• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.1-16
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• 1996

There are various defects caused by trauma or resection of maignant tumor in the orofacial region, which can be reconstructed with various regional and pararegional flaps. Among these defects, it is very difficult to reconstruct palatal and midfacial defects after maxillectomy and patients have problems in speaking and swallowing of food. Therefore it is very important for surgeons to reconstruct these defects functionally and esthetically and to return the patients to the normal social activity. These defects are usually obturated with prosthodontic appliances to assist the phonation and swallowing. But nowadays surgical reconstruction by various flaps was considered and performed for better rehabilitation. For this purpose the forehead flap, the nasolabial flap, the tongue flap, the sternocleidomastoideous flap, the temporal flap, the latissimus dorsi flap, the scapular flap etc. are used. We reconstructed small-sized plalatal defects with tongue flap, medium-sized palatal and maxillary defects after maxillectomy with temporal myofascial flap and large midfacial defects including eyeball exenteration with latissimus dorsi myocutaneous flaps. Here we are to report 5 cases of these flaps used for the reconstruction of palatal and midfacial defects and consider the versatility, reliability and limitation in use of these flaps.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.448-454
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• 2007

Purpose: The objective of this study was to evaluate the outcomes of using the free flap in the reconstruction of maxillary defects. Methods: 27 consecutive cases of maxillary reconstruction with free flap were reviewed. All clinical data were analyzed, including ideal selection of flap, time of reconstruction, recurrence of cancer, postoperative complications, flap design, and follow-up results. The main operative functional items, including speech, oral diet, mastication, eye globe position and function, respiration, and aesthetic results were evaluated. Results: Among the 24 patients who underwent maxillary reconstruction with the free flap, 14 patients underwent immediate reconstruction after maxillary cancer ablation, and 10 patients underwent delayed reconstruction. There occurred 1 flap loss. Recurrences of the cancer after the reconstruction happened in 2 cases. Postoperative complications were 3 cases of gravitational ptosis of the flap, 2 cases of the nasal obstruction, and 1 case of fistula formation. Out of 27 free flaps, there were 15 latissimus dorsi myocutaneous flaps, 5 radial forearm, 4 rectus abdominis myocutaneous flaps, 1 scapular flap, 2 fibula osteocutaneous flap, respectively. Flaps were designed such as 1 lobe in 9 cases, 2 lobes in 9 cases, and 3 lobes in 5 cases. Among the 14 patients who had intraoral defect or who had palatal resection surgery, 2 patients complained the inaccuracy of the pronunciation due to the ptosis of the flap. It was corrected by the reconstruction of the maxillary buttress and hung the sling to the upper direction. All of the 14 patients were able to take unrestricted diets. In 6 patients who had reconstruction of inferior orbital wall with rib bone graft, they preserved normal vision. Aesthetically, most of the patients were satisfied with the result. Conclusion: LD free flap is suggested in uni-maxilla defect as the 1st choice, and fibular osteocutaneous flap and calvarial bone graft to cover the larger defect in bi-maxilla defect.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.379-385
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• 2014

Purpose: This study was to determine the immediate effects of pulsed magnetic field (PMF) in subjects with upper trapezius (UT) trigger point (TrP). Methods: Fifteen subjects with UT TrP were recruited for the study's PMF group (pain threshold=$2.29kg/cm^2$), and 15 age-, weight-, and gender-matched subjects with UT TrP were recruited for control group (pain threshold=$2.25kg/cm^2$). Pressure algometer was used to measure pressure pain threshold on UT TrP and, cervical range of motion (ROM) inclinometer was used to measure cervical ROM. Surface electromyography was used to record UT, lower trapezius, and serratus anterior muscle activity and relative ratio during scapular plane abduction between pre- and post-treatment. Results: The PMF effectively improved pain threshold and concurrently increased ROM (rotation to the painful side, lateral flexion to the nonpainful side). In addition, the PMF may effectively deactivate UT activity during abduction and the muscle activity ratio between UT and serratus anterior. Conclusion: These findings provided empirical evidence that PMF can be an effective treatment method to reduce pain threshold, to increase cervical ROM, and deactivate UT activity in individuals with TrP.

• Journal of the Korean Society of Radiology
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• v.7 no.4
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• pp.271-275
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• 2013

Shoulder bone scan everyday life, sports activities at the side of the shoulder joint, or applying strong force in the lateral occurs. Mainly on upper arm abduction, temple, other rotational dislocation of the shoulder joint gahaejyeo as useful for observing the presence or absence of lesions is used. Shoulder PA oblique projection prevent distortion of the image due to the angle and the most useful diagnostic radiological investigate shooting angle. Shoulder blade body and the acromion and coracoid process Y-view is formed characters. $10^{\circ}$ angle between the shoulder blades and the acromion is the obstruction. $20^{\circ}{\sim}25^{\circ}$ to the Y-view of the humerus head looks superimposed, the position of the shoulder joint and seemed appropriate. $35^{\circ}$ of the humerus head superimposed on the Y-view, but above the humerus head and shoulder joints were distorted. When $45^{\circ}$ elevation observed on the side of the best has come Y-view also acromion and coracoid process is finished.

• Korean Journal of Acupuncture
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• v.27 no.1
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• pp.151-158
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• 2010

Objectives and Methods: The present study was performed to investigate acupuncture point location of SI11 through reviewing literatures. Results: 1. The first description of the location of SI11 appeared in "ChimGuGabEulGyong(ZhenjiuJiayiJing)", however the point description was not precise. 2. The first proportional measurement for SI11 showed up after Ching dynasty, which describes "SI11 is the point obliquely superiour 1.7 B-cun and transeversly interior to SI9" however this does not match the present WHO's standard location of SI11. 3. The WHO standard location of SI11 is in the scapular region, in the depression between the upper one third and lower two thirds of the line connecting the midpoint of the spine of the scapula with the inferior angle of the scapula, but there is no evidence to support this in classical literatures. 4. Based on myology and theories of meridian, we suggest that it is more reasonable to locate SI11 at the point in the depression between the upper two third and lower one thirds, not the upper one third and lower two thirds, of the line connecting the midpoint of the spine of the scapula with the inferior angle of the scapula. Conclusions: More studies are needed for the more reliable standard location of SI11.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.68-72
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• 1998

With the advent of microvascular free-tissue transfer, this single stage resurfacing method for large scar and soft tissue defects around the wrist in the patients of electrical burn has distinctive advantage over the conventional multistage pedicle-flap transfer. Between 1992 and 1996, we treated 9 cases of 8 patients who had large scar around the wrist due to old electrical burn with free flaps as a preparation of staged tendon graft. Mean age was 30.3 years and average scar area was $6{\times}11cm$. The length of time the injury and free flaps was 9 months on an average. Prior to the free flap, we performed the angiography to all patients in order to evaluate the circulation of the forearm and hand and to choose the recipient vessel. In all cases, proximal ulnar arteries in the forearm remained intact and all radial arteries remained intact in 8 of 9 cases on angiogram. The interosseous arteries were well visualized in all cases. We used the ulnar arteries as a recipient artery. The types of flaps used were f scapular cutaneous flaps, 2 dorsalis pedis flaps and a radial forearm flap. Flap survial was 100 percents with satisfactory functional and cosmetic results. Free flaps using ulnar artery as a recipient artery is one of the useful reconstruction methods for the resurfacing of large scar around the wrist in the patients of old electrical burn.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.1-9
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• 1998

From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.

• Restorative Dentistry and Endodontics
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• v.21 no.2
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• pp.677-687
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• 1996

This study was conducted to evaluate the tissue responses histologically to three root canal cements : Sealapex, AH-26, and zinc oxide-eugenol cement. Twelve white female Sprague-Dawley rats, weighing between 350 and 400 gm, were anesthetized with an intraperitoneal injection of Ketamine hydrochloride(0.4 ml). After shaving the sites selected(left and right scapular areas, left and right pelvic areas), the animal's backs were scrubed with soap and water, and sterilized with absolute alcohol. Each material was mixed to a thin consistency to flow out easily through a 24-guage needle, and loaded into a sterile, disposable plastic 1-ml syringe. All of the rats were injected subcutaneously with 0.1 ml of the three test sealers. Normal saline was used as a control. Animals were sacrificed after 48hr, 1, 4, and 12 weeks by overanesthetization using jars containing anesthetic ether. The tested sites were surgically removed with the surrounding tissue and fixed with 10% formalin. After 48 hours specimens were embedded in paraffin, sectioned to an average thickness of $6{\mu}m$ thick, stained with hematoxylin-eosin. The slides were examined under the light microscope. The results were obtained as follows 1. All material except the control showed various degree of inflammation on 48 hr. 2. Sealapex : In early stage, severe inflammatory cell infiltration was observed. At the 4th weeks observation, graunlomatous tissue with macrophage and foreing body giant cells containing many dark particles in their cytoplasm was observed. 3. AH-26 : Mild inflammatoy reaction was observed with AH-26 throughout the experimental period. 4. Zinc oxide-eugenol cement : Severe inflammatory cell infiltration, necrosis along the material, edema could be seen in early stage. Zinc oxide-eugenol cement maintained a moderate/severe reaction throughout the experimental period.

• The Journal of the Convergence on Culture Technology
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• v.5 no.4
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• pp.227-235
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• 2019

The purpose of this study was to investigate the effects of cervical vertebral height and shoulder stabilization on anterior head posture in people with turtle neck. The subjects of this study consisted of normal and healthy people with 30 turtle necks. Subjects were randomly assigned to shoulder stabilization exercise and cervical vertebrae exercise (30 men, 15 men and 15 women, height: $168.67{\pm}6.51$, $22.33{\pm}8.27$, $65.03{\pm}11.98$, and $28.66{\pm}1.91$), In the experimental group, shoulder stabilization exercise and cervical spine exercise were performed for 4 weeks. Deep neck flexor, leavator scapular, upper trapezius, rhomboid, and lower trapezius showed significant differences in shoulder stabilization and cervical vertebrae before and after the experiment. As a result, the CVA value decreased significantly and the muscle activity value increased significantly when exercise and Mckenzie program were applied. These results show that exercise and Mckenzie programs have a positive effect on turtle neck improvement.

• Physical Therapy Korea
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• v.26 no.4
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• pp.29-34
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• 2019

Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p<.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a $0^{\circ}$ angle than at others tilt angles (p<.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p<.05), and post-hoc analysis showed significantly greater values on the $0^{\circ}$ surface than on other tilts (p<.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with $0^{\circ}$ and $30^{\circ}$ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a $30^{\circ}$ and at a $0^{\circ}$ tilt angle for and effective but not excessive muscle activation.