• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.126-132
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• 1999

Purpose : To evaluate the functional and radiographic outcome of the modified Bosworth method in the surgical treatment of acute type V acromioclavicular joint dislocation. Materials and Methods: From June 1995 to May 1998, 20 patients were operated on for acute and complete acromioclavicular dislocation(Rockwood type V). The operative technique includes fixation of the coracoclavicular joint with Bosworth screw or 6.5mm cancellous screw and imbrication of trapezius and deltoid muscles. The average age was 34 years(range, 19 to 51 years). These 20 patients with an average follow-up of 18months, were evaluated clinically using the UCLA scoring system. Additional radiographical assessment was performed with stress radiographs. Results: Excellent or good clinical results were obtained in 95%(19 cases). And the average coracoclavicular interval ratio was decreased from 3.31(2.2-6.0) to 1.13(1-1.4) in stress radiographs. There were 4 cases of hetero­topic calcification postoperatively but there was no correlation with clinical result. Posttraumatic A-C joint arthritis was developed in one case. In that case, the distal clavicular resection was done under the arthroscopic technique. Conclusion: The severe displacement observed with type V injuries is incompatible with normal shoulder function if the shoulder is left in its displaced position. In type V injuries, significant damage to the deltoid and trapezius musculature and overlying fascia occurs, therefore open reduction and good fixation must be obtained with imbrication of trapezius and deltoid muscles. In our type V acute complete acromioclavicular dislocation, the modified Bosworth technique provides excellent results with a low complication rate.

• 한국전자통신학회논문지
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• 제16권2호
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• pp.371-378
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• 2021

본 연구에서는 한국 남동해역에 발생하는 냉수대의 공간적인 분포를 구분하기 위해 2016 ~ 2018년의 고리, 양포의 해양 관측 부이 수온자료와 GHTSST Level 4 재분석 해수면 온도자료를 K-means clustering 기법을 활용하여 분석하였다. 부이자료는 남동해역에서 고리와 양포 지점의 수온변화 및 냉수대 발생을 파악하기 위해 활용하였다. 그 결과 냉수대 발생 시점에 고리와 양포의 수온이 동일하게 감소하였다. 이에 냉수대 발생시 SST의 변화를 보기 위해 수온의 역수와 SST의 분산을 비교하였다. 수온이 변화하는 시점에 SST의 분산도 증가하는 것을 나타내었는데 이를 통해 냉수대 발생시 해역의 SST의 수온분포에 변화가 있다는 것을 알 수 있었다. 냉수대 발생해역을 분류하기 위해 K-means clustering을 활용하였다. Elbow 기법을 활용하여 분류를 위한 최적의 K값을 찾아낸 후 분류를 진행한 결과 연안의 차가운 해수가 존재하는 지역을 찾아낼 수 있었다. 이를 통해 냉수대 발생해역의 공간적인 분포 및 확산범위를 추정하여 향후 냉수대로 인한 피해 파악 및 공간적인 확산 예측연구에 활용할 수 있을 것이라 판단된다.

• 대한화상학회지
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• 제24권2호
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• pp.68-73
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• 2021

Purpose: A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. Methods: A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. Results: Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. Conclusion: Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.

• 한국의류산업학회지
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• 제20권4호
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• pp.449-456
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• 2018

This study conducted a survey of members at sports climbing centers on the purchasing and wearing conditions of sports climbing wear and design preferences. 140 participants were in their 20's and 30's, and many of them engaged in sports climbing activities over 20 times a month. They put emphasis on the motion adaptability, durability, price and functional material when purchasing a climbing wear. However, only 23% of them used sports climbing wear. The reasons for wearing sports climbing wears were suitability for physical activity, comfort, and design. On the other hand, the reasons for not purchasing them were expensive prices and lack of designs. They experienced inconveniences at sleeves and waist in shirts. In case of pants, participants experienced inconveniences with the knee and thigh when they climbing. Concerning the damage of shirts, the majority experienced the elbow part was worn out, and the knee part was either worn out or torn at pants. Design preference results showed participants preferred loose-fit short-sleeved shirts that could cover half of the hip. In case of pants, they preferred basic-fit long trousers and basic hems with no functional characteristic. 3 sports climbing instructors answered that climbing wears should put emphasis on deodorization and antimicrobial effects as well as durability and suitability for physical activity. They also pointed out limitations in price and design and presented opinions about creating various sizes for different body parts by taking into account the growth of muscles.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.56-62
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• 1997

Latissimus dorsi(LD) muscle is the largest transplantable block of vascularized tissue. Since LD free flap was introduced in 1970's, this flap has been widely used for the reconstruction of large soft tissue defect of the limb. From 1981 to 1996, we had experienced 37 cases of LD free flap. Serratus anterior muscle was combined with LD in three of them whose defects were very large. The average age of the patients was 31 years(range : 4-74 years), and thirty one patients were male. Trauma was cause of the defect in every case. For the recipient sites, the foot and ankle was the most common(22 cases); and the knee and lower leg(11 cases), the elbow and forearm(2 cases), the hand(2 cases) were the next. The duration of follow-up was averaged as 16 months(range: 6 months-12 years). Thirty one cases(84%) out of 37 were successful transplantations. In one case the failure of the flap was due to heart attack and subsequent death of the patient. One failure was caused by sudden violent seizure of the patient who had organic brain damage. Immediate reexploration of the flap was performed in 4 patients, and the flap survived in three of them. There was one necrosis of the grafted split-thickness skin on the survived LD flap. LD free flap was considered as one of the good methods, for the reconstruction of the large soft tissue defect of the limb.

• 대한물리치료과학회지
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• 제5권4호
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• pp.785-794
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• 1998

We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

• Physical Therapy Rehabilitation Science
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• 제11권3호
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• pp.356-362
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• 2022

Objective: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment alternative to surgery for various musculoskeletal diseases that have traditionally been difficult to treat conservatively, including calcific tendinitis, tennis elbow, and plantar fasciitis. This study evaluated the effect of focused and radial shock wave therapy for calcific tendinitis of the shoulder. Design: Randomized controlled study Methods: Forty participants with calcific tendinitis were randomized into focused shock wave therapy (FSWT, n=20) and radial shock wave therapy (RSWT, n=20) groups. Patients were examined before and one week after treatment. Pain intensity was subjectively assessed using the visual analogue scale and function was assessed using the Constant-Murley score (CMS) and range of motion (ROM). Results: The results showed a significant decrease in pain and significant increase in shoulder mobility and function in both groups. However, FSWT was significantly more effective than RSWT, based on CMS and ROM assessment. Conclusions: Although it is possible to raise the energy intensity of RSWT to increase the depth at which the energy becomes dispersed, higher energy intensity is associated with a greater risk of severe neurovascular damage, and that high-intensity stimulation can cause adverse effects such as pain and petechiae. Therefore, FSWT is considered to be a safe and effective method for treating tendinous lesions while minimizing adverse effects. In conclusion, both FSWT and RSWT can reduce pain and increase mobility and function. FSWT can be considered as an alternative for calcific tendinitis of the shoulder.

• 대한의용생체공학회:의공학회지
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• 제43권4호
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• 한국산학기술학회논문지
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• 제18권1호
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• pp.336-344
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• 2017

본 연구는 뇌손상 진단을 받고 병원에서 재활치료를 실시하고 있는 환자의 가족 간병인 340명을 대상으로 근골격계증상을 알아보고 그 관련요인을 파악하고자 자기 기입식 설문조사를 실시하였다. 설문조사 내용은 일반적 특성, 간병활동 특성, 근골격계 자각 증상이였다. 본 연구의 조사 기간은 2014년 3월부터 4월이며, 재활병원 및 요양병원에서 수집하였다. 연구결과 독립변수에 따른 자각증상 호소율은 신체부위별로 다르게 나타났다. 요인분석의 결과는 목의 경우 초졸의 학력이 영향을 끼쳤고, 어깨의 경우 여자, 나이 50~59세, 학력 중졸, 간병기간 1년 이내와 1년 7개월 이상 2년 이내가 영향을 끼쳤다. 팔/팔꿈치의 경우 나이 40~49세, 학력 대졸, 간병기간 1년 이내와 1년 7개월 이상 2년 이내 변인이 유의한 영향을 끼쳤다. 손/손목/손가락의 경우 나이 50~59세, 간병기간 1년 이내와 1년 7개월 이상 2년 이내 변인이 통증에 유의한 영향을 끼쳤다. 다리/발의 경우 나이 50~59세, 간병기간 6개월 이내 변인이 통증에 유의한 영향을 미치는 것으로 나타났다. 허리의 경우 학력 초졸 중졸 고졸, 간병기간 1년 이내와 1년 7개월 이상 2년 이내, 독립보행 불가능 변인이 통증에 유의한 영향을 미치는 것으로 나타났다. 진단명 별 간병활동 특성에서 근골격계 자각증상 호소율은 통계적으로 유의하지 않았다. 근골격계 자각증상 호소에 가장 영향을 미치는 간병활동 동작으로는 이동하기와 보행이었다. 근골격계 자각증상에 영향을 미치는 전체 요인에 대해서는 간병 기간 1년 이내가 전체 통증에 유의한(p<.05) 영향을 미치는 것으로 나타났다. 본 연구의 결론으로는 뇌손상 환자의 가족 간병인은 환자를 간병하는 간병활동 특성에서 근골격계 질환의 위험에 노출되어 생활하는 것을 알 수 있었다. 또한 뇌손상 환자를 돌보는 가족 간병인의 신체부위별 근골격계 증상에 영향을 미치는 요인이 다르므로 이러한 요인에 대한 체계적이며 종합적인 예방 교육과 연구가 마련되어야 할 것이다.