The purpose of this study was to analyze the effects of three different pelvic tilts on sit-to-stand ativities and to suggest a new therapeutic approach for movement reeducation in patients who have difficulty with sit-to-stand activities. The three different pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To analyze the kinematic component of STS, a motion analysis system (Zebris) was applied to the ankle, knee, hip joint, and thigh-off area. Also, to determine the onset time of muscle contraction, surface electrodes were placed to the rectus femoris muscle (RF), the vastus lateralis muscle (VL), the biceps femoris muscle (BF), the tibialis anterior muscle (TA), the gastrocnemius muscle (GCM), and the soleus muscle (SOL). One-way repeated ANOVA was used for the statistical analysis. First, significant differences were found in kinematic variables for the hip, knee, ankle joint, and thigh-off among the three activities. Second, there was significant difference in muscle activation pattern in TA. VL. and BF among three activities. In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity: (1) Changes in knee and ankle joints should be prioritized and recruitment order differences in VL and RF can be generated to accomplish abnormal STS activity. (2) APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated.
Objectives : This study was performed to analyse single dose toxicity of Sweet Bee Venom(Sweet BV) extracted from the bee venom in Beagle dogs. Methods : All experiments were conducted under the regulations of Good Laboratory Practice (GLP) at Biotoxtech Company, a non-clinical study authorized institution. Male and female Beagle dogs of 5-6 months old were chosen for the pilot study of single dose toxicity of Sweet BV which was administered at the level of 9.0 mg/kg body weight which is 1300 times higher than the clinical application dosage as the high dosage, followed by 3.0 and 1.0 mg/kg as midium and low dosage, respectively. Equal amount of excipient(normal saline) to the Sweet BV experiment groups was administered as the control group. Results : 1. No mortality was witnessed in all of the experiment groups. 2. Hyperemia and movement disorder were observed around the area of administration in all the experiment groups, and higher occurrence in the higher dosage treatment. 3. For weight measurement, Neither male nor female groups showed significant changes. 4. To verify abnormalities of organs and tissues, thigh muscle which treated with Sweet BV, brain, liver, lung, kidney, and spinal cords were removed and histologocal observation using H-E staining was conducted. In the histologocal observation of thigh muscle, cell infiltration, inflammation, degeneration, necrosis of muscle fiber, and fibrosis were found in both thigh tissue. And the changes depend on the dose of Sweet BV. But the other organs did not showed in any abnormality. 5. The maximum dose of Sweet BV in Beagle dogs were over 9 mg/kg in this study. Conclusions : The above findings of this study suggest that Sweet BV is a relatively safe treatment medium. Further studies on the toxicity of Sweet BV should be conducted to yield more concrete evidences.
Purpose: Gracilis muscle free flap transplantation is chosen in the medium sized soft tissue defect and bone exposure from trauma and chronic osteomyelitis in the lower extremity. We set a study to search for gracilis free flaps to know whether symptoms were cured or recurred in patients that have passed over 10 years from flap transplantation. Materials and Methods: From August 1995 through September 2010, we have performed 28 cases of gracilis muscle free flap in the lower extremities. Ever since no case visited to demand any discomfort, breakdown or recurrence in the flap site on outpatient basis. We made a telephone call to patients or relatives documented in the medical record and only 2 cases visited outpatient department and 9 cases postponed the visit who satisfied with the final result but 17 cases had wrong telephone numbers. Causes, area of lower extremity, recipient vessels in the lower extremity, condition of the donor thigh and overall satisfaction of the flap transplantation in activities of daily living were investigated and written down in the medical record. Results: 11 cases were reviewed after average postoperative 13.7 years. Gracilis muscle flaps were not break down at the recipient site in all cases. The wound of donor thigh wound healed good and overall activities of daily living was satisfied in all cases. Conclusion: Gracilis muscle flaps which had performed and followed up average 13.7 years revealed confident in the medium sized soft tissue defect and bone exposure from trauma and chronic osteomyelitis in the lower extremity.
We report a 29-year old female who developed bilateral femoral neuropathy combined with multiple abscesses in both thigh muscles. She was present with weakness in both lower extremities for 15 days and intermittent chilling sense for 3 months. Nerve conduction study showed complete absence of compound muscle action potentials in bilateral femoral nerves when stimulated at inguinal area. Electromyographic examination revealed no motor unit action potentials in both rectus femoris and vastus medialis muscles. CT revealed multifocal abscesses in bilateral thigh muscles. After antibiotic treatment, the patient's neurologic symptoms were improved.
Kim, Ji-Wan;Kim, Dong-Young;Ahn, Kang-Min;Lee, Jee-Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제42권5호
/
pp.265-270
/
2016
Objectives: To gain information on anatomical variation in anterolateral thigh (ALT) flaps in a series of clinical cases, with special focus on perforators and pedicles, for potential use in reconstruction of oral and maxillofacial soft tissue defects. Materials and Methods: Eight patients who underwent microvascular reconstructive surgery with ALT free flaps after ablative surgery for oral cancer were included. The number of perforators included in cutaneous flaps, location of perforators (septocutaneous or musculocutaneous), and the course of vascular pedicles were intraoperatively investigated. Results: Four cases with a single perforator and four cases with multiple perforators were included in the ALT flap designed along the line from anterior superior iliac spine to patella. Three cases had perforators running the septum between the vastus lateralis and rectus femoris muscle (septocutaneous type), and five cases had perforators running in the vastus lateralis muscle (musculocutaneous type). Regarding the course of vascular pedicles, five cases were derived from the descending branch of the lateral circumflex femoral artery (type I), and three cases were from the transverse branch (type II). Conclusion: Anatomical variation affecting the distribution of perforators and the course of pedicles might prevent use of an ALT free flap in various reconstruction cases. However, these issues can be overcome with an understanding of anatomical variation and meticulous surgical dissection. ALT free flaps are considered reliable options for reconstruction of soft tissue defects of the oral and maxillofacial area.
Purpose : Excessive alcohol causes damage to skeletal muscles, leading to the development of a specific disease entity called alcoholic myopathy. Chronic inflammation is related as an underlying mechanism for the loss of muscle mass induced by alcohol. Pro-inflammatory cytokines such as TNF-α (tumor necrosis factor-α) and IL-6 (interleukin-6) play a role in this process. The acupuncture point Feng Shi (GB 31) is located on the midline of the lateral aspect of the thigh, above the transverse popliteal crease. This acupoint is used for the treatment of weakness, atrophy, numbness, and post-stroke symptoms of lower limbs. The purpose of this study was to investigate the effect of Feng Shi stimulation on muscle atrophy caused by chronic alcohol administration. Method : Young male Sprague-Dawley rats were randomly divided into three groups of eight each: Normal, Control, and GB31. The rats in the Control and GB31 groups were orally given 25 % ethanol (5 ㎖/kg, body weight) daily for 4 weeks. The Normal group was similarly administered saline. The acupressure at Feng Shi was treated to rats in the GB31 group. After 4 weeks, the body weight, muscle weight and cross-sectional area of gastrocnemius were assessed and the histological changes in gastrocnemius muscle fiber were observed by hematoxylin and eosin staining. Moreover, TNF-α and IL-6 expressions were immunohistochemistrically evaluated. Results : Acupressure stimulation at Feng Shi had a protective effect on the weight reduction of the gastrocnemius muscle caused by alcohol intake, and had an effect of suppressing anatomical change in muscle fiber and decreasing the average cross-sectional area. Also, the immunoreactivities of TNF-α and IL-6 in the GB31 group were decreased. Conclusion : These results suggest that acupressure at Feng Shi has protective effects on chronic alcohol-induced muscle atrophy by inhibiting pre-inflammatory proteins such as TNF-α and IL-6.
석회화 건염은 주로 견관절이 가장 많이 호발하고 고관절, 슬관절 등 다른 부위의 관절에 발생하는 것으로 알려져 있다. 근육내에 허혈로 인한 근육 경색 또한 주로 당뇨병 환자에서 빈번한 합병증인 폐쇄성 혈관 병변에 의한 하지 원위부에 주로 발생하는 것으로 알려져 있다. 본 저자는 고령의 환자에서 당뇨병 같은 기존 질환이 없고 관절 부위가 아닌 하퇴 후방부 순수 건 내에 생긴 근육경색과 석회화가 같이 동반된 종괴 병변을 경험하였기에 이를 보고하고자 한다.
In the present study toxicity and immunostimulating activity of the lectin(KML-C), which was extracted from Korean mistletoe(Viscum album coloratum) were investigated in swine. To determine the toxicity, lectin was injected into thigh or cervical muscles of 4-week-old piglets(Landrace) and observed clinically and pathologically. For determination of the immnunostimulating activity, lectin($0.7{\mu}g/kg$ of body weight)-adjuvanted vaccine of Aujeszky's disease virus(ADV)(NYJ1-87) which was inactivated by 0.2% formalin was injected into the cervical muscle of antibody-negative piglets in the same age group. Subpopulation of the immune cells and serum neutralizing(SN) antibodies in the piglets were examined after vaccination, and resistance of the piglets against challenge by virulent NYJ1-87 was further examined. The results were also compared with those from piglets injected with aluminum hydroxide [$Al(OH)_3$]-adjuvanted vaccine of inactivated NYJ1-87 and NYJ1-87 vaccine without adjuvant, and the results are as follows. By injection of lectin with $30{\mu}g/kg$ of body weight to the thigh muscle, all of 12 piglets died after signs such as dyspnea, fever, systemic erythema and subcutaneous hemorrhages, and lesions pertaining to poisonous hepatitis and dysfunction of kidney were observed. By injection of lectin with $7{\mu}g/kg$ of body weight to the thigh muscle, all of 12 piglets showed signs such as edema and cutaneous hemorrhage in the injected area, lameness and depression, and lesions pertaining to poisonous hepatitis and dysfunction of kidney were observed. By injection of lectin with 1, 3 and $5{\mu}g/kg$ of body weight to the thigh muscle of each one piglet, signs such as congestion, induration and grayish coloration in the injected area, depression and inappetence were observed in all piglets. Toxic changes were also observed in the liver and kidney of piglets by lectin of 3 and $5{\mu}g$. By injection of lectin with 0.5 and $0.7{\mu}g/kg$ of body weight to the cervical muscle of each 9 piglets, all piglets were clinically normal and there were no significant changes in blood counts and chemistry values. Whereas, epithelial swelling and vacuolation of convoluted tubules were observed from one piglet injected with lectin of $0.7{\mu}g$, and necrosis and fibrosis of muscular fiber were observed in the muscle of one piglet injected with lectin of $0.5{\mu}g$. Only population of sIgM+ B lymphocytes increased among immune cells in all of 15 piglets immunized with lectin($0.7{\mu}g/kg$ of body weight)-adjuvanted vaccine, while compared to those in $Al(OH)_3$-adjuvanted vaccine and vaccine without adjuvant. No additional stimulation to the immune cells was recognized when lectin was added to $Al(OH)_3$-adjuvanted vaccine. In piglets immunized with lectin-adjuvanted vaccine, SN titers in reciprocal values for loge were 1.3-4.0 at 1-4 weeks after vaccination, which was similar to those with 1.0-3.3 by vaccine without adjuvant but lower than those with 2.0-5.7 by $Al(OH)_3$-adjuvanted vaccine. Also, no additional increase in the SN titers was recognized when lectin was added to $Al(OH)_3$-adjuvanted vaccine. Piglets immunized with lectin-adjuvanted vaccine were resistant to challenge by the virulent NYJ1-87 at 4 weeks after vaccination, and the SN titers reached to 5.0 one week after challenge, which was higher than those with 4.0 by vaccine without adjuvant but somewhat lower than those with 7.7 by $Al(OH)_3$-adjuvanted vaccine.
Purpose: Anterolateral thigh (ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. Methods: 84 patients who were treated with ALT perforator free flap from December 2004 to 2008, and February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from $3{\times}4$ to $12{\times}18$ cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. Results: Among the 84 patients, partial necrosis of flaps occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And total flap necrosis in 5 patients because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. Conclusion: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time need to consider to prevent flap necrosis. And operators should need careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.
Wide excision for curative treatment of malignant tumor on periauricular area often leads to loss of the external ear. But the auricle has rich vascular supply, Conservation of auricular contour is possible through salvage and engineering of remained auricular tissue. We experienced two cases of auricular salvage after wide excision of malignant tumor. In the first case, we performed two-staged technique. In first step, we covered soft tissue defect on periauricualr area with the anterolateral thigh free flap and remained auricle was floating over the flap after split-thickness skin graft was applied on it's posterior raw surface because it's survival was not confirmed. Second step was reposition of remained auricule on the anterolateral thigh flap. In the second case, we packed in periauricular dead space and external auditory canal with temoporalis muscle and temporoparietal fascial flap and then covered the flap with split thickness skin graft. In these two cases, there were no recurrence of tumors and we obtained cosmetically & functionally satisfactory results.
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