectoralis major m., pectoralis minor m., intercostalis m.(Sp-18, 19, 20), ant. serratus m., intercostalis m.(Sp-21) 2) Nerve; deep peroneal n. br.(Sp-1), med. plantar br. of post. tibial n.(Sp-2, 3, 4), saphenous n., deep peroneal n. br.(Sp-5), sural cutan. n., tibial. n.(Sp-6, 7, 8), tibial. n.(Sp-9), saphenous br. of femoral n.(Sp-10, 11), femoral n.(Sp-12), subcostal n. cut. br., iliohypogastric n., genitofemoral. n.(Sp-13), 11th. intercostal n. and its cut. br.(Sp-14), 10th. intercostal n. and its cut. br.(Sp-15), long thoracic n. br., 8th. intercostal n. and its cut. br.(Sp-16), long thoracic n. br., 5th. intercostal n. and its cut. br.(Sp-17), long thoracic n. br., 4th. intercostal n. and its cut. br.(Sp-18), long thoracic n. br., 3th. intercostal n. and its cut. br.(Sp-19), long thoracic n. br., 2th. intercostal n. and its cut. br.(Sp-20), long thoracic n. br., 6th. intercostal n. and its cut. br.(Sp-21) 3) Blood vessels; digital a. br. of dorsalis pedis a., post. tibial a. br.(Sp-1), med. plantar br. of post. tibial a.(Sp-2, 3, 4), saphenous vein, Ant. Med. malleolar a.(Sp-5), small saphenous v. br., post. tibial a.(Sp-6, 7), small saphenous v. br., post. tibial a., peroneal a.(Sp-8), post. tibial a.(Sp-9), long saphenose v. br., saphenous br. of femoral a.(Sp-10), deep femoral a. br.(Sp-11), femoral a.(Sp-12), supf. thoracoepigastric v., musculophrenic a.(Sp-16), thoracoepigastric v., lat. thoracic a. and v., 5th epigastric v., deep circumflex iliac a.(Sp-13, 14), supf. epigastric v., subcostal a., lumbar a.(Sp-15), intercostal a. v.(Sp-17), lat. thoracic a. and v., 4th intercostal a. v.(Sp-18), lat. thoracic a. and v., 3th intercostal a. v., axillary v. br.(Sp-19), lat. thoracic a. and v., 2th intercostal a. v., axillary v. br.(Sp-20), thoracoepigastric v., subscapular a. br., 6th intercostal a. v.(Sp-21)

• Korean Journal of Acupuncture
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• v.25 no.2
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• pp.1-32
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• 2008

Objectives : This study was performed to understand the interrelation between 'Foot three yang meridian-muscle' and 'muscular system'. Methods : We have researched some of the literatures on Meridian-muscle theory, anatomical muscular system, myofascial pain syndrome and anatomy trains. And especially we have compared myofascial pain syndrome to anatomy trains and researched what kind of relationship is exist between them. Results : It is considered that Foot taeyang meridian-muscle includes Abductor digiti minimi m., Gastrocnemius m., Biceps femoris m., Longissimus m., Omohyoid m., Occipital m., Frontal m., Orbicularis oculi m., Trapezius m., Sternocleidomastoid m., Sternohyoid m., Zygomaticus m. Foot soyang meridian-muscle includes Dorsal interosseus m., Tendon of extensor digitorum longus m., Extensor digitorum longus m., Iliotibial band, Vastus lateralis m., Piriformis m., Tensor fasciae latae m., Internal abdominal oblique m., External abdominal oblique m,, Internal intercostal m., External intercostal m., Pectoralis major m., Sternocleidomastoid m., Posterior auricular m., Temporal m., Masseter m., Orbicularis oculi m. Foot yangmyung meridian-muscle includes Extensor digitorum longus m., Vastus lateralis m., Iliotibial band, Iliopsoas m., Anterior tibial m., Rectus femoris m., Sartorius m., Rectus abdominis m., Pectoralis major m., Internal intercostal m., External intercostal m., Sternocleidomastoid m., Masseter m., Levator labii superioris m., Zygomatic major m., Zygomatic minor m., Orbicularis oculi m., Buccinator m. and the symptoms of Foot three yang meridian-muscle are similar to the myofascial pain syndrome. Superficial back line in anatomy trains is similar to the pathway of Foot taeyang meridian-muscle. Lateral Line in anatomy trains is similar to the pathway of Foot soyang meridian-muscle. Superficial Front Arm Line in anatomy trains is similar to the pathway of Foot yangmyung meridian-muscle. Conclusions : There is some difference between myofascial pain syndrome and meridian-muscle theory in that the former explains each muscle individually, while the latter classifies muscular system in the view of integrated organism. More studies are needed in anatomy and physiology to support the integration of muscular system of Foot three yang meridian-muscle in aspect of anatomy trains.

• Journal of Yeungnam Medical Science
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• v.37 no.2
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• pp.133-135
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• 2020

Intercostal nerve injury is known to occur during thoracotomy; however, rectus abdominis muscle atrophy has rarely been reported. We describe a 52-year-old man who underwent primary closure of esophageal perforation and lung decortication via left thoracotomy. He was discharged 40 days postoperatively without any complications. He noticed an abdominal bulge 2 months later, and computed tomography revealed left rectus abdominis muscle atrophy. We report thoracotomy induced denervation causing rectus abdominis muscle atrophy.

• The Journal of Korean Medicine
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• v.32 no.3
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• pp.1-9
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• 2011

Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

• Korean Journal of Acupuncture
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• v.22 no.1
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• pp.67-74
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• 2005

Objectives : This study was carried to identify the component of the Pericardium Meridian Muscle in human. Methods : The regional muscle group was divided into outer, middle, and inner layer. The inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and to expose the inner structure of the Pericardium Meridian Muscle in the order of layers. Results We obtained the results as follows; He Perfcardium Meridian Muscle composed of the muscles, nerves and blood vessels. In human anatomy, it is present the difference between terms (that is, nerves or blood vessels which control the muscle of the Pericardium Meridian Muscle and those which pass near by the Pericardium Meridian Muscle). The inner composition of the Pericardium Meridian Muscle in human is as follows ; 1) Muscle P-1 : pectoralis major and minor muscles, intercostalis muscle(m.) P-2 : space between biceps brachialis m. heads. P-3 : tendon of biceps brachialis and brachialis m. P-4 : space between flexor carpi radialis m. and palmaris longus m. tendon(tend.), flexor digitorum superficialis m., flexor digitorum profundus m. P-5 : space between flexor carpi radialis m. tend. and palmaris longus m. tend., flexor digitorum superficialis m., flexor digitorum profundus m. tend. P-6 : space between flexor carpi radialis m. tend. and palmaris longus m. tend., flexor digitorum profundus m. tend., pronator quadratus m. H-7 : palmar carpal ligament, flexor retinaculum, radiad of flexor digitorum superficialis m. tend., ulnad of flexor pollicis longus tend. radiad of flexor digitorum profundus m. tend. H-8 : palmar carpal ligament, space between flexor digitorum superficialis m. tends., adductor follicis n., palmar interosseous m. H-9 : radiad of extensor tend. insertion. 2) Blood vessel P-1 : lateral cutaneous branch of 4th. intercostal artery, pectoral br. of Ihoracoacrornial art., 4th. intercostal artery(art) P-3 : intermediate basilic vein(v.), brachial art. P4 : intermediate antebrachial v., anterior interosseous art. P-5 : intermediate antebrarhial v., anterior interosseous art. P-6 : intermediate antebrachial v., anterior interosseous art. P-7 : intermediate antebrachial v., palmar carpal br. of radial art., anterior interosseous art. P-8 : superficial palmar arterial arch, palmar metacarpal art. P-9 : dorsal br. of palmar digital art. 3) Nerve P-1 : lateral cutaneous branch of 4th. intercostal nerve, medial pectoral nerve, 4th. intercostal nerve(n.) P-2 : lateral antebrachial cutaneous n. P-3 : medial antebrachial cutaneous n., median n. musrulocutaneous n. P-4 : medial antebrachial cutaneous n., anterior interosseous n. median n. P-5 : median n., anterior interosseous n. P-6 : median n., anterior interosseous n. P-7 : palmar br. of median n., median n., anterior interosseous n. P-8 : palmar br. of median n., palmar digital br. of median n., br. of median n., deep br. of ulnar n. P-9 : dorsal br. of palmar digital branch of median n. Conclusions : This study shows some differences from already established study on meridian Muscle.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.455-457
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• 2011

A 70-year-old male visited urgent care due to coughing for 1 month and left chest pain. He had no history of trauma. The initial chest computed tomography (CT) showed the 7th left intercostal lung herniation. A follow-up CT showed an intercostal lung herniation combined with a bowl herniation, which had developed due to a Morgagni's hernia. An emergency operation was performed due to the incarceration of the bowl and lung. The primary repair of the diaphragm was performed and the direct approximation of the 7th intercostal space was determined. We concluded that the defect of the diaphragm and the intercostal muscle was a congenital lesion, and the recurrent coughing was the aggravating factor of herniation.

• 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.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.39-45
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• 2019

Background The dorsolateral branch of the posterior intercostal artery (DLBPI) can be easily found while harvesting a latissimus dorsi (LD) musculocutaneous flap for breast reconstruction. However, it remains unknown whether this branch can be used for a free flap and whether this branch alone can provide perfusion to the skin. We examined whether the DLBPI could be reliably found and whether it could provide sufficient perfusion. Methods We dissected 10 fresh cadavers and counted DLBPIs with a diameter larger than 2 mm. For each DLBPI, the following parameters were measured: distance from the lateral margin of the LD muscle, level of the intercostal space, distance from the spinal process, and distance from the inferior angle of the scapula. Results The DLBPI was easily found in all cadavers and was reliably located in the specified area. The average number of DLBPIs was 1.65. They were located between the seventh and eleventh intercostal spaces. The average length of the DLBPI between the intercostal space and the LD muscle was 4.82 cm. To assess the perfusion of the DLBPIs, a lead oxide mixture was injected through the branch and observed using X-rays, and it showed good perfusion. Conclusions The DLBPI can be used as a pedicle in free flaps for small defects. DLBPI flaps have some limitations, such as a short pedicle. However, an advantage of this branch is that it can be reliably located through simple dissection. For women, it has the advantage of concealing the donor scar underneath the bra band.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.53-57
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• 2010

Background: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. Material and Method: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. Result: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. Conclusion: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.