• 제목/요약/키워드: latissimus dorsi muscle

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Microvascular reconstruction for maxillofacial defects: a retrospective analysis of outcomes and complications in 121 consecutive cases

  • Kim, SeongRyoung;Lee, Dong-Hun;Ahn, Kang-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.29.1-29.7
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    • 2020
  • Background: Microvascular reconstruction is the treatment of choice after oral cancer ablation surgery. There are few published studies of free flap survival among Korean populations. This study aimed to determine the survival rate after 121 consecutive cases of maxillofacial microvascular reconstruction and to analyze the complications associated with microsurgery. Methods: This study included consecutive patients who underwent microsurgical reconstruction with free flaps, from January 2006 through September 2019, performed by a single surgeon at the oral and maxillofacial surgery department of a tertiary medical center. A total of 121 cases were reviewed retrospectively. The flap survival rate, flap type, radiotherapy history, complications, and treatment results were analyzed. Results: Four different flap types were used for microvascular reconstruction: radial forearm (n = 65), fibula (n = 34), latissimus dorsi (n = 21), and serratus anterior muscle with rib bone free flap (n = 1). Total necrosis of the flap was found in four cases (two latissimus dorsi flaps and two fibular flaps). The free flap survival rate was 97.5%. Nineteen patients received radiotherapy before surgery, and none of them experienced flap failure. The mean operation time was 334 ± 83.1 min, and the mean ischemic time was 48.9 ± 12.7 min. Conclusions: The success rate was reliable and comparable with previous studies. The success rate was not affected by radiation therapy. Free flaps can be safely used even after radiation treatment.

크레아틴 구강투여가 조정선수들의 근활성도와 혈중젖산농도에 미치는 영향 (The Effects of Creatine Oral Delivery on the Muscular Activity and Blood Lactate Density of Rowing Athletes)

  • 허보섭;지진구
    • 수산해양교육연구
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    • 제27권2호
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    • pp.537-545
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    • 2015
  • The purpose of this study is to investigate how effects creatine dosage has on the improvement of rowing athletes' performance ability. Rowing athletes were administered with creatine, through which to examine the change of athletic performance ability, blood fatigue substances, and muscular activity. The subjects (participants) of this Study consisted of 12 male rowing athletes at P University, with at least 5 years of rowing experiences, which divided into two groups - creatine dosing group of 6 persons and control group of 6 persons - for random sampling measurement. Enzymatic-colorimetric method using lacrate oxidase and 4-aminoantipyrine was performed for blood lactate level analysis, and wireless EMG system (QEMG-4: Lxtha Korea) for muscular activity analysis, with 4 channels set for data analysis. As body parts to be measured, two muscular parts - latissimus dorsi and lumbar spinel - were chosen. Then, on the 5th day from the date of administering them with creatine (that is, 4 days after dosing them with creatine), rowing movement with the highest level of activity was calculated as peak value, which was measured twice. The test data used for this Study were SPSS/PC 18.0, pre-movement and post-movement two-way ANOVA for repeated measurement for comparative analysis of each muscle, with significant level at .05. As a result, the change of blood lactate level was significantly higher in creatine dosing group than in non-dosing group (p<.05). As for the change of muscular activity, both latissimus dorsi and lumbar spinel showed a significantly higher change of muscle in creatine dosing group than in non-dosing group (p<.05 and p<.05, respectively).

Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right

  • Feng, Jiajun;Pardoe, Cleone I;Mota, Ashley Manuel;Chui, Christopher Hoe Kong;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • 제43권2호
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    • pp.197-203
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    • 2016
  • Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

Comparison of Muscle Activities of the Posterior Oblique Sling Muscles among Three Prone Hip Extension Exercises with and without Contraction of the Latissimus dorsi

  • Kang, Dae-kwan;Hwang, Young-In
    • 대한물리의학회지
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    • 제14권3호
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    • pp.39-45
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    • 2019
  • PURPOSE: We investigated the most effective way to activate the posterior oblique sling muscles by performing prone hip extension exercises. METHODS: An electromyography system was used to measure the activation of the posterior oblique sling muscles (latissimus dorsi, gluteus maximus, multifidus, and biceps femoris) in three different prone hip extension exercises of in 12 healthy individuals (6 men and 6 women): 1) prone hip extension, 2) prone hip extension with internal rotation and extension of the arm, and 3) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell. RESULTS: The overall muscular activation of the posterior oblique sling muscles was more increased when performing 1) prone hip extension with internal rotation and 2) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell as compared with that during prone hip extension except for the biceps femoris activation. There was a statistically significant difference in the activities of the contralateral multifidi among all three exercises; of the ipsilateral multifidi in PHE1) prone hip extension alone, PHE2) prone hip extension with internal rotation and extension of the arm and PHE3) prone hip extension with internal rotation and extension of the arm with 1-Ib dumbbell; and of the ipsilateral gluteus maximus among all the prone hip extension exercises. There was no significant difference in the activity of the biceps femoris among the three exercises. CONCLUSION: Prone hip extension with internal rotation and with internal rotation and extension of the arm with 1-Ib dumbbell can activate the posterior oblique sling muscles and so prevent back pain in healthy people.

Evaluation of Meat Color and Physiochemical Characteristics in Forequarter Muscles of Holstein Steers

  • Moon, Sung Sil;Seong, Pil-Nam;Jeong, Jin Young
    • 한국축산식품학회지
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    • 제35권5호
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    • pp.646-652
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    • 2015
  • The beef forequarter muscle comprises approximately 52% of carcass weight. The objective of this study was to evaluate the physiochemical characteristics and meat color from forequarter muscle of Holstein steers. Fifteen forequarter muscles were trimmed of external connective tissue and fat. An experimental group of eight Holstein steers was assessed using meat color, water-holding capacity, drip loss, and Warner-Bratzler shear force value at the same quality grade. The M. omotransversarius (0.45 kg) had the highest (p<0.05) lightness (L*) value, whereas the M. teres major (0.4 kg) and M. triceps brachii (caput laterale) (0.52 kg) had the lowest (p<0.05) values. The M. semispanitus capitus (1.48 kg), which is a neck muscle, had the highest values for both redness (a*) and yellowness (b*), whereas the lowest (p<0.05) values were for the M. teres major. The M. omotransversarius, M. latissimus dorsi (1.68 kg), and M. rhomboideus (1.2 kg) were ranked high (p<0.05) in water-holding capacity. The drip loss value was the highest for the M. longissimus dorsi thoracis (p<0.05; 1.86 kg), while the M. infraspinatus (2.28 kg), M. supraspinatus (1.38 kg), M. brachiocephalicus (1.01 kg), and M. pectoralis superficialis (1.18 kg) had the lowest (p<0.05). The Warner-Bratzler shear force value indicated that the M. pectoralis profundus (3.39 kg), M. omotransversarius, and M. brachiocephalicus were the toughest (p<0.05), whereas the M. subscapularis (0.86 kg), M. longissimus dorsi thoracis, M. teres major, and M. infraspinatus were the most tender cuts (p<0.05). Here, muscle type explained most of the variability in the forequarter physiochemical characteristics. Thus, our findings suggest that these muscle profile data will allow for more informed decisions when selecting individual muscles to produce value-added products from Holstein steers.

Volumetric change of the latissimus dorsi muscle after postoperative chemotherapy and radiotherapy in immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap: final results from serial studies

  • Song, Kyeong Ho;Oh, Won Seok;Lee, Jae Woo;Kim, Min Wook;Jeong, Dae Kyun;Bae, Seong Hwan;Kim, Hyun Yul;Jung, Youn Joo;Choo, Ki Seok;Nam, Kyung Jin;Joo, Ji Hyeon;Yun, Mi Sook;Nam, Su Bong
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.607-613
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    • 2021
  • Background Breast reconstruction using an extended latissimus dorsi (eLD) flap can supplement more volume than reconstruction using various local flaps after partial mastectomy, and it is a valuable surgical method since the reconstruction area is not limited. However, when performing reconstruction, the surgeon should consider latissimus dorsi (LD) volume reduction due to postoperative chemotherapy (POCTx) and postoperative radiotherapy (PORTx). To evaluate the effect of POCTx and PORTx on LD volume reduction, the effects of each therapy-both separately and jointly-need to be demonstrated. The present study quantified LD volume reduction in patients who underwent POCTx and PORTx after receiving breast-conserving surgery (BCS) with an eLD flap. Methods This study included 48 patients who received immediate breast reconstruction using an eLD flap from January 2013 to March 2017, had chest computed tomography (CT) 7-10 days after surgery and 10-14 months after radiotherapy completion, and were observed for more than 3 years postoperatively. One surgeon performed the breast reconstruction procedures, and measurements of breast volume were obtained from axial CT views, using a picture archiving and communication system. A P-value <0.05 was the threshold for statistical significance. Results The average volume reduction of LD at 10-14 months after completing POCTx and PORTx was 64.5% (range, 42.8%-81.4%) in comparison to the volume measured 7-10 days after surgery. This change was statistically significant (P<0.05). Conclusions Based on the findings of this study, when harvesting an eLD flap, surgeons should anticipate an average LD volume reduction of 64.5% if chemotherapy and radiotherapy are scheduled after BCS with an eLD flap.

흉벽에 발생한 유건종 절제후 흉벽 재건술 -1례 보고- (Chest Wall Rreconstruction after Desmoid Tumor Resection -1 Case Report-)

  • 김병균
    • Journal of Chest Surgery
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    • 제28권11호
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    • pp.1075-1078
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    • 1995
  • The desmoid tumor has been reported as the most common histologic subtype of soft tissue sarcoma occuring in chest wall and it known to be highly recurrent. The treatment of choice is a radical wide resection including a safe margin of uninvolved structures around the grossly visible tumor. We report a case of chest wall reconstruction using Marlex sandwich and latissimus dorsi musculocutaneous flap after wide resection of desmoid tumor on the chest wall.

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Characterization of Nutritional Value for Twenty-one Pork Muscles

  • Kim, J.H.;Seong, P.N.;Cho, S.H.;Park, B.Y.;Hah, K.H.;Yu, L. H.;Lim, D.G.;Hwang, I.H.;Kim, D.H.;Lee, J.M.;Ahn, C.N.
    • Asian-Australasian Journal of Animal Sciences
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    • 제21권1호
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    • pp.138-143
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    • 2008
  • A study was conducted to evaluate nutritional value for twenty-one pork muscles. Ten market-weight crossbred pigs (five gilts and five barrows) were used for evaluating proximate chemical composition, cholesterol, total iron, calorie and fatty acid contents. As preliminary analysis revealed no noticeable sex effect, pooled data from both sexes were used for the final analysis. M. rectus femoris had the highest moisture content, while m. latissimus dorsi was lowest in moisture content (p<0.05). Protein content was highest for m. longissimus dorsi and lowest for m. supraspinatus (p<0.05). The tensor fasciae and latissimus dorsi muscles contained the highest intramuscular fat (p<0.05), while rectus femoris, adductor and vastus lateralis were lowest in intramuscular fat content. When simple correlations between chemical values were computed for the pooled dataset from all muscles, intramuscular fat had significant (p<0.05) negative linear relationships with moisture (r = -0.85) and protein (r = -0.51) contents. Calorie levels were not significantly affected by fat content, while rectus femoris and latissimus dorsi muscles showed lowest and highest calorie contents, respectively (p<0.05). Polyunsaturated fatty acid content was highest (p<0.05) for both m. adductor and m. rectus femoris, while it was lowest for m. longissimus dorsi. Collectively, the current study identified a large amount of variation in nutritional characteristics between pork muscles, and the data can be used for the development of muscle-specific strategies to improve eating quality of meats and meat products.

Volumetric change of the latissimus dorsi muscle after postoperative radiotherapy in immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap

  • Park, Tae Seo;Seo, Jung Yeol;Razzokov, Anvar S.;Choi, June Seok;Kim, Min Wook;Lee, Jae Woo;Kim, Hyun Yeol;Jung, Youn Joo;Choo, Ki Seok;Song, Kyeong Ho;Nam, Su Bong
    • Archives of Plastic Surgery
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    • 제47권2호
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    • pp.135-139
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    • 2020
  • Background This study aimed to determine the magnitude of volume reduction of the latissimus dorsi (LD) muscle after treatment using only postoperative radiotherapy (PORTx) in patients who underwent immediate breast reconstruction using an extended LD musculocutaneous (eLDMC) flap after partial mastectomy. Methods We retrospectively reviewed 28 patients who underwent partial mastectomy and an eLDMC flap, received only PORTx, and underwent chest computed tomography (CT) 7 to 10 days after surgery and 18±4 months after the end of radiotherapy, from March 2011 to June 2016. The motor nerve to the LD was resected in all patients. One plastic surgeon performed the procedures, and the follow-up period was at least 36 months (mean, 46.6 months). The author obtained LD measurements from axial CT views, and the measurements were verified by an experienced radiologist. The threshold for statistical significance was set at P<0.05. Results A statistically significant decrease in the LD volume was found after the end of PORTx (range, 61.19%-80.82%; mean, 69.04%) in comparison to the measurements obtained 7 to 10 days postoperatively (P<0.05). All cases were observed clinically for over 3 years. Conclusions The size of an eLDMC flap should be determined considering an average LD reduction of 69% after PORTx. Particular care should be taken in determining the size of an eLDMC flap if the LD is thick or if it occupies a large portion of the flap.

소뇌 종양 적출 후 두개강 내 발생한 난치성 뇌척수액 고임의 치험례 (Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report)

  • 라은영;오득영;김혜영;이중호;문석호;서제원;이종원;안상태
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.95-98
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    • 2010
  • Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.