• Physical Therapy Korea
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• v.24 no.3
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• pp.30-39
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• 2017

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

• 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 the Computational Structural Engineering Institute of Korea
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• v.20 no.5
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• pp.565-572
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• 2007

This paper addresses the kinematic study for the structural analysis of the S60ME-C multi-cylinder vessel engine. The load conditions such as the lateral force and the reaction force by the crank-shaft are required for the FEM analysis. The driving parts in vessel engine are assumed to be in frictionless rigid plane motion. We analytically derive dynamic forces for a single cylinder by using the dynamic force equilibrium. But, for the structural analysis for a single cylinder block, we use the loading conditions of two neighboring cylinders. Meanwhile, we use the single cylinder's loading condition to calculate the multi-cylinder's loading conditions, because each cylinder shows a cyclic loading pattern with respect to the crank arm's rotation angle.

• Korean Journal of Head & Neck Oncology
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• v.1 no.1
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• pp.35-61
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• 1985

The surgical treatment of advanced carcinomas and some benign tumors having clinically malignant behaviors of the head and neck region often require extensive resection, necessitating large flaps for reconstruction. Since the original upper arm flap was described by Tagliacozzi in 1597, a variety of technique such as random pattern local flap, axial flap, distant flap, scalping flap, myocutaneous flap, free flap etc. have been proposed for reconstruction of head, face and neck defects. Reconstruction of the facial defects usually require the use of distant tissue. Traditionally, nasal reconstruction has been carried out with a variety of forehead flaps. In recent years, there has been more acceptance of immediate repairs following the removal of these tumors. As a result, patients are more willing to undergo these extensive resections to improve their chances of cure, with the reasonable expectation that an immediate reconstruction will provide an adequate cosmetic result. Authors experienced 13 cases of head and neck tumor during last three and half years that required wide excision and immediate reconstruction with various flaps, not with primary closure or simple skin graft. We present our experience with varied flaps for reconstruction after wide resection of head and neck tumors 3 cases of defect of dorsum of nose or medial canthus with island forehead flaps, lower eyelid defect with cheek flap, cheek defect with Limberg flap, orbital floor defect with Temporalis muscle flap, lateral neck defects with Pectoralis major myocutaneous flap or Latissimus dorsi myocutaneous free flap, subtotal nose defect with scalping flap, wide forehead defect with Dorsalis pedis free flap and 3 cases of mandibular defect or mandibular defect combined with lower lip defect were reconstructed with free vascularized iliac bone graft or free vascularized iliac bone graft concomitantly combined with free groin flap pedicled on deep circumflex iliac vessels We obtained satisfactory results coincided wi th goal of treatment of head and neck tumors, MAXIMAL CURE RATE with MINIMAL MORBIDITY, OPTIMAL FUNCTION, and an APPEARANCE as close to normal as possible.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.111-117
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• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.164-171
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• 2000

Fascia and fasciocutaneous free flaps (using perforators) are adequate reconstructive options with aesthetic and functional advantages, particularly for reconstruction of variable soft tissue defects of the extremities. Although various donor sites have been used for these concerns including temporoparietal fascia, serratus fascia, scapular fascia, fascial component of lateral arm and posterior calf fascia. The authors used temporoparietal and scapular fascia as a free flap for coverage of soft tissue defects and we compare two flap mainly their histologic studies and clinical applications. In our expierience both fascia provide thin, pliable coverage for exposed bone and tendons and provide good postoperative functional restoration on the recipient area. Histologically temporoparietal fascia flap has more rich blood supply and scapular fascia flap is rich in adipose tissue in their composition. In donor site morbidity, both flaps can bring satisfactory results about the donor sites, but the donor site of the temporoparietal fascia flap sometimes revealed conspicious linear scar and transient alopecia in short-haired patients and the scapular fascia flap has a tendency to be wider and thicker in obese patients. After successful application of the both fascia flap as a free flap in 38 patients (25 temporoparietal fascia, 13 scapular fascia) since 1995 ; authors recommend using the temporoparietal fascia flap for women, who tend to have more fat and longer hair, and the scapular fascia flap for men, who tend to be leand & shorter hair.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.131-135
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• 2007

We report an isolated anterior dislocation of the radial head in a 23-year-old man after a fall on the outstretched arm. At the time of the injury, the patient's elbow was in a position of mild flexion and pronation which was suddenly further pronated as he fell down. The radial head was incarcerated by the lateral portion of brachialis muscle, and annular ligament was interposed between capitellum and radial head. Open reduction was performed. During 12 months follow-up, reduction of radial head was well maintained without a limitation of range of motion.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.307-310
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• 1998

Selective lumbosacral radiculography and nerve root block techniques are very useful in determining the nerve root involved. We have done the lumbar root block to 61-year-old female who had suffered from low back pain radiating to right lower leg which was not relieved by epidural steroid injection two times. $L_5$ root block was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we injected contrast medium (Isovist$^{(R)}$ - 300, Schering, Germany). After we injected 1.5 cc isovist, the S1 root was figured but L5 root was not figured. When we reinjected 1.5 cc isovist, $S_1$ root was enhanced and $L_5$ root was slightly visible due to severe disc bulging and lateral spinal stenosis.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.578-581
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• 2015

A rigid spino-pelvic fixation to anchor long constructs is crucial to maintain the stability of long fusion in spinal deformity surgery. Besides obtaining immediate stability and proper biomechanical strength of constructs, the S2 alar-iliac (S2AI) screws have some more advantages. Four Korean fresh-frozen human cadavers were procured. Free hand S2AI screw placement is performed using anatomic landmarks. The starting point of the S2AI screw is located at the midpoint between the S1 and S2 foramen and 2 mm medial to the lateral sacral crest. Gearshift was advanced from the desired starting point toward the sacro-iliac joint directing approximately $20^{\circ}$ angulation caudally in sagittal plane and $30^{\circ}$ angulation horizontally in the coronal plane connecting the posterior superior iliac spine (PSIS). We made a S2AI screw trajectory through the cancellous channel using the gearshift. We measured caudal angle in the sagittal plane and horizontal angle in the coronal plane. A total of eight S2AI screws were inserted in four cadavers. All screws inserted into the iliac crest were evaluated by C-arm and naked eye examination by two spine surgeons. Among 8 S2AI screws, all screws were accurately placed (100%). The average caudal angle in the sagittal plane was $17.3{\pm}5.4^{\circ}$. The average horizontal angle in the coronal plane connecting the PSIS was $32.0{\pm}1.8^{\circ}$. The placement of S2AI screws using the free hand technique without any radiographic guidance appears to an acceptable method of insertion without more radiation or time consuming.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.2
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• pp.39-52
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• 2012

Objectives : The purpose of this study was to investigate the correlation between lumbar lordotic angle and the power of trunk flexors, extensors in normal adults Methods : 34 normal participants participated in this study. Their lumbar lordotic angle(L1-S1 Cobb's angle and L1-L5 cobb's angle) was measured by x-ray taken on lateral direction, erect cross-arm position. And muscle power of trunk flexors and extensors of each participant measured using Cybex HUMAC NORM. Results : 1. The average of L1-S1 Cobb's angle was $47.21{\pm}8.88^{\circ}$ and the average of L1-L5 Cobb's angle was $36.32{\pm}9.62^{\circ}$(Table IV). 2. The average ratio of trunk flexors/extensors was $6.44{\pm}19.31%$(Table V). The average power of the trunk flexors was $165.18{\pm}55.05$(Newton-Meter/kg), and the power of trunk extensors was $257.18{\pm}85.53$ (Newton-Meter/kg)(Table VI). 3. Lumbar lordotic angle has no relation to the ratio of trunk flexors/extensors(Table VII, Fig. 4). 4. Lumbar lordotic angle has no relation to both the power of the trunk flexors and extensors(Table VIII, Fig. 5, Fig. 6). Conclusions : These results suggest that the lumbar lordotic angle measured by radiograph could not evaluate the power and ratio of trunk flexors, extensors.