• 제목/요약/키워드: Pectoralis major

검색결과 201건 처리시간 0.033초

피부괴사로 노출된 심장 Pacemaker에 대한 처치 : 증례 보고 (A technique for treating exposed cardiac Pacemaker)

  • 신극선;유재덕;홍승록
    • Journal of Chest Surgery
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    • 제17권1호
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    • pp.125-128
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    • 1984
  • The management of the exposed cardiac pacemaker or its lead is a new challenge to the plastic surgeon. This complication is not rare. Coburn et al. [1972] reported less than 5 percent, but Sowton et al. [1974] showed that over a period of 19 years, in a series of 372 patients, the pacing system had to be removed because of local wound breakdown or infection in 10 percent of the cases. The methods used to treat exposure may vary from removal and re-introduction at anterior site to the rotation of local flaps to cover the exposed pacemaker. Recently we have experienced 6 times of migration and recurrent skin ulcerations without pyogenic infection overlying the pacemaker in one patient. We developed a new technique, anchoring the pacemaker to the clavicle by a wire through the hole of clavicle and by creating a pocket under the pectoralis major muscle. Then we would like to emphasize this operating method could be choice of treatment to prevent the migration of pacemaker and the ulceration of skin when complication of implantation of pacemaker is occurred.

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외상성 기관식도루 -수술체험 1례- (A Case Report of Traumatic Tracheoesophageal Fistula)

  • 최승호
    • Journal of Chest Surgery
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    • 제27권10호
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    • pp.888-892
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    • 1994
  • Acquired, traumatic tracheoesophageal fistula [TEF] is rare and difficult problem to manage. This 55 years old man met with a roller accident of a tractor. During accident, he received a penetrating injury on the left upper sternal border. At local clinic, he received closed thoracotomy drainage [CTD]for relief of pneumothorax[left]. Three days after CTD, he complained abdominal pain and hematemesis. The endoscopy revealed large ulcer at the stomach, so he received subtotal gastrectomy. On 10th day post subtotal gastrectomy, he developed aspiration and coughing from a TEF. The esophagogram showed large TEF at the mid-trachea level. So he transfered to our hospital for operation. This patient was operated on for late TEF three weeks after injury. We have used absorble 4-0 Vicryl sutures to repair trachea. We repair all esophageal injuries with two layers of nonabsorbable silk suture. Where suture line on the esophagus, the strap muscle was interposed for reinforcement. And for feeding, the feeding jejunostomy was performed. Postoperatively the osteomyelitis of the manubrium site was developed, so on the 30th postoperative day, an ostectomy of manubrium, both clavicle and fight 1st, 2nd ribs, and the pectoralis major musculo-cutaneous flap coverage were performed.

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골격근의 전위술의 흉부외과적 적용 (Surgical Applications of Thoracic Skeletal Muscle Transposition)

  • 조규철;박주철;유세영
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.376-380
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    • 1995
  • We experienced 17 skeletal muscle transpositions in chest surgery during the past 8 years. There were 3 female and 14 male patients with ranging from 5 to 71 years of age [ average 47.3 Seventeen patients underwent 27 musele flaps : 11 latissimus dorsi, 6 pectoralis major, 6 serratus anterior and 4 other muscles. An average of 2.0 previous operations was performed. Hospitalization averaged 24 days.Follow up ranged from 7 days to 45 months;There were two postoperative deaths; one, 20 days after from operation due to pneumonia and the other, 130 days after from operation due to cor pulmonale.Fifteen patients who were alive after operation had good results at the time of last follow up.

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정적자세 유지시 수공구의 무게가 상완의 postural tremor에 미치는 영향에 관한 연구

  • 송호영;김재영;조창규;윤명환;이면우
    • 한국경영과학회:학술대회논문집
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    • 대한산업공학회/한국경영과학회 1996년도 춘계공동학술대회논문집; 공군사관학교, 청주; 26-27 Apr. 1996
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    • pp.151-157
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    • 1996
  • Postural tremor of the upper arm in a static posture was measured to provide guidelines of hand tool weight. Three types of camera recording postures were selected. Postural tremor was measured on five levels of tool weights; no weight, 400g, 800, 1200g, and 1600g. For each conditions, upper arm postural tremor was measured together with EMG of biceps, deltoid, and pectoralis major, and Borg's CR-20 scale ratings of perceived exertion. Results of the experiment are as follows; Frequency analysis of tremor revealed that increased amplitude of frequency band of 2-4Hz and 10-14Hz was observed. Postural tremor of the upper arm maintained the initial level until fatigue developed. After the development of fatigue, the rate of the change of postural tremor was significantly increased. Different tool weights and hand postures showed different rate of tremor increase. And time to fatigue and the corresponding endurance time was positively correlated with Borg's RPF scores.

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휠췌어 추진시 근전도 신호의 특성 변화 (Changes in Surface EMG Parameters during Dynamic Wheelchair Propulsion)

  • 최화순
    • The Journal of Korean Physical Therapy
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    • 제13권3호
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    • pp.777-789
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    • 2001
  • The purpose of this study was to investigate the possibility of using surface electromyographic signals as a measure of muscle fatigue during the wheelchair propulsion. Subjects performed wheelchair exercise tests on a motor-driven treadmill with a constant-velocity of 1.25 m/sec. During each test, the raw EMC signals were acquired from the surface electrodes attached on the belly of five muscle groups: biceps brachii, pectoralis major. deltoid, triceps brachii, and trapezius. The median power frequency(MPF), and the root mean square(RMS) amplitude were calculated for each cyclic contraction in order to quantify muscle fatigue. During the wheelchair propulsion, the MPF decreased and the RMS increased in the trapezius and deltoid. However, the decreasing MPF and the increasing RMS also fluctuated severly during dynamic muscle contractions. Therefore, the MPF and RMS values should be estimated with well-designed methods and used with caution to quantify muscle fatigue during wheelchair propulsion.

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유리전완요골판(Free Radial Forearm Flap)을 이용한 구강안면부 결손의 재건 ; 전완요골판 12례의 경험 (THE OROFACIAL RECONSTRUCTION USING FREE RADIAL FOREARM FLAP ; THE EXPERIENCE OF 12 CONSECUTIVE FOREARM FLAPS)

  • 이종호;서구종
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권3호
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    • pp.305-318
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    • 1991
  • Reconstructive techniques of orofacial defects are very varied. In recent years, myocutaneous flaps, in particular the pectoralis major or latissimus doris myocutaneous flap have achieved popularity. In 1983, Soutar et. al. used the forearm free flap that had been developed in in China and popularised the radial forearm fasciocutaneous flap to reconstruct defects in the orofacial region. This paper presents the authors experience with 10 consecutive patients in which 12 flaps were used either as a fascioncutaneous flap or as a composite flap incorporating part of the radius. Some literatures were reviewed and the clinical results were discussed.

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설암 및 구강저암의 수술적 치료 (Surgical Treatment of Cancer of Tongue and Floor of Mouth)

  • 홍기환;양윤수
    • 대한기관식도과학회지
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    • 제3권2호
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    • pp.270-276
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    • 1997
  • The records of 18 patients with squamous cell carcinoma of the tongue and floor of mouth treated surgically were reviewed. Surgical approaches, staging, treatment modalities, recurrence and vital status were evaluated. The distrubutions of involved sites were tongue(9 cases) and mouth floor(9 cases). Patients were treated by surgery primarily, combined chemotherapy and radiation, and by surgical salvage in the failure cases of radiation and chemotherapy. All ipsilateral necks of mouth floor cancer and advanced tongue cancer were treated with neck dissection. Cases of early tongue cancer could be excised with transoral route, and advanced cases needed transmandibular approach. Whereas, majorites of mouth floor cancer needed transmandibular approach, and other cases could be excised transoral and pull-through approaches. In the recontructions, we used primary closure, pectoralis major myocutaneous flap, forearm free flap, fibular osteocutaneous flap and skin graft. One year survival rate was 93% and 2 year survival rate was 60%.

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토끼와 한국관박쥐 대흉근의 근소포체 마이크로솜의 Calcium Uptake에 관한 연구 (Ca2+ Uptake of the Sarcoplasmic Reticulum-Microsome of Fine Structure Pectoralis Major Muscle in the rabbit and the Korean Greater Horseshoe Bat*)

  • 오영근;양원석
    • 한국동물학회지
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    • 제38권1호
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    • pp.10-19
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    • 1995
  • 동면동물인 한국관박쥐(Korean greater horseshoe bat)와 비롱면 롱물인 토끼의 근소포체가 지니는 생리 및 근조직의 형태적 특징을 비교해 보고자 본 실험을 수행하여 다음과 같은 결론을 내렸다 Caffeine과 Mgcl2는 농도별로 처리하고, p연와 온도에 변화를 주는 등 각각의 생리조건하에서 한국관박쥐와 토끼 대흉근 근소포체 마이크로솜의 C32' 흡수정도가 다르게 나타났으며, Ca2'ATPase 활성 역시 상이함을 보였는데. 이로 미루어 보아 in vivo 상태에서 두 동물의 근소포체가 지니는 생리적 특성에 차이가 있을 것으로 추측된다. 형태학적 측면에서도 근심유의 수기와 미토콘드리아의 크기에 있어서 뚜렷한 차이를 발견할 수 있었는데. 이는 두 동물의 대흉근이 수행하는 운동의 종류와 관련이 있을 것으로 생각된다.

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전폐절제술후 발생한 농흉의 흉곽성형술과 근성형술을 이용한 수술치험 -1례 보고- (Thoracoplasty and Myoplasty for Operative Treatment of Postpneumonectomy Empyema - A Case Report -)

  • 윤양구
    • Journal of Chest Surgery
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    • 제22권5호
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    • pp.851-856
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    • 1989
  • Initial successful treatment of postpneumonectomy empyema depends to a large extent on adequate dependent drainage of the empyema sac and the use of antibiotics. But definite control of the infected space remains a disturbing and controversial area in the field of thoracic surgery. A 55-year-old man had a right pneumonectomy for tuberculosis with the development of postoperative thoracic empyema and in October 1973. Postoperatively, an empyema developed and the condition was managed with closed drainage and an open window thoracostomy. He was transferred to our institution in October 1988, and underwent thoracoplasty for the obliteration of the empyema space, resulting in a remaining space. The remaining space after thoracoplasty was obliterated by myoplasty using a rotation flap of splitted pectoralis major muscle three months later. He was discharged with uneventful course 12 days after operation, and continues to do well 3 months following operation. Our experience shows that thoracoplasty and myoplasty offer an effective alternative method of management of post-pneumonectomy empyema.

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Prepectoral breast reconstruction

  • Kim, Sung-Eun
    • Journal of Yeungnam Medical Science
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    • 제36권3호
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    • pp.201-207
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    • 2019
  • Implant-based breast reconstruction is the most commonly used reconstruction technique after mastectomy. This is because skin-sparing mastectomy has become possible with advancements in oncology. In addition, the development of breast implants and the advent of acellular dermal matrices have reduced postoperative complications and resulted in superior cosmetic results. The most frequently performed surgical breast reconstruction procedure for the past 20 years was the insertion of an implant under the pectoralis major muscle by means of the dual plane approach. However, some patients suffered from pain and animation deformity caused by muscle manipulation. Recently, a prepectoral approach has been used to solve the above problems in select patients, and the results are similar to subpectoral results. However, this technique is not always chosen due to the number of considerations for successful surgery. In this article, we will discuss the emergence of prepectoral breast reconstruction, indications and contraindications, surgical procedures, and outcomes.