• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.31-37
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• 2013

Background: The purpose of this study was to identify the effects of cervical manipulation for improve blood velocity and flow in the subjects with asymmetric vertebral artery. Methods: Twenty-four subjects on asymmetric vertebral artery with right side have less blood flow than left side participated in this study for apply to non-specific cervical manipulation on lower portion. Measurement method were using duplex ultrasound with colour doppler imaging for blood velocity and flow on left and right vertebral artery. Results: Compared changes of blood velocity and flow on unilateral after the cervical manipulation, the left blood velocity decreased significantly (p<.01) and the right blood velocity increased significantly (p<.01). The left blood flow no significant changes and the right blood flow increased significantly (p<.01). Compared changes of blood velocity and flow on bilateral, the left and right blood velocity and flow made significantly difference on pre-manipulation (p<.01). However, both side no significantly difference on post-manipulation. Conclusions: These findings suggest that the non-specific cervical manipulation took effect for improve blood velocity and flow in the subjects with asymmetric vertebral artery. Therefore, therapeutic approaches for improve to asymmetric vertebral artery should be consider non-specific cervical manipulation.

• Proceedings of the KSME Conference
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• 2002.08a
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• pp.717-720
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• 2002

The present study is to evaluate the performances of flow velocity and wall shear stress in the stenosed coronary artery using human in vivo hemodynamic Parameters and computer simulation. Initial and follow-up coronary angiographics in the patients with angulated coronary stenosis are performed. Follow-up coronary angiogram demonstrated significant difference in the percent of diameter in the stenosed coronary between two groups ($Group\;1:\;40.3{\%},\;Group\;2:\;25.5{\%}$). Flow-velocity wave obtained from in vivo intracoronary Doppler ultrasound data is used for the boundary condition for the computer simulation. Spatial and temporal variations of flow velocity vector and recirculation area are drawn throughout the selected segment of coronary models. The WSS of pre- and post-intracoronary stenting are calculated from three-dimensional computer simulation. Then negative shear stresses area on 3D simulation we noted on the inner wall of the post-stenotic area before stenting. The negative WSS is disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2. The present study suggest that hemodynamic forces exerted by pulsatile coronary circulation termed WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. The local recirculation area which has low or negative WSS, might lead to progression of atherosclerosis.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.375-378
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• 2018

In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasound-guided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.14-18
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• 2008

Purpose: Evaluation of results of free flap as a method of reconstruction in soft tissue defect after wide excision of soft tissue tumor of extremity. Materials and Methods: From 2000 through 2007, 11 patients received free flap surgery for soft tissue defect after wide excision operation for soft tissue tumor of limbs. Four cases were upper extremities and seven were lower extremities. Four subjects were diagnosed as squamous cell carcinoma, three as malignant melanoma, two as synovial sarcoma and one as malignant fibrous histiocytoma and alveolar soft part sarcoma. Donor sites of free flap varied with anterolateral thigh flaps in six cases, latissimus dorsi flaps in four, reverse forearm flap in one. By the method of doppler ultrasound, venous circulation was evaluated for the survival of each flap on the third, fifth and seventh day respectively after the operation. Results: 10 of 11 free flaps were successfully survived. Necrosis of free flaps in 1 cases occurred in case of anterolateral thigh flap. Conclusion: Free flap can be a useful method for reconstruction of soft tissue defect after wide excision of soft tissue sarcoma of extremity.

• Archives of Reconstructive Microsurgery
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• v.25 no.2
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• pp.69-71
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• 2016

Reconstruction of the lower extremities is difficult due to a lack of skin laxity and muscular tissues. Here, we present a case of lower extremity reconstruction via the anterior tibial artery perforator based segmental muscle island flap. Our patient was a 75-year-old male with a chronic ulcerative wound on the right lower leg from an old car accident. A $5.0{\times}0.5cm$ size ulcerative wound with tibial bone exposure was noted. We planned to reconstruct the lower extremity defect with a free flap, but the vessel status was severely compromised intraoperatively. Thus, we found the anterior tibial artery perforator using Doppler ultrasound, elevated the tibialis anterior muscle segment flap, and transposed it to cover the defect successfully. The flap presented with a nice contour and the skin graft covering the flap survived completely. There were no complications of the surgical site at three months follow-up and no gait morbidity. This is a meaningful case applying the concept of segmental muscle flap based on a perforator that had advantages including proper bulkiness, vascularization, and preservation of function, which were well applied, leading to great success.

• Archives of Reconstructive Microsurgery
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• v.25 no.2
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• pp.72-74
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• 2016

The keystone flap is a fascia-based island flap with two conjoined V-Y flaps. Here, we report a case of successful treatment of a trochanter pressure sore patient with the traditional keystone flap. A 50-year-old male patient visited our department with a $3{\times}5cm$ pressure sore (grade III) to the left of the greater trochanter that was covered with eschar. Debridement was done and the defect size increased to $5{\times}8cm$ in an elliptical shape. Doppler ultrasound was then used to locate the inferior gluteal artery perforator near the wound. The keystone flap was designed to the medial side. The perforator based keystone island flap covered the defect without resistance. The site remained clean, and no dehiscence, infection, hematoma, or seroma developed. In general, greater trochanter pressure sores are covered with a perforator based propeller flap or fascia lata flap. However, these flaps have the risk of pedicle kinking and require a large operation site. For the first time, we successfully applied the keystone flap to treat a greater trochanter pressure sore patient. Our design was also favorable with the relaxation skin tension lines. We conclude that the keystone flap including a perforator is a reliable option to reconstruct trochanteric pressure sores.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.43-47
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• 2015

Background: The purpose of this study was to identify the effects of the blood flow on carotid and vertebral artery during the forward shift on head. Methods: A 20-year female healthy subject participated in this study. This study was set up the forward shift on head at the 3cm and 6cm in a shoulder midline (acromion). Measurement method were using duplex ultrasound with colour doppler imaging for the blood flow on carotid and vertebral artery. Results: Carotid artery was increased the blood flow and vertebral artery was decreased the blood flow during forward shift on head. Conclusions: These findings suggest that carotid and vertebral artery changes to the blood flow during forward shift on head. Therefore, we should be consider that hemodynamic factor when apply to the therapeutic exercise for patients of forward head posture.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.314-316
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• 1996

To diagnose cardiac malfunctions, various imaging techniques have been applied to heart : DSA(Digital Subtracted Angiography), Doppler Ultrasound, MR Angio. But it is difficult to observe three dimensional heart motion which is the most intuitive tool for diagnosis, only by using these methods. In this research, we have suggested 4-Dimensional reconstruction scheme of heart motion images that can be acquired by ECG-gated cine MR imaging. One cardiac cycle was devided into $9\sim15$ phases and for each phase 3D reconstructed volumn heart was made. We can observe 3D volumns along the cardiac cycle, time. So the results were 4-D reconstructed data.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.77-81
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• 1996

To emulate tri-phasic pulsatile flow of human circulatary system, we have selected control parameters and examined the changing effect of each parameter by using Doppler ultrasound. In this experiment, it was shown that the distal complaince and the break time were the major factors to form tri-phasic flow.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.320-324
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• 1996

Digital fetal monitoring system based on the personal computer combined with the digital signal processing board was implemented. The DSP board acquires and digitally processes ultrasound fetal Doppler signal for digital rectification, FIR filtering, autocorrelation function calculation, its peak detection and MEDIAN filtering. The personal computer interfaced with the DSP board is in charge of graphic display, hardcopy, data transmission and on-line analysis of fetal heart rate change including and variability. I used a recursive technique for autocorrelation function computation method and MEDIAN filter which can greatly reduce the amount of calculation and accuracy. I also implemented analysis algorithm of fetal heart rate change based on normal fetal sample data in order to exact diagnosis.