• 대한한의학회지
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• 제41권4호
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• pp.72-77
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• 2020

Objectives: This study was carried out to concrete the concept of Hand Gworeum Skin referred in Suwen of Huangdi Neijing. Methods: The Hand Gworeum Meridian was labeled with latex in the body surface of the cadaver, subsequently dissecting a superficial fascia and muscular layer in order to observe internal structures. Results: Skin histologically encompasses a common integument and a immediately below superficial fascia, this study established the skin boundary with adjacent structures such as relative muscle, tendon as its compass. The realm of the Hand Gworeum Skin is as follows: The skin close to the nipple on the 4th intercostal space, the interceps of biceps brachii muscle, the cubital surface at ulnad of bicipital aponeurosis, the anterior surface of the forearm, between flexor carpi radialis and palmaris longus(from wrist crease to 5chon above), the palm between the 3rd and 4th metacarpals on the cross part with the palm crease, the radiod from the middle finger nail(or the end of middle finger). The realm of the Hand Gworeum Skin is situated on between Hand Taeeum Skin and Hand Soeum Skin in front of arm. Conclusion: The realm of Hand Gworeum Skin from the anatomical viewpoint seems to be the skin area outside the superficial fascia or the muscle involved in the pathway of the Hand Gworeum Meridian vessel, Collateral Meridian vessel, and Meridian muscle, being considered adjacent vessels or nerves at the same time.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.894-898
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• 2011

Purpose: Coverage of full-thickness large flank defect is a challenging procedure for plastic surgeons. Some authors have reported external oblique turnover muscle flap with skin grafting, inferiorly based rectus abdominis musculocutaneous flap, and two independent pedicled perforator flaps for flank reconstruction. But these flaps can cover only certain portions of the flank and may not be helpful for larger or more lateral defects. We report a case of large flank defect after resection of extraskeletal Ewing's sarcoma which is successfully reconstructed with reverse latissimus dorsi myocutaneous flap. Methods: A 24-year-old male patient had $13.0{\times}7.0{\times}14.0$ cm sized Ewing's sarcoma on his right flank area. Department of chest surgery and general surgery operation team resected the mass with 5.0 cm safety margin. Tenth, eleventh and twelfth ribs, latissimus dorsi muscle, internal and external oblique muscles and peritoneum were partially resected. The peritoneal defect was repaired with double layer of Prolene mesh by general surgeons. $24{\times}25$ cm sized soft tissue defect was noted and the authors designed reverse latissimus dorsi myocutaneous flap with $21{\times}10$ cm sized skin island on right back area. To achieve sufficient arc of rotation, the cephalic border of the origin of latissimus dorsi muscle was divided, and during this procedure, ninth intercostal vessels were also divided. The thoracodorsal vessels were ligated for 15 minutes before divided to validate sufficient vascular supply of the flap by intercostal arteries. Results: Mild congestion was found on distal portion of the skin island on the next day of operation but improved in two days with conservative management. Stitches were removed in postoperative 3 weeks. The flap was totally viable. Conclusion: The authors reconstructed large soft tissue defect on right flank area successfully with reverse latissimus dorsi myocutaneous flap even though ninth intercostal vessel that partially nourishes the flap was divided. The reverse latissimus dorsi myocutaneous flap can be used for coverage of large soft tissue defects on flank area as well as lower back area.

• Journal of Chest Surgery
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• 제15권3호
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• pp.295-298
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• 1982

Persistent bronchopleural fistula still presents a troublesome therapeutic challenge and demands an aggressive approach when conventional measures fail. Empyema associated bronchopleural fistula developed after resectional surgery and their primary diseases were lung abscess in one case, bronchiectasis in two cases. Three cases of postpneumonectomy empyema associated bronchopleural fistula were treated surgically with a pedicled intercostal muscle grafting and concomittent thoracoplasty. After the procedure, patients had no recurrent symptoms or signs of bronchopleural fistula and discharged from hospital with improved condition.

• Journal of Chest Surgery
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• 제22권3호
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• pp.518-523
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• 1989

A 42-year old male was seen with symptoms of dysphagia, chest pain and dyspnea of 9 months duration. A benign tumor of the posterior mediastinum was diagnosed from x-ray studies and a transthoracic needle aspiration biopsy which was inconclusive. A left thoracotomy revealed a huge mass occupying the retrocardiac space and the contra-lateral mediastinum. It was resected by blunt dissection and, during this process, a 3.0 cm laceration was created in the esophageal wall. This was repaired with Tevdec sutures and staplers and was reinforced with an intercostal muscle flap to prevent leakage. The postoperative course was entirely uneventful.

• 대한물리의학회지
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• 제13권1호
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• pp.129-136
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• 2018

PURPOSE: This Study compared the level of activation of the muscles around the shoulder at the time of abduction through Pilates breathing and regular breathing by using quantified biofeedback. METHODS: Experiment was conducted on 25 healthy males and females in the age bracket of 20's~30's as the subjects. The level of activation of muscles displayed at the time of Pilates breathing were measured at intercostal (InC) muscle, transverse abdominis (TrA) muscle, internal oblique (IO) muscle and external oblique (EO) muscle by using surface electromyogram (EMG) and were provided as biofeedback. Moreover, the changes in the level of muscular activation at sternocleidomastoid (SCM) muscle, upper trapezius (UT) muscle and Deltoid (Del) muscle, which are the muscles around the shoulder, at the time of abduction of shoulder during Pilates breathing and regular breathing were measured. RESULTS: When abduction of shoulder is executed through Pilates breathing, the level of muscular activation of UT muscle was $11.56{\pm}7.10%$ at the time of exhaling of Pilates breathing and $17.54{\pm}9.57%$ at the time of exhaling of regular breathing. Del muscle also displayed lowered level of muscular activation at the time of Pilates breathing with $12.88{\pm}5.80%$ during inhaling and $15.14{\pm}5.49%$ during exhaling. CONCLUSION: In conclusion, the results could be interpreted as indicating that the muscle activities of upper trapezius and deltoid muscle were decreased based on Pilates breathing more than those on regular breathing.

• Journal of Acupuncture Research
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• 제22권5호
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• pp.29-36
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• 2005

Objectives : This study is performed to understand the interrelation between 'Foot soyang muscle of the Gall bladder channel' and 'muscular system' on the basis of the link between meridian muscle theory and myofascial pain syndrome. Methods : We have researched some of oriental medical books about meridian muscle theory and western medical books about anatomical muscular system. Results & Conclusion : 1. Myofascial pain syndrome is the medical treatment which finds the start point of the pain in fascia and then treats it on the basis of object and concrete anatomical theory, so its application is needed for objectification of the oriental medicine. 2. There is a wide difference between myofascial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. Foot soyang muscle contains Dorsal interosseous m, Extensor digitorum longus m, Musculus peroneus brevis, longus and, tertius, lliotibial tract, Vastus lateralis m, Gluteus m, Aximus m, Piriformis m, Tensor fasciae latae m, Gluteus minimus m, Obliquus internus & externus abdominis m, External & Internal intercostal m, Serratus anterior m, Pectoralis major m, Sternocleidomastoid m, Auricularis posterior m, Temporalis m, Masseter m, Orbicularis oculi m etc. on the basis of function and the nature of a disease reflected in muscle. 4. Foot soyang muscle keeps the balance of left md right of the body on the outside, while the Gall bladder keeps the balance of the JangBuKiHyeul(臟腑氣血) on the inside.

• Physical Therapy Rehabilitation Science
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• 제4권2호
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• pp.108-114
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• 2015

Objective: The purpose of this study was to examine the effect on vital capacity (VC) and inspiratory muscle activation according to the anterior and posterior pelvic tilt positions. Design: One group pretest-posttest design. Methods: Twenty-six healthy adult men and women, age 19 to 27 years, volunteered to participate in this study. Forced vital capacity (FVC), and forced expiratory volume in 1 second ($FEV_1$) were measured by desktop spirometer in the pelvic positions during respiration, and muscle activation was recorded from sternocleidomastoid, upper trapezius, external intercostal, rectus abdominis, and external oblique muscles by surface electromyography (EMG) at the same time. EMG values were normalized by maximum muscle contractions (% maximum voluntary isometric contraction). Subjects were to breathe in as much air as possible and then exhale as quickly as possible in both anterior and posterior pelvic tilt positions. To measure lung capacity, inspiration was measured for 5 seconds and expiration was measured for 7 seconds with data collection taken place during the middle three seconds. Lung capacities were measured in each position three times. Results: For the results of this study, there was a significant increase in both FVC and $FEV_1$ values during the anterior pelvic tilting compared to the posterior pelvic tilting posture (p<0.05). The sternocleidomastoid, upper trapezius muscle, rectus abdominus and external oblique muscle activation was significantly increased during anterior pelvic tilt compared to the posterior pelvic tilt position (p<0.05). Conclusions: These findings suggest that pelvic anterior tilt position could be more effective for vital capacity and respiratory muscles activation during respiration.

• 대한수의학회지
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• 제44권2호
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• pp.269-277
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• 2004

Trichinella spiralis is one of the important zoonotic parasites with a wide variety of vertebrates hosts in nature. The purpose of this study were to analyze ESP(Excretory-Secretory Protein) antigen, to evaluate ELISA for the serological diagnosis of Trichinosis, and to survey T. spiralis infection in finishing pigs using the pepsin digestion method and ELISA in Korea. In the analysis of ESP antigen by SDS-PAGE and Western blot, 4 major bands (70, 55, 52.6, and 49 kDa) were revealed from the ESP antigen. Predilection sites of T. spiralis were the diaphragm, the tongue, masseter muscles, intercostal muscle, and hindlimb in orders in the experimentally infected rats. Sera from 581 swine were tested by ELISA with ESP antigen. The 54 (9.3%) sera were suspected as positive reactors, however, these 54 sera were determined as false positives by the use of Western blotting. This study demonstrated that the ELISA was not suitable for the examination of T. spiralis in pork. The diaphragm muscle samples of 251 finishing pigs were tested by the method of pepsin-digestion for the presence of Trichinella larvae, however, T. spiralis was not detected from the samples. We could not find out T. spiralis infection in pig in Korea pork.

• Journal of Chest Surgery
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• 제25권3호
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• pp.271-275
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• 1992

One hundred forty patients with empyema thoracis were managed under the general anesthesia at the Seoul National University Hospital between 1980 and 1990. The patients, who were managed by thoracentesis or intercostal tube drainage alone, were excluded in this study. There were 92 males and 48 females, ranging from 8 to 80 years of age. Underlying pathologic lesions of empyema thoracis were primary bronchopulmonary infection [84%], postoperative empyema[11%], malignancy, paragonimiasis, spontaneous pneumothorax and so on. A single causal organism was isolated only in 17 patients[the most common being staphylococcus aureus, pseudomonas, & streptacoccus pneumoniae], multiple organism in 31, and no growth in 32. Surgical treatment modalities were decortication[75], pleuropneumonectomy[30], decortication with lobectomy[10], empyemectomy[9], open drainage[13], Clagett procedure [6], thoracoplasty with or without muscle transposition[9]. Hospital mortality were in 2 cases[1.4%], one empyema related and the other nonrelated. In this study, bacteriologic findings were nonspecific and often polymicrobial. We conclude that early thoracotomy can be lifesaving in the presence of a benign clinical course.

• Journal of Chest Surgery
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• 제37권2호
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• pp.193-196
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• 2004

Ivor Lewis 수술 후에 발생하는 위기관지 누공은 매우 드물지만 위중한 합병증이다. 본 증례는 식도암환자에서 Ivor Lewis 수술 후 15개월째에 발생한 위기관지 누공에 대하여 단 단계 교정술을 시행한 것으로, 먼저 위식도 누공을 분리한 후 기관지 부위와 위 부위의 결손을 직접 봉합했고, 대망편과 5번째 늑간근편을 이용하여 봉합된 결손부위 사이를 보강하였다. 본원에서 시행한 식도 절제술 후의 합병증으로 발생한 위기관지 누공에 대한 치료로 좋은 결과를 보였기에 문헌 고찰과 함께 보고한다.