• Title/Summary/Keyword: Vascular stiffness

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Reconstruction of the Large Soft Tissue Defects around Knee Joint with Para-Scapular and Latissimus Dorsi Myocutaneous Free Flap based on Subscapular Vessels (슬관절 주변의 광범위한 연부조직 결손 시에 시행한 광배근-부견갑 피판을 동시에 사용한 유리 피판술의 효과)

  • Chung, Duke-Whan;Lee, Jae-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.11-18
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    • 2002
  • Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

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Association between physical activity measured using an accelerometer and arterial stiffness based on pulse wave velocity and ankle-brachial index in healthy adults (건강한 성인에서 가속도계로 측정한 신체활동과 맥파전달속도 및 상완-발목 간 혈압비에 기반한 동맥경화지표와의 관계)

  • Lee, Hyunju;Park, Kye Wol;Jun, Ha Yeon;Gwak, Ji Yeon;Kim, Eun Kyung
    • Journal of Nutrition and Health
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    • v.55 no.4
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    • pp.506-520
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    • 2022
  • Purpose: Physical activity (PA) has a beneficial effect on the prevention of arteriosclerosis in healthy adults. The purpose of this study was to analyze the relationship between PA measured using an accelerometer and arterial stiffness in healthy Korean adults. Methods: This study involved 87 subjects (36.8% women) aged 20-64 years. PA was evaluated using an accelerometer (wGT3X-BT, ActiGraph, Florida, USA) for 7 days. Based on the results of the accelerometer measurement, subjects were classified into active and inactive groups according to the World Health Organization (WHO) PA guidelines. The brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) to assess arterial stiffness were measured by a non-invasive vascular screening device (VP-1000 Plus, Omron). Results: The average age of the study subjects was 47.7 ± 11.3 years and the WHO PA guideline achievement rate was 29.9%. There was no significant difference in arterial stiffness (baPWV and ABI) between the active and inactive groups. In females, the time spent in light PA were positively correlated with ABI (r = 0.396; p < 0.05) and the number of sedentary bouts over 50 minutes was inversely correlated with ABI (r = -0.402; p < 0.05). However, there was no significant correlation between PA and arterial stiffness in males. Conclusions: The results of this study suggest that light PA and sedentary behavior have a positive correlation with arterial stiffness in females.

AIx Change According to Pressing Angle and Pressing Force of the Radial Artery Pulse by Tonometry (토노메트리 방식 맥파 측정의 가압 각도와 가압력에 따른 AIx 변화)

  • Cho, JungHee;Jeon, Young Ju;Jun, Min-Ho;Kim, Young-Min
    • Journal of Sensor Science and Technology
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    • v.27 no.4
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    • pp.259-263
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    • 2018
  • A radial artery pulse wave is measured while pressing an artery with constant force. However, pulse waveform measurements vary depending on pressing force and direction. Accurate pulse waveform measurements are important for analysis. Thus, it is necessary to define the measurement range of the permissible force and direction from which a correct pulse waveform is derived. In this study, pulse waves were generated by a pulse wave generator for accurate control. The pulse waves generated for different angles and pressing forces were analyzed. The augmentation index (AIx), which is the most commonly used index for evaluating vascular stiffness, was analyzed. The AIx was measured within ${\pm}6^{\circ}$ of the vessel direction and within ${\pm}8^{\circ}$ perpendicular to the vessel direction with a force that was 25% or more of the pressing force at which the maximum pressure wave was generated. We identified the applicable pressing force and angle range by analyzing the effect of pressing angle on the pulse wave. The AIx analysis performed using the pulse wave measurement device is reliable and reproducible.

APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP (인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복)

  • Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.227-232
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    • 2007
  • The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

A Clinical Study of Tension Headache Patients using Depression & Anxiety Scales (우울(憂鬱), 불안(不安) 척도(尺度)를 이용(利用)한 긴장성(緊張性) 두통(頭痛) 환자(患者)의 임상고찰(臨床考察))

  • Jung, In-Chul;Lee, Sang-Ryong;Park, Ji-Un
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.145-154
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    • 2003
  • Objective : The aims of this study were to show the clinical state and to investigate depression and anxiety by BDI and STAI scale in tension headache patients. Method : The patient group was consisted of the 20 patients with Tension Headache who were treated in Department of Neuropsychiatry, Daejeon University Oriental Hospital from 3 March 2003 to 30 September 2003. The control group was consisted of the 20 patients on physical therapy with cerebaral vascular disorder in the Daejeon University Cheonan Oriental Hospital. The patient group was investigated by various characteristics, and compared with the control group by BDI and STAI scores. Result : 1. The ratio of female was higher, the 40 aged were higher frequence, in distribution of the period of the clinical history, short term within 1 week was the most.. 2. Tension headache was most frequent at whole portion, neck stiffness, shoulder pain, general body weakness were mainly coexited, and the prescription invigorating spleen supplementing qi and tonifying qi and blood. 3. The BDI score was higher in patient group, but there was no significant difference 4. The STAI score was higher in patient group, but there was no significant difference.

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The impacts of exercise on pediatric obesity

  • Headid, Ronald J. III;Park, Song-Young
    • Clinical and Experimental Pediatrics
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    • v.64 no.5
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    • pp.196-207
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    • 2021
  • Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.

Leg Amputation due to Buerger's Disease: Management with Combined Korean Medicine

  • Won, Eun Sol;Lee, Hyun;Ryu, Hwa Yeon;Ku, Yong Ho;Jung, Ga Hyeon;Park, Chae Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.325-330
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    • 2021
  • In this Case Report, a patient with Buerger's disease who had a leg amputation below his lower right knee and a vascular bypass of right leg, developed a wound caused by his prosthetic leg and subjective discomfort. The patient received skin flap surgery but the wound did not heal properly. He was admitted to the Korean Medicine Hospital where his wound, right leg coldness, and phantom pain were treated with combined Korean medicine. The patient was hospitalized again where he underwent micro-drilling surgery. The patient was re-admitted to the Korean Medicine Hospital where he received combined Korean medicine treatment (CKMT) and carbon arc light treatment (CALT) for his wound, leg coldness, stiffness, and hypoplasia. The temperature of his right leg increased, the numeric rating scale score for assessing pain fell from 5 to 1.5, and subjective discomfort was reduced (< 20%) suggesting this may be an effective treatment.

Age-related Changes of the Finger Photoplethysmogram in Frequency Domain Analysis (연령증가에 따른 지첨용적맥파의 주파수 영역에서의 변화)

  • Nam, Tong-Hyun;Park, Young-Bae;Park, Young-Jae;Shin, Sang-Hoon
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.12 no.1
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    • pp.42-62
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    • 2008
  • Objectives: It is well known that some parameters of the photoplethysmogram (PPG) acquired by time domain contour analysis can be used as markers of vascular aging. But the previous studies that have been performed for frequency domain analysis of the PPG to date have provided only restrictive and fragmentary information. The aim of the present investigation was to determine whether the harmonics extracted from the PPG using a fast Fourier transformation could be used as an index of vascular aging. Methods: The PPG was measured in 600 recruited subjects for 30 second durations, To grasp the gross age-related change of the PPG waveform, we grouped subjects according to gender and age and averaged the PPG signal of one pulse cycle. To calculate the conventional indices of vascular aging, we selected the 5-6 cycles of pulse that the baseline was relatively stable and then acquired the coordinates of the inflection points. For the frequency domain analysis we performed a power spectral analysis on the PPG signals for 30 seconds using a fast Fourier transformation and dissociated the harmonic components from the PPG signals. Results: A final number of 390 subjects (174 males and 216 females) were included in the statistical analysis. The normalized power of the harmonics decreased with age and on a logarithmic scale reduction of the normalized power in the third (r=-0.492, P<0.0001), fourth (r=-0.621, P<0.0001) and fifth harmonic (r=-0.487, P<0.0001) was prominent. From a multiple linear regression analysis, Stiffness index, reflection index and corrected up-stroke time influenced the normalized power of the harmonics on a logarithmic scale. Conclusions: The normalized harmonic power decreased with age in healthy subjects and may be less error prone due to the essential attributes of frequency domain analysis. Therefore, we expect that the normalized harmonic power density can be useful as a vascular aging marker.

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The Study of Vascular Dynamics for the Effect of a Compress Pack on Pain Relief using Magnetic Resonance Angiography (자기공명영상을 이용한 찜질 자극에 의한 통증 완화 효과에 대한 혈류 영상학적 고찰)

  • Baek, Ji-Won;Lim, Young-Khi
    • Journal of Radiation Protection and Research
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    • v.40 no.4
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    • pp.277-282
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    • 2015
  • This study was to investigate the effects of the hot compress pack on alleviating local muscular discomfort, stiffness in limbs as well as the chronic pains such as migraine in terms of hemodynamics. In this study, the hot compress band was put on the neck and the local physiological change on the stimulation site and the cranial blood circulation change were examined. We recruited healthy volunteers (n=8, mean age: 32.13 (4.61)), who participated in the magnetic resonance imaging (MRI) study. Local skin color and temperature were measured for the local effect of the hot compress band and the changes of intra-cranial and extra-cranial blood vessels were examined with MR angiography (MRA) images. The skin temperature increased from $36.4^{\circ}C$ at the rest condition to $36.7^{\circ}C$ and $37.1^{\circ}C$ after 15 min and 30 min stimulation, respectively. The change of the extra-cranial blood vessels between pre-stimulation and post-stimulation of 30 min was significantly increased (+38.8%), while the change of the intra-cranial blood vessels was negligible. In this study, we demonstrated that the hot compress band on the neck yielded the increase of local skin temperature on the stimulation site and it made an effect on the extracranial circulation. In conclusion, the stimulation with a hot compress could facilitate the blood circulation, causing to relieve the muscular discomfort, stiffness in limbs as well as the chronic pains such as migraine.

An Analysis of Health Problems Experienced by the Clients Receiving Hemodialysis (혈액투석 환자들이 경험한 건강문제 분석)

  • 신미자
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.903-916
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    • 1996
  • The purpose of this study was to discover practical health problems which hemodialysis clients experienced so as to present basic data for development of a health assessment tool. The research subjects were 70 clients receiving hemodialysis in Seoul and Inchon from Mar. 1996 to Sep. 1996. Data were collected by researcher's informal indepth interview and nurses' open ended question. Content analysis was applied to collect similar contents and common experiences in order to derivate concepts and categories for better understanding of hemodialysis clients' experiences. As a result, 9 categories derivated to identify the health problems of clients receiving hemodialysis were as follows : 1) They experienced 'the decreased digestive function' which contained the changed appetite, nausea, vomiting, constipation and diarrhea. 2) They experienced 'the decreased respiratory and circulatory function' which contained dyspnea, changed blood pressure, tingling sensation and the fear of aggrevated vascular condition. 3) They experienced 'the aggrevated oral condition' which contained dry mouth and destruction of teeth and their soft tissue. 4) They experienced 'the decreased sensory function' which contained visual disturbances, sensation difficulty, and hearing loss. 5) They experienced 'the aggrevated skin condition' which contained dark brown skin color, dry skin (and hyperpigmentatic freckle, seborrheric keratosis, scale), itching sense, and alopethia. 6) They experienced 'the decreased urinary reproductive function' which contained anuria or oliguria, dysmenorrhea, sterility and decreased libido. 7) They experienced 'the restricted activity' which contained decreased activity, muscle cramp and stiffness of joint. 8) They experienced 'the changed mental status' which contained memory disturbance, decreased cognition, disorientation, neurosis and psychosis. 9) They experienced 'the aggrevated general condition' which contained kyphosis, weight loss, fatigue, sleep disturbance, bleeding tendency, inflammation, generalized edema and foul oder of uremia.

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