• Archives of Plastic Surgery
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• v.38 no.6
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• pp.894-898
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• 2011

Purpose: Coverage of full-thickness large flank defect is a challenging procedure for plastic surgeons. Some authors have reported external oblique turnover muscle flap with skin grafting, inferiorly based rectus abdominis musculocutaneous flap, and two independent pedicled perforator flaps for flank reconstruction. But these flaps can cover only certain portions of the flank and may not be helpful for larger or more lateral defects. We report a case of large flank defect after resection of extraskeletal Ewing's sarcoma which is successfully reconstructed with reverse latissimus dorsi myocutaneous flap. Methods: A 24-year-old male patient had $13.0{\times}7.0{\times}14.0$ cm sized Ewing's sarcoma on his right flank area. Department of chest surgery and general surgery operation team resected the mass with 5.0 cm safety margin. Tenth, eleventh and twelfth ribs, latissimus dorsi muscle, internal and external oblique muscles and peritoneum were partially resected. The peritoneal defect was repaired with double layer of Prolene mesh by general surgeons. $24{\times}25$ cm sized soft tissue defect was noted and the authors designed reverse latissimus dorsi myocutaneous flap with $21{\times}10$ cm sized skin island on right back area. To achieve sufficient arc of rotation, the cephalic border of the origin of latissimus dorsi muscle was divided, and during this procedure, ninth intercostal vessels were also divided. The thoracodorsal vessels were ligated for 15 minutes before divided to validate sufficient vascular supply of the flap by intercostal arteries. Results: Mild congestion was found on distal portion of the skin island on the next day of operation but improved in two days with conservative management. Stitches were removed in postoperative 3 weeks. The flap was totally viable. Conclusion: The authors reconstructed large soft tissue defect on right flank area successfully with reverse latissimus dorsi myocutaneous flap even though ninth intercostal vessel that partially nourishes the flap was divided. The reverse latissimus dorsi myocutaneous flap can be used for coverage of large soft tissue defects on flank area as well as lower back area.

• Journal of Pharmacopuncture
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• v.7 no.2
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• pp.57-64
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• 2004

This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

• The Journal of Internal Korean Medicine
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• v.31 no.4
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• pp.901-907
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• 2010

Hiccups are defined as abrupt involuntary contractions of diaphragm and intercostal muscles with sudden closure of the glottis. Hiccups are one of the common transient symptoms but when hiccups last more than 48 hours, or have no response to treatment, they are defined as intractable hiccups. Intractable hiccups can induce multiple problems such as weight loss, dehydration and sleep disturbance. We report a 76-year-old male patient who suffered from intractable hiccups for 6 days after laparoscopic cholecystectomy. Hiccupping was so severe as to continue all day long and limit sleeping and eating. We succeeded in cure intractable hiccups with acupuncture and herbal formula; Gyulyeohwadam-tang.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.73-78
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• 1992

Background: From 1973 we performed EPPT for the 3,500 cases of the cavitary tuberculosis who were not responded well to the antimicrobial drugs, and we evaluated the 1,003 cases who could be followed up to more than 3 years postoperatively. Method: The key of the EPPT was that the 5-8 ribs of unilateral chest were denuded at the one stage operation and the paraffine was used as the plomb of filling the dead space out of the collapsed periosteums and intercostal muscles. Result and Conclusion: Number of patients who had unilateral EPPT was 759 and bilateral 244. The late complication were subscapular abscess (12) lump formation (42) and paraffine expectoration (26). All of those complications was cured after removal of the packed paraffine. Sputum conversion rates were 91.6% in the group with cavity less than 3 cm and 41.8% in the group with cavity bigger than 5cm.

• Korean Journal of Veterinary Research
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• v.44 no.2
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• pp.269-277
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• 2004

Trichinella spiralis is one of the important zoonotic parasites with a wide variety of vertebrates hosts in nature. The purpose of this study were to analyze ESP(Excretory-Secretory Protein) antigen, to evaluate ELISA for the serological diagnosis of Trichinosis, and to survey T. spiralis infection in finishing pigs using the pepsin digestion method and ELISA in Korea. In the analysis of ESP antigen by SDS-PAGE and Western blot, 4 major bands (70, 55, 52.6, and 49 kDa) were revealed from the ESP antigen. Predilection sites of T. spiralis were the diaphragm, the tongue, masseter muscles, intercostal muscle, and hindlimb in orders in the experimentally infected rats. Sera from 581 swine were tested by ELISA with ESP antigen. The 54 (9.3%) sera were suspected as positive reactors, however, these 54 sera were determined as false positives by the use of Western blotting. This study demonstrated that the ELISA was not suitable for the examination of T. spiralis in pork. The diaphragm muscle samples of 251 finishing pigs were tested by the method of pepsin-digestion for the presence of Trichinella larvae, however, T. spiralis was not detected from the samples. We could not find out T. spiralis infection in pig in Korea pork.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.293-299
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• 2007

Objective : Thoracoscopic spinal surgery provides minimally invasive approaches for effective vertebral decompression and reconstruction of the thoracic and thoracolumbar spine, while surgery related morbidity can be significantly lowered. This study analyzes clinical results of thoracoscopic spinal surgery performed at our institute. Methods : Twenty consecutive patients underwent video-assisted thoracosopic surgery (VATS) to treat various thoracic and thoracolumbar pathologies from April 2000 to July 2006. The lesions consisted of spinal trauma (13 cases), thoracic disc herniation (4 cases), tuberculous spondylitis (1 case), post-operative thoracolumbar kyphosis (1 case) and thoracic tumor (1 case). The level of operation included upper thoracic lesions (3 cases), midthoracic lesions (6 cases) and thoracolumbar lesions (11 cases). We classified the procedure into three groups: stand-alone thoracoscopic discectomy (3 cases), thoracoscopic fusion (11 cases) and video assisted mini-thoracotomy (6 cases). Results : Analysis on the Frankel performance scale in spinal trauma patients (13 cases), showed a total of 7 patients who had neurological impairment preoperatively : Grade D (2 cases), Grade C (2 cases), Grade B (1 case), and Grade A (2 cases). Four patients were neurologically improved postoperatively, two patients were improved from C to E, one improved from grade D to E and one improved from grade B to grade D. The preoperative Cobb's and kyphotic angle were measured in spinal trauma patients and were $18.9{\pm}4.4^{\circ}$ and $18.8{\pm}4.6^{\circ}$, respectively. Postoperatively, the angles showed statistically significant improvement, $15.1{\pm}3.7^{\circ}$ and $11.3{\pm}2.4^{\circ}$, respectively(P<0.001). Conclusion : Although VATS requires a steep learning curve, it is an effective and minimally invasive procedure which provides biomechanical stability in terms of anterior column decompression and reconstruction for anterior load bearing, and preservation of intercostal muscles and diaphragm.

• Journal of Acupuncture Research
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• v.22 no.5
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• pp.29-36
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• 2005

Objectives : This study is performed to understand the interrelation between 'Foot soyang muscle of the Gall bladder channel' and 'muscular system' on the basis of the link between meridian muscle theory and myofascial pain syndrome. Methods : We have researched some of oriental medical books about meridian muscle theory and western medical books about anatomical muscular system. Results & Conclusion : 1. Myofascial pain syndrome is the medical treatment which finds the start point of the pain in fascia and then treats it on the basis of object and concrete anatomical theory, so its application is needed for objectification of the oriental medicine. 2. There is a wide difference between myofascial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. Foot soyang muscle contains Dorsal interosseous m, Extensor digitorum longus m, Musculus peroneus brevis, longus and, tertius, lliotibial tract, Vastus lateralis m, Gluteus m, Aximus m, Piriformis m, Tensor fasciae latae m, Gluteus minimus m, Obliquus internus & externus abdominis m, External & Internal intercostal m, Serratus anterior m, Pectoralis major m, Sternocleidomastoid m, Auricularis posterior m, Temporalis m, Masseter m, Orbicularis oculi m etc. on the basis of function and the nature of a disease reflected in muscle. 4. Foot soyang muscle keeps the balance of left md right of the body on the outside, while the Gall bladder keeps the balance of the JangBuKiHyeul(臟腑氣血) on the inside.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.246-249
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• 1997

Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term "intractable" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve block including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.55-64
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• 1995

During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.

• Tuberculosis and Respiratory Diseases
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• v.64 no.1
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• pp.39-43
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• 2008

A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.