Objective : The objective of this study was to evaluate the characteristics and surgical outcome of the conus medullaris tumors. Methods : We retrospectively reviewed 26 patients who underwent surgery for conus medullaris tumor from August 1986 to July 2007. We analyzed clinical manifestation, preoperative MRI findings, extent of surgical resection, histopathologic type, adjuvant therapy, and outcomes. Results : There were ependymoma (13), hemangioblastoma (3), lipoma (3), astrocytoma (3), primitive neuroectodermal tumor (PNET) (2), mature teratoma (1), and capillary hemangioma (1) on histopathologic type. Leg pain was the most common symptom and was seen in 80.8% of patients. Pain or sensory change in the saddle area was seen in 50% of patients and 2 patients had severe pain in the perineum and genitalia. Gross total or complete tumor resection was obtained in 80.8% of patients. On surgical outcome. modified JOA score worsened in 26.9% of patients, improved in 34.6%, and remained stable in 38.5%. The mean VAS score was improved from 5.4 to 1.8 among 21 patients who had lower back pain and leg pain. Conclusion : The surgical outcome of conus medullaris tumor mainly depends on preoperative neurological condition and pathological type. The surgical treatment of conus medullaris tumor needs understanding the anatomical and functional characteristics of conus meudllaris tumor for better outcome.
Han, Sun Sook;Sim, Sung Eun;Kim, Yang Hyun;Lee, Eun Hyoung;Joh, Ju Yeon;Kim, Ji Young;Lee, Sang Chul
The Korean Journal of Pain
/
v.18
no.2
/
pp.187-191
/
2005
Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.
Purpose: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature since this entity was initially described by Keasbey in 1953 who called it calcifying juvenile aponeurotic fibroma. The tumor is a slowly growing, painless mass. In most cases the mass is poorly circumscribed and causes neither discomfort nor limitation of movement. Most lesions occur in children, with a peak incidence ages of 8-14 years. There is no evidence of any increased familial prevalence. Predilection sites are palm, finger, toe, but it also occurs in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. We herein describe a rare case of calcifying aponeurotic fibroma occurring on the chin with review of the literature. Methods: A 14-year-old male had painless, slowly growing mass(${\phi}2.5cm$) on a chin for a year. The tumor was excised elliptically under local anesthesia and the excisional site was repaired directly. Due pathological examination was processed. Results: Histological examination revealed an illdefined fibrous growth that extends with multiple processes into the surrounding tissue with centrally located foci of calcification. The tumor is composed of short spindled plump fibroblasts with round or ovoid nuclei separated by collagenous stroma, showing vaguely palisading pattern. Diagnosis of calcifying aponeurotic fibroma was conferred. Postoperatively, the patient did well, and the lesion had not recurred. Conclusion: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature. The most common occurring sites are palm, finger & toe, but it has been reported in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. Two cases of calcifying aponeurotic fibroma occurring on the neck have been reported in the literature. To the authors knowledge, our case of calcifying aponeurotic fibroma occurring on the chin is the first to be reported.
Park, Cheol;Kang, Hee-Ju;Lee, Ju-Yeon;Kim, Seon-Young;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Yoon, Jin-Sang
Anxiety and mood
/
v.10
no.1
/
pp.24-29
/
2014
Objectives : This study aimed to investigate the associations between physical disorders and prevalent/incident suicidal ideation in a community dwelling older population aged 65 years or over. Methods : 1204 people aged 65 years or over evaluated at baseline. Suicidal ideation was identified using the questions from the community version of the Geriatric Mental State Schedule ("GMS B3"). Reported physical disorders covering 11 common and generally chronic health problems were ascertained. Covariates included were depression, age, gender, years of education, accommodation status, past occupation, and current occupation. Of 1066 without suicidal ideation at baseline, 805 (76%) were followed 2 years later, and incident suicidal ideation was evaluated. Results : Prevalent suicidal ideation was significantly associated with 4 of 11 physical disorders: eyesight problems, persistent cough, heart disease and paralysis or weakness in one leg or arm. Incident suicidal ideation was associated with 3 physical disorders: asthma, high blood pressure and paralysis or weakness in one leg or arm. Both prevalent and incident suicidal ideation were significantly associated with increased number of physical disorders. Conclusions : Certain physical disorders were comorbid and precipitating factors of suicidal ideation in elders. And appropriate intervention and treatment of physical disorders might prevent suicidal ideation in elderly.
The current paper presents a novel control strategy of a three-phase, four-wire Unified Power Quality (UPQC) to improve power quality. The UPQC is realized by the integration of series and shunt active power filters (APF) sharing a common dc bus capacitor. The realization of shunt APF is carried out using a three-phase, four-leg Voltage Source Inverter (VSI), and the series APF is realized using a three-phase, three-leg VSI. To extract the fundamental source voltages as reference signals for series APF, a zero-crossing detector and sample-and-hold circuits are used. For the control of shunt APF, a simple scheme based on the real component of fundamental load current (I $Cos{\Phi}$) with reduced numbers of current sensors is applied. The performance of the applied control algorithm is evaluated in terms of power-factor correction, source neutral current mitigation, load balancing, and mitigation of voltage and current harmonics in a three-phase, four-wire distribution system for different combinations of linear and non-linear loads. The reference signals and sensed signals are used in a hysteresis controller to generate switching signals for shunt and series APFs. In this proposed UPQC control scheme, the current/voltage control is applied to the fundamental supply currents/voltages instead of fast-changing APF currents/voltages, thus reducing the computational delay and the required sensors. MATLAB/Simulink-based simulations that support the functionality of the UPQC are obtained.
The right hip adbuctor musculature has been reported to demonstrate 'stretch weakness' attributable to chronic elongation imposed by standing posture common to right-handed healthy persons. Kendall and associates have described the concept of 'stretch weakness'. The purpose of this study was to assess isometric hip abduction torque and surface electro-myographic activity (using MYOMED 432) in a sample of 40 healthy right-handed persons (20 male, 20 female), all of whom agreed to participate in the study, and compare side difference in the hip abductor musculature. In order to assure the statistical significance of the results, the paired t-test was applied at the .05 level of significance. The results were as follows : 1. The difference in apparent leg length of right and left legs was significant at the .05 leve1. 2. There was a significant difference between right and left pelvic height (standing position) at the .005 level measurements, and scapula height at the .05 level. 3. Power measurements and action potentials of right hip adbuctor were greater than the left hip adbuctor regardless of the range of joint motion (inner range, outer range). 4. The difference in muscle power and action potentials according to inner or outer range of both hip abductor were significant at the .05 level. 5. In supine during active left hip abduction, the appearance of action potentials in the right hip abductors is indicative of contra-lateral effect (p<.005). These results suggest : In healthy right-handed persons. the apparent leg length on the right is longer than on the left, and pelvic height is elevated on the right side. Muscle torque and muscle action potentials of the right hip adbuctor art higher than those of the hip abductor in the lengthened position. Therefore, the results in this study are contrary to Kendall's. This type of study should be carried out in many physical therapy departments.
From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.
Objectives : The objective of this study was to investigate the effects of Zingiberis Rhizoma Pharmacopuncture(ZP) at GB30 and ST36 in neuropathic pain induced SD rats by the block of Transient Receptor Potential Vanilloid 1(TRPV1). Methods : Neuropathic pain in rats was induced by tibial and common peroneal nerve transection of right leg. The rat subjects were divided into 6 groups : normal(Nor, n=5), control(Con, n=5), neuropathic pain plus 2 mg/kg ZP injection at GB30 and ST36(ZP-A, n=5), 10 mg/kg ZP(ZP-B, n=5), 20 mg/kg ZP(ZP-C, n=5) and 0.45 mg/kg Tramadol(Tra, n=5). Three days after the surgery, injections were administered once a day for 17 days. Withdrawal response of neuropathic rats' legs were measured by stimulating the paw of Right leg with von frey filament, acetone and radient heat on day 3, 7, 11, 15, 19 after surgery. After all treatments were completed, c-Fos in the midbrain central gray and TRPV1 & TRPA1 of DRG(L5) were analyzed. Results : Groups ZP-B and ZP-C showed a meaningful decrease in the withdrawal response of mechanical allodynia, thermal hyperalgesia and cold allodynia compared to the control group(p<0.05, p<0.01, p<0.001). Groups ZP-B and ZP-C showed a meaningful decrease in the expression of c-fos and TRPV1 protein level compared to the control group(p<0.05, p<0.01, p<0.001). Conclusions : These results suggest that Zingiberis Rhizoma Pharmacopuncture at GB30 and ST36 could decrease mechanical & cold allodynia and thermal hyperalgesia by block the TRPV1 on the model of neuropathic pain.
Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.30
no.2
/
pp.13-26
/
2024
Background: The most common form of injury in soccer is a hamstring strain. Eccentric bias exercises are crucial for reducing injury risk and improving sprinting performance. The purpose of this study was to compare a 4-week hip-dominant hamstring strengthening exercise program (HDE) with a knee-dominant hamstring strengthening exercise program (KDE) in youth soccer players. Method: The sample (n=31) was randomly divided into two groups: HDE (n=17) and KDE (n=14), with soccer players in HDE performing hip joint-dominant hamstring strengthening exercises and those in KDE performing knee joint-dominant hamstring strengthening exercises. Each intervention was conducted three times per week for four weeks. The outcome measures included the hamstring strength test (isometric strength test, eccentric strength test), knee joint range of motion (90/90 active knee extension; AKE) test, lower limb function test Y-balance test and Agility T-test. Results: Following the intervention, both groups showed significant improvement in isometric and eccentric hamstring strength on both dominant and non-dominant sides (p<.05). The AKE test showed significant improvement in the dominant leg (p<.05) and non-dominant leg only in KDE. The agility test significantly improved in HDE (p<.05). There was a slight improvement in the Y-balance test score; however, the difference was not statistically significant. There were no differences between the two groups in the values before, and after the intervention for all items. Conclusion: The hip-dominant and knee-dominant hamstring strengthening exercise should be coordinated and used based on the environment during hamstring injury prevention training.
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