• Title/Summary/Keyword: pubis

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The Superficial Inferior Epigastric Artery Flap and its Relevant Vascular Anatomy in Korean Women

  • Kim, Byung Jun;Choi, Jun Ho;Kim, Tae Hoon;Jin, Ung Sik;Minn, Kyung Won;Chang, Hak
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.702-708
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    • 2014
  • Background Lower abdominal soft tissue transfer is the standard procedure for breast reconstruction. However, abdominal wall weakness and herniation commonly occur postoperatively at the donor site. To reduce the morbidities of the donor site, the superficial inferior epigastric artery (SIEA) flap was introduced, but inconsistent anatomy of the SIEA has reduced its utility. In the present study, the anatomy of the superficial inferior epigastric vessels in Korean women was determined with regards to breast reconstructive surgery. Methods The vascular anatomies of the SIEA and superficial inferior epigastric vein (SIEV) were evaluated on 32 breast cancer patients receiving free transverse rectus abdominis musculocutaneous flap reconstruction after mastectomy. The existence, pulsation, location, external diameter, and depth of the SIEA and SIEV were measured at the lower abdominal incision level. Results SIEA and SIEV were present in 48/64 (75.00%) and 63/64 (98.44%) hemi-abdomens, respectively. Pulsation of the SIEA was found in 44/48 (91.67%) cases. The mean locations of SIEA and SIEV were +5.79 (${\pm}12.87$) mm, and -8.14 (${\pm}15.24$) mm from the midpoint between the anterior superior iliac spine and symphysis pubis, respectively. The mean external diameters of SIEA and SIEV were 1.20 (${\pm}0.39$) mm and 1.37 (${\pm}0.33$) mm, and they were found at a mean depth of 9.75 (${\pm}2.67$) mm and 8.33 (${\pm}2.65$) mm, respectively. Conclusions The SIEA was absent in 25% of Korean women and had a relatively small caliber. Therefore, careful preoperative assessment of the lower abdominal vasculature is required to achieve successful breast reconstruction using SIEA flaps.

Location of the umbilicus in Korean women and its changes after breast reconstruction with an ipsilateral pedicled rectus abdominis musculocutaneous flap

  • Oh, Sangho;Jeon, Hyojin;Son, Daegu
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.425-431
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    • 2018
  • Background The umbilicus makes an important contribution to the natural appearance of the abdomen. To date, studies on its position in Korean women are lacking, and no standards have been established. The purpose of this study was to investigate the position of umbilicus in Korean women and to review changes in its position after ipsilateral pedicled rectus abdominis musculocutaneous (IP-RAM) flap. Methods This research consisted of two studies. In first study, 100 females who visited the emergency department with gastroenteritis between 2007 and 2011 were included. In second study, 40 women who underwent IP-RAM flap in the same period were included. Using abdominal computed tomography, we measured the distance between xiphoid process and umbilicus, represented by value a, and the distance between umbilicus and symphysis pubis, represented by value b. Thus, the location of the umbilicus was represented by the ratio a/b. The data were analyzed using Pearson correlation test and paired t-test. Results In study 1, the mean value of a/b was 1.07. Pearson correlation test revealed a significant correlation between age and a/b. In study 2, the mean value of a/b was 1.16 in preoperative measurements and 1.01 in postoperative measurements. The paired t-test showed a significant difference between preoperative and postoperative measurements, indicating cephalic migration of the umbilicus after surgery. Conclusions The natural position of the umbilicus showed caudal migration with aging. Additionally, in a comparison of preoperative and postoperative measurements in patients who underwent IP-RAM flap, cephalic migration of the umbilicus was observed after surgery.

Anatomical Review of Rectus Abdominis Muscle Free Flap for the Oral and Maxillofacial Reconstruction (구강악안면재건을 위한 복직근 유리피판의 해부학적 고찰)

  • Park, Jung Min;Seo, Mi Hyun;Kim, Soung Min;Kang, Ji Young;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.367-375
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    • 2012
  • Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.

A Study on Standardization of Pattern Design of Korean Men's Traditional Trousers (한복바지 원형설계의 표준화를 위한 연구)

  • 정옥임
    • Journal of the Korean Home Economics Association
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    • v.39 no.10
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    • pp.97-109
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    • 2001
  • It is thought that a composition of trousers is related to fabrics with single breadth. Therefore, trousers are designed with pattern using this fabrics with single breadth. However, in the old pattern of trousers, the breadth of 33cm-35cm was not considered in designing patterns. In this context, deciding which pattern design is better is not easy as there are a variety of estimation methods. So in this study, standardization of drafting is pursued by an objective pattern design. For this, a base angle of the trouser closely relating to a form and function was measured and using the height and the base angle, a trouser pattern design was tried. For a measurement of the base angle, 5 subject were selected. They are 25-29 year-old male graduates with fine physical standard. The base angle was measured with symphysis pubis point as a standard when subjects sat with their legs crossed, when they stood with their legs open (not forced artificially) and when they laid down with their legs open. The distance between a knee inside joint and knees was measured three times and the resultant value was used for the pattern design. For a design of trousers, the height was applied and the base angle was fixed. As a pattern drawing, using the height, a base angle and circumference of the hip, a trouser was designed. The production method for the pattern design is as follow: (1) The length formula, is height + $\frac{height}{2}$ (2) The hip girth formula is $\frac{hipgirth}{2}$ - $\frac{hipgirth}{20}$(3) A crotch angle is fixed at $72^{\circ}$. (4) The ratio of outer leg length to leg width is 5 : 8. (5) The component ratio of the upper outer leg length to the pant length is 5 : 8. (6) The ratio of the division point of front right inner leg length and left inner width to upper outer leg length is 5 : 8.

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The Effect of Core Program Exercise on Dynamic Balance of the Patient with Post-Stroke Hemiplegia (코어프로그램이 편마비환자의 동적 균형 감각에 미치는 영향)

  • Kim, Kwang-Soo;Seo, Hyun-Du;Lee, Byoung-Hee;Kim, Seong-Yeol;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.79-87
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    • 2010
  • Objectives : The purpose of this study is to analyze and to compare the difference and the change between dynamic balance exercise group and dynamic balance exercise with core program exercise group. Also, based on this data, to prescribe effective exercises for hemiplegic patients and the pubis in order to achieve more effective dynamic balance exercise rehabilitation and better dynamic balance exercise in the field of therapeutical exercise. Methods : Twenty subjects(Core program exercise plus Dynamic balance exercise group, CP: 10, Dynamic balance exercise group, NCP: 10) were chosen among hemiplegic patients. Measurements of dynamic balance were evaluated at initial presentation(pretest) and after 4, 8, 12 weeks'. Paired t-test and Repeated measured ANOVA was utilized to detect the mean difference between the groups. Results : Firstly, after 4 weeks' and 8 weeks' and 12 weeks' CP exercise and NCP exercise, there were all significant difference to increase dynamic balance (p<0.05). secondly, after 4 weeks' and 8 weeks' and 12 weeks' CP and NCP exercise, there was significant difference to increase dynamic balance more CP group than NCP group. Lastly, among 4 weeks' and 8 weeks' and 12 weeks' CP exercise, there was progressively significant difference to increase dynamic balance(p<0.05). Conclusions : This study showed that dynamic balance exercise with core program exercise is an effective treatment strategy for hemiplegic patients than dynamic balance exercise rehabilitation.

Triple Pelvic Osteotomy and Autograft to the Gap of Ischium for the Treatment of Pelvic Canal Narrowing in a Cat

  • Park, Ji-Hun;Kim, Keun-Yung;Lee, Chae-Yeong;Lee, Si-Eun;Park, Hyojin;Hwang, Tae-Sung;Lee, Hee-Chun;Lee, Dongbin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.38 no.5
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    • pp.235-239
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    • 2021
  • Pelvic canal narrowing secondary to pelvic fractures can lead to episodes of recurrent constipation in cats. Triple pelvic osteotomy is considered as a surgical treatment method; however, there is potential for future recurrence of pelvic canal narrowing. This report describes a surgical method using a pelvic symphyseal autograft to keep the distraction of the ischial osteotomy gap to prevent the recurrence of pelvic canal narrowing. A triple pelvic osteotomy was planned to expand the narrow pelvic canal. The cranial ramus of the pubis was cut, and ischiatic and iliac osteotomies were performed. After expanding the ilium, the malunion pelvic symphysis was cut approximately 1 cm and then autografted to the gap of the ischiatic osteotomy line to keep the distraction. The patient showed clinical improvement postoperatively without recurrent pelvic canal narrowing related to triple pelvic osteotomy. However, constipation recurred on post-operative month-5. It was managed conservatively, and subtotal colectomy was performed eventually nine months post-operatively. There were no complications for five months of follow-up.

Percutaneous Screw Fixation in a Displaced Pubic Fracture: Technical Note (전위성 치골 골절의 경피적 고정술: 술기보고)

  • Kong, Gyu Min;Kim, Seung Chul
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.361-365
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    • 2021
  • Pelvic fractures are high-energy injuries, often accompanied by damage to the adjacent tissues and organs. For patients with pelvic trauma, active treatment is required early in the injury, because mortality can increase if appropriate treatment is not provided. In most cases, however, minimally invasive surgery is considered because extensive surgery cannot be performed due to the patient's condition. Percutaneous fixation of the pubis has been introduced because it can be applied easily to achieve the stability of the anterior part of the pelvis. Although many studies introduced percutaneous fixation of pubic bone fractures, most describe screw fixation for nondisplaced fractures. When treating displaced fractures with percutaneous screw fixation, it is difficult for the guide pin or drill bit to avoid the joint surface. Using a bent guide pin could allow easy insertion of the cannulated screw while avoiding the articular surface.

Percutaneous two unilateral iliosacral S1 screw fixation for pelvic ring injuries: a retrospective review of 38 patients

  • Son, Whee Sung;Cho, Jae-Woo;Kim, Nam-Ryeol;Cho, Jun-Min;Choi, Nak-Jun;Oh, Jong-Keon;Kim, HanJu
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.34-42
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    • 2022
  • Purpose: Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18-102 minutes), 0.6 g/dL (range, 0.3-1.0 g/dL), 100%, and 153.2 days (range, 61-327 days), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and three patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.

Clinical Study on the Effect of Chuna Manupulation in Treating Postpartum Patients with Low Back Pain and Pelvic Girdle Pain (산후 요통 환자의 추나 수기 치료 효과에 대한 임상적 고찰)

  • Lee, Sung-Cheul;Bae, Sang-Eun;Kim, Hee-Jeong;Kim, In-Joong;Shin, Joon-Sik;Kim, Chul-Soo;Ahn, Young-Tae
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.3
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    • pp.117-131
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    • 2012
  • Objectives: This study was designed to observe the effect of chuna manupulation in alleviating the symptoms of postpartum patients with low back pain and pelvic girdle pain. Methods: Targeted by outpatient 30 postpartum patients, A group was patients who were treated with acupuncture, traditional Korean medicine, physical therapy, B group was patients who were treated with acupuncture, traditional Korean medicine, physical therapy, and chuna manupulation. After 2-months, the progress of symptoms was evaluated by visual analogue scale(VAS) and Oswestry Disability Index(ODI) and Pain drawing. Results: 1. Group A and B were analyzed for general characteristics, with an average age of both groups, average weeks at admission after delivery, parity and method of delivery, weight gain and BMI during pregnancy were no significant differences in. 2. VNRS improvement in the rate of group A was $2.84{\pm}4.73$, VNRS improvement in the rate of group B was $4.85{\pm}1.49$. Between the two groups was statistically significant. 3. ODI improvement rate in group A was $10.14{\pm}4,39$, ODI improvement rate in Group B was $15.16{\pm}3.41$. Between the two groups was statistically significant. 4. Patients who received acupuncture, traditional Korean medicine, physical therapy, and chuna manupulation. in group B compared pubis, thighs, buttocks showing more effective in pain relief than group A, who received only acupuncture, traditional Korean medicine, physical therapy. Conclusions: In case of postpartum patients with low back pain and pelvic girdle pain, it is more effective to treat with Integrated traditional Korean therapy and chuna manupulation than to treat with only integrated traditional Korean therapy.

Anatomical Studies on the Skeleton of Pelvic Limb of Korean Native Goat (한국재래산양의 후지골격에 관한 해부학적 연구)

  • Kim, Jin-sang;Lee, Heung-shik S.;Lee, In-se;Yoon, Yeo-sung
    • Korean Journal of Veterinary Research
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    • v.28 no.1
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    • pp.1-16
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    • 1988
  • The anatomical structure of pelvic limb, of thirty-one adult Korean native goats (Body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows: 1. The pelvic limb of the Korean native goat was composed of the hip bone, femur, patella, tibia, fibula, tarsal bones, metatarsal bone, phalanges and sesamoid bones. 2. The hip bone consisted of the ilium, ischium and pubis which fused each other, The gluteal surface of the ilium was directed dorsolaterally. The tuber sacrale and tuber coxae were formed at the dorsal apex and ventrolateral part of the iliac wing, respectively. The lesser ischiatic notch was deeper than the greater one. The ischiatic tubercles were triangular form and consisted of the dorsal, lateral and caudal ischiatic tubercles. The left and right hip bone indexes were 67.08, 66.20, the acetabular indexes were 93.78 and 92.10 and the obturator foramen. indexes were 53.84 and 54.77, respectively. 3. In femur, both of the greater and lesser trochanter were well developed but the third trochanter was not observed. The left and right femur indexes were 26.55 and 26.14, head indexes were 81.66 and 81.49 and the trochlear-epicondyle indexes were 42.47 and 41.63, respectively. 4. The patella was observed as an isosceles triangle with base lying proximal and the cranial surface was more convex. 5. The tibial shaft was sigmoid form and the popliteal notch was deep. There was a large nutrient foramen at the cranial aspect of the cranial intercondylar area. The tibial indexes were 22.09 in left and 21.10 in right. 6. The proximal extremity of the fibula was fused with the lateral condyle of the tibia but the distal one was observed independently as the malleolar bone. 7. The tarsal bones were five in number; the talus, calcaneus, centroquartal tarsal bone, first tarsal bone, and second-third tarsal bone. 8. The metatarsal bone was composed of a large metatarsal bone. resulted from the fusion of the third and fourth metatarsal bones, The structure of metatarsal bone was similar to the metacarpal bone but longer about 7mm. 9. The phalanges and sesamoid bones were similar to these of the thoratic limb. 10. The ratios of the lengths among the hip bone, femur, tibia and metafarsal bone were 1.71 : 1.54 : 1.73 : 1.00 in left and 1.68 : 1.53 : 1.72 : 1.00 in right, respectively.

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