• 제목/요약/키워드: Pectoralis muscle

검색결과 195건 처리시간 0.024초

Poland 증후군 환자의 흉벽 및 유방 재건술 (Chest Wall and Breast Reconstruction in Poland's Syndrome)

  • 오득영;이백권;서병철;이종원;안상태
    • Archives of Plastic Surgery
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    • 제34권3호
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    • pp.346-351
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    • 2007
  • Purpose: As a rare congenital anomaly, Poland's syndrome has been known to show hypoplasia in breast and nipple, absence of pectoralis major muscle, and aplasia or deformity of rib or costal cartilage which has been reported to be more common in male. However, most patients who are seeking operation are female patients having one-side deformity. In the field of plastic surgery, the major surgical indications could be asymmetric chest wall depression in man or breast hypoplasia in woman. There are many reconstruction options according to the degree of patient's deformity: a prosthetic implant, breast implant with or without tissue expander, latissimus dorsi musculocutaneous pedicled flap with or without implant and/or tissue expander, and free tissue transfer with or without tissue expander. Methods: The authors have treated 4 patients(2 male, 2 female) who had a diagnosis of Poland's syndrome. According to the degree of patient's deformity, all patients underwent correction of breast asymmetry and unilateral anterior thoracic hypoplasia with one-staged or two-staged reconstruction. Results: All patents were satisfied with the results and there occurred no specific complications. Conclusion: The authors propose the treatment plan for patient with Poland's syndrome, according to the degree of patient's deformity. In case of male patient with mild deformity, the prosthetic implant or latissimus dorsi musculocutaneous pedicled flap will simulate the missing pectoralis and improve the contour deformity. In case of female patient with moderate to severe breast asymmetry and upward displaced nipple areolar complex (NAC), NAC can be lowered with tissue expander, breast can be enlarged with autologous free flaps or latissimus dorsi musculocutaneous pedicled flap with implant.

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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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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Foreign Body Granulomas of the Breast Presenting as Bilateral Spiculated Masses

  • Boo-Kyung Han;Yeon Hyeon Choe;Young-Hyeh Ko;Seok-Jin Nam;Jung-Hyun Yang
    • Korean Journal of Radiology
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    • 제2권2호
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    • pp.113-116
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    • 2001
  • In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.

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Can Suboccipital Release Followed by Cranio-Cervical Flexion Exercise Improve Shoulder Range of Motion, Pain, and Muscle Activity of Scapular Upward Rotators in Subjects With Forward Head Posture?

  • Kim, Bo-been;Lee, Ji-hyun;Jeong, Hyo-jung;Cynn, Heon-seock
    • 한국전문물리치료학회지
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    • 제23권2호
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    • pp.57-66
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    • 2016
  • Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

거북목 증후군 예방용 기능성 의류의 자세 교정 효과 (The posture correction effect of functional clothing to prevent turtle neck syndrome)

  • 김현숙;천종숙;지정우
    • 복식문화연구
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    • 제24권3호
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    • pp.358-366
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    • 2016
  • This study was performed to measure the posture correction effect of wearing ergonomic experimental clothing. Two types of experimental clothing (A, B) were developed. Both of them reinforced the muscles surrounding the spine. Experimental clothing A was developed by reflecting the shape and position of the pectoralis major muscle, abdominal muscle, and latissimus dorsi muscle. Experiment clothing B was developed by reflecting the integrated form of those muscles. Subjects were males in their 20s~30s (n=32). They were divided into two groups based on their acromion distance (AD): the turtle neck syndrome group (n=16, AD=3.81cm) and the normal group (n=16, AD=1.27cm). The correction of body posture was detected by three index values: change of the cervical curvature angle, horizontal distance between the seventh cervical vertebra and tragion, and AD. The comfort and tightness of the clothing were also measured. The results showed that both types of experimental clothing corrected body posture and that turtle neck syndrome can be prevented by wearing these types of posture correcting clothing. Two index values were decreased: cervical curvature angle ($0.31{\sim}1.32^{\circ}$) and horizontal distance between seventh cervical vertebra and tragion (0.22~0.31cm). The chest was also stretched. The comfort was rated as good for both types of experimental clothing. These results indicate that the experimental clothing had a posture correction effect without any discomfort for daily living.

수술현미경하 액와접근 갑상선 절제술 (Axillary Approach for Thyroidectomy under Operating Microscope)

  • 최종욱;전병선;이장우;이동진;손항수
    • 대한두경부종양학회지
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    • 제23권1호
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    • pp.32-36
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    • 2007
  • Background and Objective:A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods:From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$;OPMI $pico^{(R)}$;Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results:There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion:Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

셀프 피트니스 의류 개발을 위한 근전도 센싱 위치 연구 (A Study of Sensing Locations for Self-fitness Clothing base on EMG Measurement)

  • 조하경;조상우
    • 한국의류산업학회지
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    • 제18권6호
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    • pp.755-765
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    • 2016
  • Recently, interest in monitoring health and sports is growing because of the emphasis on wellness, which is accelerating the development and commercialization of smart clothing for biosignal monitoring. In addition to exerciseeffect monitoring clothing that tracks heart rate and respiration, recently developed clothing makes it possible to monitor muscle balance using electromyogram (EMG). The electrode for EMG have to attached to an accurate location in order to obtain high-quality signals in surface EMG measurement. Therefore, this study develops monitoring clothing suitable for different types of human bodies and aims to extract suitable range of EMG according to movements in order to develop self-fitness monitoring clothing based on EMG measurement. This study identified and attached electrodes on six upper muscles and two lower muscles of ten males in their 20s. After selecting six main motions that create a load on muscles, the 8-ch wireless EMG system was used to measure amplitude value, noise, SNR and SNR (dB) in each part and statistical analysis was conducted using SPSS 20.0. As a result, the suitable range for EMG measurement to apply to clothing was identified as four parts in musculus pectoralis major; three parts in muscle rectus abdominis, two parts each in shoulder muscles, backbone erector, biceps brachii, triceps brachii, and musculus biceps femoris; and four part in quadriceps muscle of thigh. This was depicted diagrammatically on clothing, and the EMG-monitoring sensing locations were presented for development of self-fitness monitoring.

Efficient Exercise Volume Analysis through Number of Repetitions and EMG Response of Agonist Muscle During the Bench Press

  • Kim, Ki Hong
    • Medical Lasers
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    • 제10권4호
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    • pp.220-228
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    • 2021
  • Background and Objectives In designing a resistance exercise program, intensity, rest, and exercise volume are important. Many studies have been conducted to find the most suitable resistance exercise program incorporating the above, and in particular, many prior studies have been conducted on intensity. This study attempted to determine the effective volume of exercise by analyzing the number of repetitions performed at intensities of 65% one-repetition maximum (1RM) and 75% 1RM during the bench press exercise, and the electromyography (EMG) response of the agonist muscle. Materials and Methods Eight males in their 20s were selected as study subjects and they performed five sets of bench presses at two levels of intensity (65% 1RM, 75% 1RM). The following results were obtained by measuring the number of repetitions and the EMG response according to the exercise intensity and sets during the workout. Results First, the number of repetitions showed a sharp drop from the first set to the third set at 65% 1RM intensity and showed no change in the fourth and fifth sets. At 75% 1RM intensity, the intensity of hypertrophy showed a gradual decrease from the first set to the fifth set. Second, at 75% 1RM exercise intensity, the pectoralis major, anterior deltoid and triceps brachii showed high muscle activity, and the activity of the anterior deltoid continued to increase from the first set to the fourth set at 65% 1RM intensity, and from the first set to the fifth set at 75% 1RM. Conclusion It was found that during the bench press exercise, three minutes of rest at 75% 1RM intensity, five sets of five sets, one minute rest at 65% 1RM intensity, and three sets of the exercise were effective.