• The Korean Journal of Pain
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• v.13 no.1
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• pp.123-125
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• 2000

Rectus abdominis syndrome is the abdominal pain which occurs in the distribution of the medial or lateral cutaneous branch of the 7~12th intercostal nerves. It is frequently cause that results in unnecessary pain and expense to patient. The physical examination is difficult because of severe abdominal pain. We must have attention to the possibility that patients with abdominal pain, in whom no intra- abdominal cause is founded, may suffer from this presumed nerve entrapment syndrome. If we can find the cause of pain in the abdominal rectus muscle, no evaluation and surgery are required and therapy can be simple.

• Korean Journal of Acupuncture
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• v.23 no.2
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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.

• Archives of Reconstructive Microsurgery
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• v.23 no.2
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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.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.71-74
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• 2010

Purpose: Nowadays spinal cord stimulator is frequently used for the patients diagnosed as complex regional pain syndrome. The lead is placed above the spinal cord and connected to the stimulation generator, which is mostly placed in the subcutaneous layer of the abdomen. When the complication occurs in the generator inserted site, such as infection or generator exposure, replacement of the new generator to another site or pocket of the abdomen would be the classical choice. The objective of our study is to present our experience of the effective replacement of the existing stimulation generator from subcutaneous layer to another layer in same site after the wound infection at inexpensive cost and avoidance of new scar formation. Methods: A 50-year-old man who was diagnosed as complex regional pain syndrome after traffic accident received spinal cord stimulator, Synergy$^{(R)}$ (Medtronic, Minneapolis, USA) insertion 1 month ago by anesthetist. The patient was referred to our department for wound infection management. The patient was presented with erythema, swelling, thick discharge and wound disruption in the left upper quadrant of the abdomen. After surgical debridement of the capsule, the existing generator replacement beneath the anterior layer of rectus sheath was performed after sterilization by alcohol. Results: Patient's postoperative course was uneventful without any complication and had no evidence of infection for 3 months follow-up period. Conclusion: Replacement of existing spinal cord stimulation generator after sterilization between the anterior layer of rectus sheath and rectus abdominis muscle in the abdomen will be an alternative treatment in wound infection of stimulator generator.

• 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.

• The Korean Journal of Pain
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• v.26 no.3
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• pp.291-294
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• 2013

There are various origins for chronic abdominal pain. About 10-30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy.

• Journal of Trauma and Injury
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• v.26 no.1
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• pp.14-17
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• 2013

Purpose: The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen. Methods: A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery. Results: There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery. Conclusion: Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen.

• Sleep Medicine and Psychophysiology
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• v.14 no.1
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• pp.49-53
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• 2007

Mitochondrial myopathy is characterized by variable clinical manifestations from mild limb weakness to fatal respiratory failure and central nervous system sequela. But it is a rare event that sleep disordered breathing become a clue of diagnosis for mitochondrial myopathy. We report a case of a 21 year-old man who was diagnosed as mitochondrial myopathy during the investigation for the possible cause of chronic hypoventilation syndrome. Before being admitted to our hospital, he was suspected as having sleep apnea syndrome in another hospital. We re-evaluated the history, physical examination, laboratoy findings and polysomnography in detail. Severe hypoxemia was noted during REM sleep on nocturnal polysomnography and the diagnosis of mitochondrial myopathy was made by muscle biopsy in rectus abdominis muscle. We treated him with bilevel positive airway pressure therapy during sleep and it could reverse the hypoxemia during REM sleep. He could be discharged with improved condition and is being well with the use of this ventilatory assistance.