• Asian Spine Journal
• /
• 제12권6호
• /
• pp.1043-1052
• /
• 2018

Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

• 한국전문물리치료학회지
• /
• 제7권2호
• /
• pp.1-19
• /
• 2000

Decreased equilibrium in standing and walking is a common problem associated with hemiparesis secondary to cerebral vascular accident. In patients with hemiplegia, postural sway is increased and often displaced laterally over the non-affected leg, reflecting asymmetry in lower extremity weight bearing during standing balance. Human balance is a complex motor control task, requiring integration of sensory information, neural processing, and biomechanical factors. Limits of stability (LOS) is a one of the biomechanical factors. The purposes of this study were to establish the influence of asymmetrical weight-bearing on the LOS of independent ambulatory hemiparetic patients. The subjects of this study were 29 hemiparetic patients (18 males, 11 females) being treated as admitted or out patients at Young-Nam University Hospital and Taegu Catholic University Hospital, all of whom agreed to participate in the study. Participants were asked to lean and displace their center of gravity (COG) as far as possible in directions to the sides and front of the body. The LOS and weight-bearing ratio were measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. In order to assure the statistical significance of the results, the independent t-test and a Pearson's correlation were applied at the .05 and .01 level of significance. The results of this study were as follows: 1) There were statistically significant differences in anteroposterior LOS according to the cause of brain demage (p<.01). 2) There were statistically significant differences in mediolateral LOS according to the hemiparetic side (p<.05). 3) There were statistically significant differences in anteroposterior and mediolateral LOS according to the brain operation (p<.01). 4) The mediolateral LOS significantly correlated with weight-bearing ratio (p<.01).

• 한국식품영양학회지
• /
• 제19권1호
• /
• pp.47-52
• /
• 2006

본 연구는 키토산을 첨가한 한방액에 침지하여 보존성과 기능성을 갖는 튀김닭을 만들 목적으로 닭고기 다리를 보통 침지액(A액), 한방 침지액(B액) 그리고 한방과 키토산 침지액(C액)에 4시간 침지한 다음, $4^{\circ}C$에서 8일까지 저장하면서 닭고기 다리의 pH의 변화,휘발성염기질소량의 변화, 총 세균수의 변화 및 관능검사 등을 실시하였다. 그 결과는 다음과 같다. 침지액 A, B, C의 닭고기 다리의 pH변화는 초기와 8일후까지 3구 모두 큰 변화는 없었다. 휘발성 염기질 소량은 침지액 A와 침지액 B에 비해 침지액 C가 약간 낮은 것으로 나타났으며, 총 세균수의 변화에 있어서도 A와B액에 비해서 C액에서 낮은 cfu (log/g)를 나타내어 미미하지만 보존성이 있는 것으로 나타났다. 그리고 관능 검사에서도 침지액 C가 색과 냄새면에서 가장 좋았다.

• 대한한방내과학회지
• /
• 제39권4호
• /
• pp.772-783
• /
• 2018

The aims of this study were to use the Rydoraku test, electrogastrography, and enterotachography to examine the presence of familial gastric dysmotility among monozygotic twins and their mothers; to determine the relationship between the symptoms and the indexes of the Rydoraku test, electrogastrography, and enterotachography; and to observe the therapeutic reaction for each differential treatment between twins with familial gastric dysmotility. The same herbal medication (Banhasasim-tang extract three times/day and Sojuckkunbi-tang extract three times/day) was given to each twin, but the younger twin also underwent manual acupuncture on the CV 10, 12, and 13 points of the abdominal wall and electrical stimulation of both ST 36 points of the lower leg 2-3 times per week. Evaluation of the therapeutic effect was followed after six weeks. The presence of familial gastric dysmotility was shown in the autonomic nerve system and gastric muscle and was thought to be a common pathophysiology induced by genetic co-ownership. Only the younger twin showed any marked relief of the dyspeptic symptoms associated with improvement of pyloric sphincter function, which was induced by acupuncture treatment. The Rydoraku test, electrogastrography, and enterotachography results showed the presence of familial gastric dysmotility. Although Korean traditional medicine had no effect on the familiar gastric dysmotility associated with genetic influences, the acupuncture treatment had a beneficial effect on the secondary disorder of pyloric sphincter function, which is associated with the relief of dyspeptic symptoms.

• Archives of Plastic Surgery
• /
• 제41권6호
• /
• pp.709-715
• /
• 2014

Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

• 한국전자파학회논문지
• /
• 제20권12호
• /
• pp.1243-1251
• /
• 2009

본 논문에서는 능동 위상 배열 레이더에 사용되는 X-밴드 송수신 모듈의 설계와 측정 결과에 대해 기술한다. 일반적으로 능동 위상 배열 레이더는 고출력, 낮은 잡음 지수, 높은 TOI(Third Order Intercept), 송수신에서의 충분한 이득을 갖는 반도체 송수신 모듈을 요구한다. 송수신 모듈은 광대역에서 9 W의 출력 특성을 나타낸다. 잡음 지수는 2.8 dB로 낮다. 위상과 이득은 각각 6비트 위상 변위기와 5비트 감쇄기로 조정된다. LTCC(Low Temperature Co-fired Ceramic)을 사용하여 높은 집적도를 갖는 송수신 모듈을 구현하였다. 모듈은 디지털 인터페이스를 통합하고 3개의 전원을 사용한다.

• Journal of Korean Neurosurgical Society
• /
• 제59권6호
• /
• pp.615-621
• /
• 2016

Objectives : To review surgical results of post-fusion lumbar flatback treated with pedicle subtraction osteotomy (PSO) or Smith-Petersen osteotomies (SPOs). Methods : Twenty-eight patients underwent osteotomies. Radiological outcomes by sagittal vertical axis (SVA), and pelvic tilt (PT), T1 pelvic angle (T1PA), and pelvic incidence (PI)-lumbar lordosis (LL) at preoperative, postoperative 1 month, and final were evaluated. Oswestry Disability Index (ODI), visual analog scale (VAS) score of back pain/leg pain, and Scoliosis Research Society-22 score (SRS-22r) were analyzed and compared. Patients were divided into 2 groups (SVA ${\leq}5cm$ : normal, SVA >5 cm : positive) at final and compared outcomes. Results : Nineteen patients (68%) had PSO and the other 9 patients had SPOs with anterior lumbar interbody fusions (ALIFs) (Mean age : 65 years, follow-up : 31 months). The PT, PI-LL, SVA, T1PA were significantly improved at 1 month and at final (p<0.01). VAS score, ODI, and SRS-22r were also significantly improved at the final (p<0.01). 23 patients were restored with normal SVA and the rest 5 patients demonstrated to positive SVA. SVA and T1PA at 1 month and SVA, PI-LL, and T1PA at final were significantly different (p<0.05) while the ODI, VAS, and SRS-22r did not differ significantly between the groups (p>0.05). Common reoperations were early 4 proximal junctional failures (14%) and late four rod fractures. Conclusion : Our results demonstrate that PSO and SPOs with ALIFs at the lower lumbar are significantly improves sagittal balance. For maintenance of normal SVA, PI-LL might be made negative value and T1PA might be less than $11^{\circ}$ even though positive SVA group was also significantly improved clinical outcomes.

• 대한기계학회논문집A
• /
• 제38권9호
• /
• pp.989-997
• /
• 2014

본 논문에서는 6 족 다관절 해저로봇 크랩스터를 위한 정적 보행 알고리즘 설계 방법에 대하여 기술하였다. 정적 보행 알고리즘 설계를 위해 보행계획 벡터와 다리쌍 벡터의 개념을 도입하여 6 족 로봇 보행기법 설계의 편의성과 확장성을 확보하고, 이를 이용하여 수중환경이나 탐사조건에 따라 운용할 수 있는 여섯 가지 정적 보행기법을 설계하였다. 그리고, 공통 제어변수를 사용하여 각 보행 간 자유로운 연동과 자세제어와의 복합보행을 수행할 수 있도록 하였다. 설계된 여섯 가지 정적 보행기법은 시뮬레이션을 통하여 확인하였고, 크랩스터에 적용하여 보행기법 간 연동성과 복합보행 기능 등을 검증하였다.

• The Korean Journal of Pain
• /
• 제29권4호
• /
• pp.217-228
• /
• 2016

The musculoskeletal system is mainly composed of the bones, muscles, tendons, and ligaments, in addition to nerves and blood vessels. The greatest difficulty in an ultrasonographic freeze-frame created by the examiner is recognition of the targeted structures without indicators, since an elephant's trunk may not be easily distinguished from its leg. It is not difficult to find descriptive ultrasonographic terms used for educational purposes, which help in distinguishing features of these structures either in a normal or abnormal anatomic condition. However, the terms sometimes create confusion when describing common objects, for example, in Western countries, pears have a triangular shape, but in Asia they are round. Skilled experts in musculoskeletal ultrasound have tried to express certain distinguishing features of anatomic landmarks using terms taken from everyday objects which may be reminiscent of that particular feature. This pictorial review introduces known signature patterns of distinguishing features in musculoskeletal ultrasound in a normal or abnormal condition, and may stir the beginners' interest to play a treasure-hunt game among unfamiliar images within a boundless ocean.

• 대한간호학회지
• /
• 제39권2호
• /
• pp.288-297
• /
• 2009

Purpose: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. Methods: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). Results: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. Conclusion: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.