• 대한족부족관절학회지
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• 제11권2호
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• pp.232-237
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• 2007

Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.

• 대한물리의학회지
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• 제15권1호
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• pp.123-132
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• 2020

PURPOSE: This study examined the effects of both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation on the balance and gait of stroke patients. METHODS: Ten patients with stroke were divided randomly into two groups of five patients each who met the selection criteria. The training was conducted five times a week, for 60 minutes. The experimental group received both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation while the control group received general physical therapy with functional electrical stimulation. RESULTS: The timed Up-and-Go (TUG) test result was statistically significant after the intervention in the experimental group (p<.041). Berg Balance Scale (BBS) assessment was statistically significant after the intervention in the experimental group (p<.047) and between the experimental and control groups (p<.012). The cadence assessment was statistically significant after intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). The stride length assessment was not statistically significant after intervention in the experimental group and between the experimental and control groups. Gait velocity assessment was statistically significant after the intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). CONCLUSION: Both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation had positive effects on the balance and gait of stroke patients.

• 대한간호학회지
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• 제36권3호
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• pp.514-522
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• 2006

Purpose: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. Method: The subjects were 60'stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, $\chi^2-test$, and t-test using the SPSS/Win 10.0 computerized program. Result: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. Conclusion: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.

• Archives of Plastic Surgery
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• 제41권4호
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• pp.374-378
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• 2014

Background Angioleiomyoma, a vascular leiomyoma, is a rare, benign smooth-muscle tumor that originates in the tunica media of vessels. It occurs anywhere in the body, most frequently in the lower extremities. Methods We reviewed the medical records of 16 patients who were treated for angioleiomyoma between 2000 and 2012. The clinical features of angioleiomyoma and the correlation between symptoms and pathological subtypes were investigated. Results There were 9 males and 6 females. Ages of the patients ranged from 21 to 61. Pain was the primary symptom in 44% of the patients. Tumors were smaller than 2.0 cm in all dimensions and were located in the face in 4 patients, whereas 5 lesions occurred in the upper extremities and the remaining 7 in the lower extremities. Three histologic subtypes were identified: solid, venous, and cavernous. The subtypes did not correlate with the clinical symptoms. Conclusions Angioleiomyoma appears to be a rare tumor that occurs in the face and the extremities. The tumor usually occurs in middle age. A differential diagnosis of this tumor is difficult, but the tumor should be considered in the diagnosis of painful subcutaneous masses. Ultrasonography and magnetic resonance imaging can be helpful in the diagnosis of angioleiomyoma. These tumors can be successfully treated with simple excision, with a low recurrence rate.

• Archives of Reconstructive Microsurgery
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• 제3권1호
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• pp.90-96
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• 1994

1. 교통사고 등으로 인한 외상성 골노출이 8례로 가장 많았으며, 원인으로서는 교통사고가 7례이었고 1례는 기계사고 이었으며, 부위 별로는 하지 경골이 7례, 종골이 1례이었다. 2. 2례의 만성 골수염에서는 유리조직 이식술과 함께 골소파술 및 정주 항생제 요법을 병행하였다. 3. 총 10례중 9례에서 완전 생존하여 90%의 성공률을 보였다. 4. 공여부위에 대한 합병증은 소량의 혈종을 형성한 1례에서 2차 탐구술과 흡인술을 시행하였으며 합병증없이 치유되었다.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.58-62
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• 2004

Purpose: To cover the exposed tendons and bones after trauma and cure the concomitant osteomyelitis in the lower extremities, gracilis muscle free flaps are frequently preferred. 32 cases of gracilis muscle free flap we had done were analysed according to the indications, specification of flap length and width, pedicle length, vessels used in the anastomosis and final healing after at least over 1 year follow up. Materials and methods: From August 1995 through November 2002, we have performed 32 cases of gracilis muscle free flap transplantation with the general microsurgical procedures in the lower extremities. Open fracture of the middle and distal tibia were 12, exposed heel 6, crushing injury in the foot 5 cases, open fracture of the ankle 4, chronic osteomyelitis of the tibia 3 and osteomyelitis of the tarsal bones 2. Tailored flap length were ranged from 16 cm to 4 cm, width were from 5cm to 4cm. Pedicle length averaged around 4 cm. Anastomosis of one artery and two veins in both of donor and recipient were performed in 17 cases and one artery and one vein in 15 cases. Results: All flaps were survived, except 2 cases. Final flap healing was satisfactory to both of the patients and microsurgeon. Conclusion: Gracilis muscle free flaps are frequently chosen to cover the exposed components and cure the osteomyelitis in the lower extremities.

• 대한골관절종양학회지
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• 제4권2호
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• pp.88-93
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• 1998

Neurilemoma usually discovered incidentally, is a benign nerve-sheath tumor which has been described as a painless mass. In most cases, the size of the mass was smaller than 5cm. However, it was reported that there were masses, sometimes associated with local tenderness and pain, whose size was over 6cm. Then, we have found there is a relationship between mass size and neurologic symptoms, as well as with, postoperative complications. It is important to diagnose early and to treat it. Twenty neurilemoma patients, who were treated at Keimyung University Dongsan Medical Center were analyzed using their clinical symptoms, pathologic findings, radiologic findings and complications. There was no sexual difference in tumor incidence. The anatomical locations of tumors were as follows. ; upper extremities in 15 cases(69%), axilla in 1 case(4%) and lower extremities in 6 cases(27%). Symptoms were palpable mass in 22 cases, local tenderness in 8 cases(36%), radiating pain in 6 cases(27%) and paresthesia in 6 cases(27%), Median nerve was involved most frequently(33%). There were 2 patients(10%) with multiple symptoms. Tumor enucleation was done in all cases. The size of tumors in longest axis was smaller than 2cm in 2 cases, between 2 and 4cm in 11 cases and more than 5cm in 9 cases. There was no case of malignant transformation or recurrence. In conclusion, incidence of clinical symptom and postoperative complications are increased with the size of the tumor especially over the 5cm. Preoperative MRI finding was the most accurate method of diagnosis and most helpful in determining surgical resection margin.

• Journal of Korean Neurosurgical Society
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• 제65권2호
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• pp.307-314
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• 2022

Objective : The percutaneous thread transection technique is a surgical dissecting method using a dissecting thread inserted through a needle under ultrasound guidance without skin incision. As the new dissecting threads were developed domestically, this cadaver study was conducted to compare the effectiveness and safety between the new threads (ultra V sswire and smartwire-01) and a pre-existing commercial dissecting thread (loop & shear) by demonstrating a modified looped thread cubital tunnel release. Methods : The percutaneous cubital tunnel release procedure was performed on 29 fresh cadaveric upper extremities. The pre-existing commercial thread was used in 5 upper extremities. The two newly developed threads were used in 24 upper extremities. Two practitioners performed the procedures separately. After the modified looped thread cubital release, anatomical and histological analyses were performed by a blinded anatomist. The presence of the dissected cubital tunnel and damaged adjacent soft tissue was assessed. Results : Out of the 29 cadaveric upper extremities, 27 specimens showed complete dissection of the Osborne ligament and the proximal fascia of the flexor carpi ulnaris muscle. One specimen was incompletely dissected in each of the ultra V sswire and smartwire-01 groups. There were no injuries of adjacent structures including the ulnar nerve, ulnar artery, medial antebrachial cutaneous nerve, or flexor tendon with either the commercial thread or the newly developed threads. The anatomical analysis revealed clear and sharp incisional margins of the cubital tunnel in the Smartwire-01 and loop & shear groups. All three kinds of threads maintained proper linear elasticity for easy handling during the procedure. The smartwire-01 provided higher visibility in ultrasound than the other threads. Conclusion : The newly developed threads were effective and safe for use in the thread cubital tunnel release procedure.

• 대한영상의학회지
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• 제84권4호
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• pp.846-854
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• 2023

상하지 혈관 손상은 높은 사망률과 관계가 있다. 사지 혈관 손상에 대한 전통적인 치료법은 수술이었으나 최근 기술과 시술법의 비약적인 발달로 인해 혈관 내 치료법(endovascular treatment)의 효용 및 임상 적용이 증가하고 있다. 상하지 혈관 손상에서 시행할 수 있는 혈관 내 치료는 크게 스텐트 그래프트(stent graft) 설치술과 색전술로 나눠볼 수 있으며 일반적으로 손상 혈관의 위치와 크기, 혈관 손상의 성격에 따라 치료법이 달라진다. 겨드랑-쇄골하동맥과 장골 동맥 손상의 경우 해부학적 위치상 수술적인 접근이 어려운 것으로 알려져 있으며 스텐트 그래프트 설치술이 수술을 대신할 수 있는 중요한 치료법으로 활용되고 있다. 활동성 출혈, 가성동맥류, 동정맥루 및 색전 시 허혈이 우려되지 않는 동맥의 손상에 대해서는 색전술을 고려해 볼 수 있다. 상하지의 혈관 손상에 대한 혈관 내 치료법은 최소침습적으로 진단과 치료를 동시에 할 수 있다는 장점이 있어 향후 그 적응증이 더 넓어질 것으로 기대된다.

• 문화기술의 융합
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• 제10권4호
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• pp.537-542
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• 2024

본 연구의 목적은 기초체력요인 중 일회적인 카프라이즈 동작이 하지의 순발력에 미치는 영향을 분석하는 것입니다. 본 연구의 대상은 D광역시 소재 Y대학교 체육학과 16명이며, 모든 대상자들은 측정항목과 방범에 대한 내용을 숙지하였으며, 설문에 응답하고 동의한 학생들을 대상으로 실험을 진행하였습니다. 요약하면, 단 한 번의 카프레이즈만이 하지의 순발력 강화에 효과가 있는 것으로 보이며, 특히 종아리 근육의 둘레가 두꺼울수록 하지의 순발력에 영향을 미치는 것으로 판단됩니다. 또한, 본 연구의 결과가 모든 연령대에 효과가 있다고 볼 수는 없지만, 단 한 번의 운동만으로 기록을 향상시키는 효과를 보여주고 있어 체력 평가의 기초 자료로 활용하기에 좋을 것으로 사료됩니다. 향후 연구에서는 연령별 대상자를 모집하여 연령 차이를 통해 운동의 필요성을 높일 수 있는 연구를 진행하면 좋을 것으로 판단됩니다.