• Archives of Reconstructive Microsurgery
• /
• v.13 no.1
• /
• pp.51-57
• /
• 2004

Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

• Archives of Reconstructive Microsurgery
• /
• v.24 no.1
• /
• pp.1-6
• /
• 2015

Purpose: The main cause of flap loss in microsurgical tissue transfer is venous insufficiency. Whether or not multiple venous anastomoses prevents vascular thrombosis and reduces the risk of flap failure remains controversial. Some researchers are in favor of performing dual venous anastomoses, but the counterargument holds that performing a single venous anastomosis does provide advantages. Materials and Methods: We carried out a retrospective analysis of 15 cases of anterolateral thigh free flap for extremity reconstruction performed between January 2011 and December 2013. The patients were categorized into two groups: group A that received a single venous anastomosis and group B that received dual venous anastomoses. The time of the anastomosis, size of the flap, complications of the flap, and survival rate of each group were analyzed. Results: The total microsurgical time in the single venous anastomosis group ranged from 28 to 43 minutes (mean 35.9 minutes). The total time in the dual anastomoses group ranged from 50 to 64 minutes (mean 55.7 minutes). No statistically significant difference was found between the two groups with regards to postoperative complications and flap failure. Conclusion: Our study suggests that the use of a single venous anastomosis in the venous drainage of anterolateral thigh free flaps is a safe and feasible option for extremity reconstruction and provides shorter operative time and easy flap dissection.

• Archives of Reconstructive Microsurgery
• /
• v.18 no.2
• /
• pp.49-54
• /
• 2009

Purpose: To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives. Materials and Methods: The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus. Results: At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent. Conclusion: The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.

• The Journal of Korean Medicine
• /
• v.18 no.1
• /
• pp.25-39
• /
• 1997

Shoulder hand syndrome is characterized by pain, vasomotor instability, and tenderness, mainly in the distal upper extremity. The pathophysiologic mechanism of this syndrome is not yet proved. The purpose of this study is to evaluate the usefulness of thermographic imaging on shoulder hand syndrome after stroke for early diagnosis and its clinical pattern analysis including acupuncture and electroacupuncture therapy. This study was performed from June to September in 1996 on 46 stroke patients who were admitted at Oriental hospital of Kyung Hee Medical Center. The study group were 23 patients with shoulder hand syndrome. The control group were 23 patients without shoulder hand syndrome. Skin temperatures on the both upper extremities were measured by Digital Infrared Thermographic Imaging(D.I.T.I.) before the study and 3 weeks later again. The results were as follows; 1. The shoulder hand syndrome group were significantly more restricted in shoulder passive range of motion than the control group. 2. The shoulder hand syndrome group showed significant temperature difference of both dorsal hands. 3. The electroacupunture therapy group were significantly more improved on the temperature difference of both dorsal hands than acupuncture therapy group in 3 weeks later. 4. Both posterior arms showed the biggest temperature difference from 11 to 30 days in shoulder hand syndrome group. 5. The lesser passive ROM(range of motion) of shoulder group showed significantly increased temperature difference of both hands. The above results show that measurement of shoulder passive range of motion and D.I.T.I. is a useful method for early diagnosis on shoulder hand syndrome and its clinical pattern analysis including evaluation of acupuncture and electroacupuncture therapy. Continuous study will be needed for more clinical application and evaluation on shoulder hand syndrome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.3
• /
• pp.186-190
• /
• 2003

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.

• Journal of Korean Medicine Rehabilitation
• /
• v.19 no.2
• /
• pp.203-212
• /
• 2009

Objectives : Spurling test is one of the most widely used physical tests to diagnose herniated cervical intervertebral disc. The purpose of this study is to analyse diagnostic validity of Spurling test. Methods : This study was carried out on 382 subjects who visited Bu-Chun Ja-Seng oriental hospital with the neck pain or radiating pain from neck to upper extremities from November, 2007 to October, 2008. All subjects underwent both Spurling test and cervical magnetic resonance imaging(MRI). The associations between Spurling test and herniated cervical intervertebral disc were analysed. Results : 1. The sensitivity of Spurling test for herniated cervical intervertebral disc was 64%. 2. The specificity of Spurling test for herniated cervical intervertebral disc was 86%. 3. The positive predictive value of Spurling test for herniated cervical intervertebral disc was 93%. 4. The negative predictive value of Spurling test for herniated cervical intervertebral disc was 44%. Conclusions : This study suggests that Spurling test is not useful in screening for herniated cervical intervertebral disc due to the test's relatively low sensitivity. Thus it is necessary to consult advanced tests such as diagnostic imaging to diagnose herniated cervical intervertebral disc.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.32 no.4
• /
• pp.682-686
• /
• 2005

Incontinentia pigmenti(IP), so called Block-Sulzberger syndrome is a rare genodermatosis that occurs almost in female infant; usually lethal in males, X-linked dominantly inherited disorder. IP is characterized by abnormalities of mesodermal and ectodermal tissues including eye, tooth, skin, nail, breast and hair as well as neurological deficiencies. Dental problems are congenital missing of teeth, delayed eruption, abnormal crown shape and so on. Here is a case of 6 year-old female with IP. She had congenital missing of primary and permanent teeth, delayed eruption, maxillary deficiency and extra cusps, resulting in unstable occlusion. Systemically, she had a history of operating eyes due to problem of retina and hyperpigmented macules on her trunk and extremities as typical character of IP.

• The Korean Journal of Rehabilitation Nursing
• /
• v.20 no.1
• /
• pp.22-32
• /
• 2017

Purpose: This research was conducted to determine the effects of fall prevention exercise and education on physical fitness, fall efficacy, and fall prevention behavior among community-dwelling older adults. Methods: This study applied nonequivalent control group pretest-posttest design. Data were collected from January 8th to March 4th, 2015. There were 24 subjects in the experimental group and 21 in the control group from two different senior citizen center in B city. The fall prevention program consisted of exercise, education, and telephone coaching was developed using self-efficacy theory: 'Performance accomplishment', 'Vicarious experience', 'Verbal persuasion', 'Emotional arousal'. Then, it was conducted once a week for 8 weeks. Data were analyzed with $x^2$ test and t-test using the SPSS program. Results: The findings indicated that fall prevention program conducted on older adults is good for improving their muscular strength in lower extremities (t=6.25, p<.001), physical balance (t=2.66, p=.014), physical flexibility (t=2.88, p<.001) and fall prevention behavior (t=6.19, p<.001). Conclusion: The fall prevention program can be used for community-dwelling older adults as a nursing intervention that enables older adults to enhance their self-care continuously. It is necessary to conduct a follow-up study to see if a self-help meeting could improve self-efficacy.

• Tuberculosis and Respiratory Diseases
• /
• v.58 no.1
• /
• pp.59-63
• /
• 2005

A-67-year-old man was hospitalized due to fever, cough and dyspnea upon exertion, and was treated with intravenous antibiotics. During the hospital course he presented with weakness in his low extremities. The laboratory tests showed an elevated CK level and myoglobinuria. He was diagnosed with rhabdomyolysis with community-acquired pneumonia and treated accordingly. Subsequently, his symptoms and signs of rhabdomyolysis improved.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.4
• /
• pp.427-431
• /
• 2005

Lambert-Eaton myasthenic syndrome (LEMS), a rare autoimmune neurological syndrome, is caused by defects in the secretion of acetylcholine from the presynaptic membrane, and is associated with the destruction of voltage gated calcium channels (VGCC) in the neuromuscular junction. LEMS can be confirmed by repetitive nerve stimulation and by the clinical symptoms, which are characterized by proximal muscle weakness in the lower extremities, decreased deep tendon reflexes and autonomic dysfunctions. In about 60% of patients with this disorder, underlying cancer-small cell lung cancer may be detected. Clinical symptoms may precede the diagnosis of malignancy, with the early diagnosis and treatment of the underlying malignancy being possible through the diagnosis of LEMS. A case of LEMS, with positive VGCC antibodies, in a 48-year-old man, which improved after chemotherapy of the underlying small cell lung cancer, is reported.