• Archives of Plastic Surgery
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• 제32권4호
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• pp.421-427
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• 2005

Although the incidence of mediastinal wound infection in patient undergoing median sternotomy for cardiovascular surgery is relatively low(less than 1%), it is not only a devastating and potentially life-threatening complication but also associated morbidity, mortality and cost are unacceptably high. During the past few decades various methods had been applied for the treatment of postoperative mediastinitis. Currently, chest wall reconstruction by using muscle flaps-especially pectoralis major muscle and rectus abdominis muscle are commonly selected for the reconstruction after wide debridement has become widely accepted. We performed bilateral pectoralis major-rectus abdominis muscles in-continuity bipedicle flap to overcome the limit of each flap for reconstruction of sternal defects in 17 patients. We analyzed the results of the surgery. Recurrent infection developed in 17.6% of cases and abdominal herniation was observed in one patient. There was no postoperative hematoma or death. We conclude that this flap is very valuable in reconstruction of the anterior chest wall defect caused by post-sternotomy infection because it provides sufficient volume to fill the entire mediastinum, and the complication rate compares favorably to that of other methods.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.89-92
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• 2014

An 8-year-old girl diagnosed with dilated cardiomyopathy and Russell-Silver syndrome was admitted to our pediatric intensive care unit due to low cardiac output and multiple-organ dysfunction. The patient was placed on the heart transplant waiting list and extracorporeal membrane oxygenation was performed as a bridge to transplantation. After 17 days, heart transplantation was performed. The donor was a 46-year-old female (weight, 50 kg; height, 150 cm). The donor:recipient weight ratio was 3.37:1. Because the dimension and volume of the recipient's thoracic cage were insufficient, the sternum could not be closed. Nine days after transplantation, the patient underwent delayed sternal closure. To obtain adequate space, we left the sternum 4.5 cm apart from each margin using four transverse titanium plates. A transverse rectus abdominis musculocutaneous flap was chosen to cover the wound. Due to the shortage of donors, a size-mismatched pediatric heart transplantation is sometimes unavoidable. Closure of the opened sternum of a transplant recipient can be challenging. Sternal reconstruction after an extremely oversized heart transplantation with transverse titanium plate fixation and a musculocutaneous flap can effectively achieve sternal closure and stability.

• 대한통합의학회지
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• 제6권2호
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• pp.37-44
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• 2018

Purpose : The aim of this study is to compare the trunk muscle activities in trunk stabilization on the stable and unstable supporting surfaces using by sEMG. Methods : The subjects of this study include seventeen male. We measured sEMG activities of rectus abdominis and erector spine in subjects during trunk stabilization such as plank exercise, quadruped position, quadruped position with rising hand and foot on the stable and unstable surface. Results : sEMG activities in plank exercise was significantly higher in left rectus abdominis and left erector spine on unstable surface then stable surface (p<.05). sEMG activities of left rectus abdominis and left erector spine in quadruped position was significantly higher in unstable surface than stable surface (p<.05). In comparison with posture, Plank exercise showed a significant difference increase other postures (p<.05). Conclusion : sEMG activities of muscle in trunk stabilization was significantly higher in unstable surface than stable surface and plank exercise. So, we suggest that trunk stabilization on the unstable supporting surface and plank exercise were more effective method than stable surface to improve trunk muscles activities.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.68-73
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• 2004

Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.98-104
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• 2000

Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

• The Journal of Korean Physical Therapy
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• 제34권4호
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• pp.187-191
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• 2022

Purpose: The purpose of our study aimed to identify the effect of static and dynamic bridge exercise with gym ball using gym ball on muscle activation of trunk and lower-limb in healthy individuals. Methods: A total of 20 healthy adults participated in this study. The individuals performed general bridge exercise, static and dynamic bridge exercise using gym ball. During the three methods of bridge exercises, electromyography (EMG) data (% maximum voluntary isometric contraction) of the rectus abdominis, erector spinae, biceps femoris, and gastrocnemius were recorded using a wireless surface EMG system. Results: Rectus abdominis activation showed significantly greater during dynamic bridge exercise compared with general bridge exercise and dynamic bridge exercise. Erector spinae, biceps femoris, and gastrocnemius were greater during static and dynamic bridge exercise compared with general bridge exercise. Conclusion: Based on our results, bridge exercise using gym ball, particularly integrating lower-limb movement, could be a useful method to enhance muscle activation of trunk and lower-limb (rectus abdominis, erector spinae, biceps femoris, and gastrocnemius).

• Archives of Plastic Surgery
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• 제50권2호
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• pp.166-170
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• 2023

Diaphragmatic reconstruction is required for extensive diaphragmatic defects associated with tumor resection. Methods using artificial mesh and autologous tissues, such as pedicled flaps, have been reported predominantly for diaphragmatic reconstruction. We present the case of a 61-year-old woman who presented with a 14×13×12 cm tumor in the abdominal cavity of the upper left abdomen on computed tomography. The diaphragm defect measuring 12×7 cm that occurred during excision of the malignant tumor was reconstructed using the rectus abdominis muscle and fascial flap. The flap has vertical and horizontal vascular axes; therefore, blood flow is stable. It also has the advantage of increasing the range of motion and reducing twisting of the vascular pedicles. Fascial flap does not require processing such as thinning and can be used during suture fixation. This procedure, which has rarely been reported so far, has many advantages and may be a useful option for diaphragm reconstruction.

• 한국전문물리치료학회지
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• 제6권2호
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• pp.16-31
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• 1999

The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.

• 한국의류학회지
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• 제17권2호
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• pp.197-206
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• 1993

We studied relation between the clothing pressure applied by foundations(waist nipper, girdle, body suit) on the waist of bodies and muscular activity, feeling of tightness. The main results were summerized as follows ; 1. Clothing pressure applied by foundations was high in order of girdle>waist nipper>body suit, also clothing pressure was higher back than front and side, sitting on the chair than standing posture, ventral flection than repose. Individual differences, even if size of body was equal, were shown in clothing pressure applied by foundations with subcutaneous fat's amount in measuring region. 2. The muscular activity of rectus abdominis than obliquus externus abdominis was more affected by foundations in all kinds of postures and motions. Amplitude of electromyogram was high sitting on the chair than standing posture, but there was little difference with motion variation. The wearing girdle strongly affected on the muscular activities of rectus abdominis and obliquus externus abdominis as compared with waist nipper and body suit. 3. The value for feeling of tightness by wearing waist nipper was higher than girdle and body suit. Also the case when sitting on the chair and ventral flection, the value for feeling of tightness was high. When the foundations were on the body, most tightened on the region of the body was anterior abdominal region.

• Korean Journal of Acupuncture
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• 제23권2호
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• pp.39-46
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• 2006

Objective & Methods: This study is performed to understand the interrelation between 'Foot yangmyung meridian-muscle' and 'muscular system'. We studied the literatures on Meridian-muscle theory, anatomical muscular system, myofascial pain syndrome and the theory of anatomy trains. Results & Conclusion: 1. It is considered that Foot yangmyung meridian-muscle includes extensor digitorum longus m., tibialis anterior m., quadriceps femoris m., rectus abdominis m., pectoralis major m., sternocleidomastoid m., platysma m., orbicular oris m., zygomaticus major m., zygomaticus minor m., masseter m., Gluteus medius m., and Obliquus externus abdominis m. 2. The symptoms of Foot yangmyung meridian-muscle are similar to the myofascial pain syndrome with referred pain of extensor digitorum longus m., tibialis anterior m., quadriceps femoris m., rectus abdominis m., obliquus abdominis m., masseter m. 3. Superficial frontal line in anatomy trains is similar to the pathway of Foot yangmyung meridian-muscle, and more studies are needed in anatomy and physiology to support the continuity of muscular system of Foot yangmyung meridian-muscle in aspect of anatomy trains.