• Archives of Plastic Surgery
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• v.33 no.6
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• pp.742-747
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• 2006

Purpose: The purpose of this study was to evaluate the role of mast cell and histamine as typical product of mast cell in ischemia-reperfusion injury of muscle flap using H2 receptor blocker and mast cell stabilizer. Methods: Thirty-five Sprague-Dawley rats weighing 250-300 gm were divided into four groups; Group I: Control group without ischemia, Group II: Normal saline injection group with ischemia, Group III: Cimetidine injection group with ischemia, Group IV: Sodium cromoglycate injection group with ischemia. Well established single pedicled transverse rectus abdominis musculocutaneous(TRAM) flap was designed in all rats and were rendered ischemia by clamping the artery for 150 minutes. All injections were applied intramuscular around gluteal area 30 minutes before reperfusion. The flap survival was evaluated at 7 days after operation. Neutrophil counts and mast cell counts were evaluated 24 hours after reperfusion. Results: The difference of skin flap survival between control group and cimetidine injection group was not significant. In the normal saline injection group flap survival was markedly decreased compared to that of control group. The muscle flap survival was similar to the results of skin flap survival. The neutrophil counts were significantly decreased in control group and sodium cromoglycate injection group than normal saline injection group. The mast cell counts were significantly decreased in cimetidine injection group and control group than both normal saline injection and sodium cromoglycate injection groups. The protective effect of sodium cromoglycate was not seen in the skin flap, but the muscle flaps showed protective effects of sodium cromoglycate compared to normal saline injection group. Conclusions: It is suggests that commonly used antihistamine(H2 receptor blocker) has protective effect against ischemia-reperfusion injury to skin and muscle flaps by reducing neutrophil and mast cell. The mast cell stabilizer was not effective for skin flap but, possibly, for muscle flap.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.384-389
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• 2017

Background The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. Methods Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes) was applied with a latex tourniquet (remote ischemic conditioning). In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning). In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning). In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning). Results The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning). Conclusions The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemiareperfusion injury in muscle flaps.

• Physical Therapy Korea
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• v.28 no.1
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• pp.84-91
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• 2021

Background: A hip fracture may occur spontaneously prior to the hip impact, due to the muscle pulling force exceeding the strength of the femur. Objects: We conducted falling experiments with humans to measure the activity of the hip muscles, and to examine how this was affected by the fall type. Methods: Eighteen individuals fell and landed sideways on a mat, by mimicking video-captured real-life older adults' falls. Falling trials were acquired with three fall directions: forward, backward, or sideways, and with three knee positions at the time of hip impact, where the landing side knee was free of constraint, or contacted the mat or the contralateral knee. During falls, the activities of the iliopsoas (Ilio), gluteus medius (Gmed), gluteus maximus (Gmax) and adductor longus (ADDL) muscles were recorded. Outcome variables included the time to onset, activity at the time of hip impact, and timing of the peak activity with respect to the time of hip impact. Results: For Ilio, Gmed, Gmax, and ADDL, respectively, EMG onset averaged 292, 304, 350, and 248 ms after fall initiation. Timing of the peak activity averaged 106, 96, 84, and 180 ms prior to the hip impact, and activity at the time of hip impact averaged 72.3, 45.2, 64.3, and 63.4% of the peak activity. Furthermore, the outcome variables were associated with fall direction and/or knee position in all but the iliopsoas muscle. Conclusion: Our results provide insights on the hip muscle activation during a fall, which may help to understand the potential injury mechanism of the spontaneous hip fracture.

• Journal of Acupuncture Research
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• v.37 no.4
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• pp.275-280
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• 2020

This study reports the effectiveness of traditional Korean medicine in treating tetraplegia and respiratory symptoms (including dyspnea) after traumatic cervical spinal cord injury surgery. The patient was treated with complex Korean medical treatment including electroacupuncture, pharmacopuncture, and herbal medicine. The manual muscle test (expanded Medical Research Council system) was used to measure the patient's muscle strength. The Korean version of the modified Barthel index and the functional independent measure were used to evaluate the patient's independence in performing daily activities. Following 2 hospitalizations and treatments, the patient's muscle strength improved > 4+ score for all joints, and the Korean version of the modified Barthel index and functional independent measure scores increased from 26 to 79 and 56 to 95, respectively. Symptoms of dyspnea, coughing, and sputum gradually improved and finally disappeared during hospitalization. This study suggests complex Korean medicine treatment may be effective in the rehabilitation of post-surgical cervical spinal cord injury patients.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.192-195
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• 2009

We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.1
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• pp.1-8
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• 2009

Purpose : The purpose of this study was to evaluate the effects of cold therapy and thermal therapy, and immunoreactivity of vascular endothelial growth factor(VEGF), Interleukin-1(IL-1) and Interleukin-6(IL-6) on angiogenesis after muscle contusion injury. Methods : Muscle contusion injury was induced in the gastronemius muscle by dropping a metal bead(22.8g). Cold and thermal theraphy was applied immediately and directly to the skin of injured muscle daily for three days. (experimental group-1 : $5^{\circ}$ cold pack, experimental group-2 : $50^{\circ}$ hot pack, control group non applied, treatment time : 10minutes) Results : The experimental group-1 and 2 showed higher immunoreactivity of VEGF, IL-1, IL-6 than control group during 3 days(P<0.05). And the experimental group-2 showed higher than the experimental group-1 especially VEGF(P<0.05). Conclusion : There data thermal therapy was more effective than cold therapy in the acute muscle contusion injury.

• The Journal of Korean Physical Therapy
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• v.14 no.4
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• pp.87-94
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• 2002

Low intensity laser irradiation is potential physical agent that triggers the muscle regeneration by previous study. In muscle regeneration, a number of growth factors also promotes that is triggered in response to muscle damage. The transforming growth factor(TGF)-$\beta$ is involved in the activation of cell proliferation and the inhibition of cell differentiation in muscle regeneration. This is secreted not only autocrine system but also paracrine and endocrine. Therefore, We investigated that effects of Gallium aluminum arsenide(GaAlAs) diode laser for the expression of TGF-$\beta$ on lumbar spinal cord after extensor digitorum muscle crush injury. After laser irradiation, the immunoreactivity of TGF-$\beta$ was increased bilaterally in gray mater of spinal cord. Especially, in 1 day, experimental group was highed than control, and in 3 day, lateral motor nucleus were storong immunoreactivy of TGF-$\beta$. Also, in 1 and 2 day, TGF-$\beta$ was showed in white mater as well as gray mater, but in 3 day, only showed in gray mater. These data may suggests to the establishment of laser irradiation on spinal cord for skeletal muscle injury.

• Journal of Korean Biological Nursing Science
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• v.10 no.1
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• pp.88-95
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• 2008

Purpose: The purpose of this study was to examine the effect of neuropathic pain by peripheral nerve injury on mass and Type I and II fiber cross-sectional areas on hindlimb muscles of the neuropathic pain model rat. Method: Adult male Sprague-Dawley rats (body weight 200-220 g) were assigned to one of two groups: a neuropathic pain group (n=7) that had a ligation of the left L5 spinal nerve, a control group (n=5), a naive rat without any procedures. Withdrawal threshold, activity, body weight and food intake were measured daily. At 8 days after neuropathic pain, all rats were anesthetized and the soleus and plantaris muscles were dissected from the both hindlimbs. Body weight, food intake, muscle weight and Type I and II fiber cross-sectional area of the dissected muscles were determined. Result: The neuropathic pain group showed a significant decreases (p<.05) as compared with the control rats, in diet intake, body weight, muscle weight and Type II fiber cross-sectional area of the left (affected side) soleus and plantaris muscles, and the right (unaffected side) muscle weight of plantaris and Type II fiber cross-sectional area of the soleus muscle. Conclusion: The hindlimb muscle atrophy occurs in both affected and unaffected side due to neuropathic pain by the peripheral nerve injury. The hindlimb muscle atrophy of the affected side is more pronounced than that of the unaffected side.

• Journal of Biomedical Engineering Research
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• v.27 no.2
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• pp.73-77
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• 2006

Prolonged immobilization leads to significant weakness and atrophy of the skeletal muscle and can also impair the recovery of muscle strength following injury. Therefore, it is important to minimize the period under immobilization and accelerate the return to normal activity. This study examined the effects of combined heat treatment and rest-inserted exercise on the muscle activity of the lower limb during knee flexion/extension. Twelve healthy subjects were assigned to 4 groups that included: (1) heat treatment + rest-inserted exercise; (2) heat treatment + continuous exercise; (3) no heat treatment + rest-inserted exercise; and (4) no heat treatment + continuous exercise. Heat treatment was applied for 15 mins prior to exercise. Continuous exercise groups performed knee flexion/extension at 0.5 Hz for 300 cycles without rest whereas rest-inserted exercise groups performed the same exercise but with 2 mins rest inserted every 60 cycles of continuous exercise. Changes in the rectus femoris and hamstring muscle activities were assessed at 0 and 2 weeks of treatment by measuring the electromyography signals of isokinetic maximum voluntary contraction. Significant increases in both the rectus femoris and hamstring muscles were observed after only 2 weeks of treatment when both heat treatment and rest-inserted exercise were performed. These results suggest that combination of various treatment techniques, such as heat treatment and rest-inserted exercise, may accelerate the recovery of muscle strength following injury or immobilization.

• Clinics in Shoulder and Elbow
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• v.21 no.2
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• pp.101-104
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• 2018

Since shoulder have a higher proportion of muscle which would have low electrical resistance, there could be more electrical damage to the rotator cuff muscles. We present a patient with acute rotator cuff tear by sudden uncontrolled jerking contractions caused by an electrical shock. A case of 42-year-old man with acute rotator cuff tear due to electrical injury to the shoulder was presented. Magnetic resonance imaging showed a full thickness tear and an undulating appearance of the peripheral end of the torn supraspinatus and infraspinatus muscle, suggesting an acute complete rupture. By arthroscopic surgery, the torn rotator cuff tendons were repaired with a suture bridge technique. At the final follow-up, the patient had a full, pain-free range of motion and had fully recovered shoulder muscle power.