• The Korean Journal of Pain
• /
• v.32 no.1
• /
• pp.47-50
• /
• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.33 no.2
• /
• pp.75-81
• /
• 2019

In order to research the pathological entity of Jueyin disease in ${\ll}Shanghanlun{\gg}$, some sharing concept of three-yin-three-yang used in ${\ll}Neijing{\gg}$ and ${\ll}Shanghanlun{\gg}$ were investigated first, and then the meaning of jueyin and jueyin disease were analyzed. In cold damage disease, time-space factor is important because the pathological change is rapid and the symptoms along path are similar, therefore three-yin-three-yang having complex meaning of time and space can be used as an appropriate pathological concept. So to speak, it is able to be interpreted as various modes like variations of yin-yang, qi-blood, change of pulse condition, theories of opening, closing, pivot or exuberance and debilitation of form and qi manifested in the six districts of the human body following disease process. Jueyin is between front taiyin and rear shaoyin, and it's attribution is inherent in qi stagnation and yin exuberance in relative to the location of flank and liver. Putting together above descriptions, pathological entity of jueyin disease is that the symptoms mingled with cold and stagnant heat competing each other when a subject having qi stagnation in flank with cold in extremities and lower abdomen in particular is seized with cold influenza.

• Archives of Plastic Surgery
• /
• v.46 no.1
• /
• pp.69-74
• /
• 2019

Background Local symptoms and signs of snake envenomation mimic the clinical features of compartment syndrome. It is important to measure the intracompartmental pressure to diagnose compartment syndrome. In this study, we present our experiences of confirming compartment syndrome and performing fasciotomy in snakebite patients based on high intracompartmental pressure findings. Methods The medical records of patients who visited the trauma center of Wonju Severance Christian Hospital from January 2010 to December 2015 for the management of venomous snakebite were retrospectively reviewed. Starting in 2014, fasciotomy was performed in patients with an intracompartmental pressure of more than 40 mmHg in addition to the clinical symptoms of compartment syndrome. Results A total of 158 patients with snakebite came to the hospital within 48 hours for treatment. Most patients (110 patients) were bitten at the upper extremities (69.6%). Since 2014, 33 out of 59 patients were suspected to have compartment syndrome, and their intracompartmental pressures were measured. Seventeen of those patients had a high intracompartmental pressure (average, 49.6 mmHg; range, 37-88 mmHg), and fasciotomy was performed. Conclusions In this study, as many as 10.8% of all cases were in need of fasciotomy when compartment syndrome was diagnosed by measuring the intracompartmental pressure. Previously, it was reported that fasciotomy was not required in many cases of compartment syndrome originating from snakebite. However, some patients may develop very severe compartment syndrome, requiring fasciotomy.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.4
• /
• pp.154-163
• /
• 2018

Objective: The purpose of this study was to investigate the effects of eccentric contraction training (ECT) and concentric contraction training (CCT) on the muscle thickness (MT), muscle strength (MS) and delayed onset of muscle soreness (DOMS) of the lower extremities in persons with chronic stroke. Design: Randomized controlled trial. Methods: Thirty persons with chronic stroke were randomly assigned to the ECT or the CCT group. The ECT was performed in a specially designed system of eccentric contraction of both legs and, the CCT was performed using a traditional stepper system for concentric contraction of both legs. The training was performed for 30 min/times, 3 times/wk for 6 weeks. Rehabilitation ultrasound imaging was used to measure MT of the vastus medialis/lateralis (VL), and soleus (SOL), a digital muscle tester was used to measure MS, and a visual analog scale was used to assess DOMS. Results: In the ECT group, MT was significantly improved except for SOL resting (p<0.01). In the CCT group, the MT was significantly improved except for VL contraction (p<0.05). The MS was significantly improved in both groups, especially in the ECT group (p<0.01). In the ECT group, muscle soreness was highest in the first week after training but gradually decreased, and in the CCT group, it was highest in the second week of training but gradually decreased (p<0.01). Conclusions: ECT can improve lower limb MT, MS, and DOMS of chronic stroke survivors. Therefore, it is recommended that ECT be used in the rehabilitation of persons with chronic stroke.

• PNF and Movement
• /
• v.17 no.1
• /
• pp.11-18
• /
• 2019

Purpose: This study verifies the muscle activity around the amputation site during proprioceptive neuromuscular facilitation (PNF) pattern exercise for the upper extremities on the non-amputated part in upper extremity amputees and provides basic data on effective exercise around an amputation site. Methods: Manual resistance was applied to the PNF upper extremity pattern of the non-amputated part to generate muscle activity around the amputation site. The resistance was adjusted to an intensity that could cause maximal isometric contraction. The muscle activity of the amputation site and the non-amputated part was measured using a surface electromyogram for the upper trapezius, middle trapezius, infraspinatus, serratus anterior, and pectoralis major. Results: During the scapular exercise in the painless range, the amputated side showed significantly lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. During the PNF pattern exercise in the painless range, the amputated side showed lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. When the direct scapular exercise of the amputated side was compared with the PNF pattern exercise of the non-amputated side, their muscle contraction ratios were similar. Conclusion: This study confirmed the effectiveness of the PNF pattern exercise of the non-amputated part as a way to indirectly train the injured site with no pain for rehabilitation of patients with serious body injuries, such as amputation. It is necessary to develop effective exercise programs for the rehabilitation of the amputation site based on the results of this study.

• Archives of Plastic Surgery
• /
• v.48 no.1
• /
• pp.55-60
• /
• 2021

Background In patients with congenital melanocytic nevus (CMN), single-stage removal of large lesions can be difficult because the high tension created by excising and repairing a large lesion may result in scar widening. Herein, we introduce a method to effectively excise lesions while minimizing scarring and compare its outcomes to those of existing surgical methods. Methods We compared patients who underwent surgery using the anchoring technique (n=42) or the conventional elliptical technique (n=36). One side of the lesion was removed via en bloc resection up to the superficial fascia. The other side of the lesion was removed via de-epithelialization. The de-epithelialized dermal flap was then fixed by suturing it to the superficial fascia on the opposite side. The length of the lesion's long axis and amount of scar widening were measured immediately after surgery and at 2, 6, and 12 months postoperatively. At 12 months, patients were assessed using the Patient and Observer Scar Assessment Scale. Results The lesion locations included the face, arms, legs, back, and abdomen. The anchoring method resulted in shorter and smaller scars than the conventional method. There were no cases of postoperative hematoma or wound dehiscence. Significant differences in postoperative scar widening were found in the arm and leg areas (P<0.05). Conclusions The anchoring method introduced in this study can provide much better outcomes than the conventional method. The anchoring method is particularly useful for the removal of CMN around the joints or extremities, where the surgical site is subjected to high tension.

• Journal of the Korean Society of Physical Medicine
• /
• v.16 no.1
• /
• pp.33-39
• /
• 2021

PURPOSE: This study compared the body composition according to the sport of short-distance and middle & long-distance athletes to identify the factors that affect the body composition. METHODS: Forty-eight athletes selected as youth national athletes in 2019 participated in the study. The study participants measured the length of the lower extremities, body composition, and anaerobic ability. An independent sample t-test was conducted to compare the body composition according to the event. In addition, the Pearson correlation was performed to identify the factors that influence the body composition. RESULTS: The leg length of the Short and Middle & long-distance athletes were similar (p = .584). On the other hand, there were differences in the body fat percentage (p = .001), lean percentage (p = .001), and BMI (p = .001). In addition, the body fat percentage was correlated with the lean body mass (r = .419) and BMI (r = .447). Furthermore, the lean body mass was correlated with the BMI (r = .849) and the peak power (r = .662) and mean power (r = .686) of the anaerobic capacity. Moreover, the BMI was correlated with the peak power (r = .490) and mean power (r = .543) of the anaerobic capacity. The peak power of the anaerobic ability was correlated with the mean power (r = .931). CONCLUSION: The body composition differed according to the sport. The body fat percentage correlated with the lean body mass and the BMI. The lean body mass correlated with the BMI, peak power of anaerobic ability, and mean power. The BMI correlated with the anaerobic capacity.

• PNF and Movement
• /
• v.12 no.3
• /
• pp.143-150
• /
• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

• Pediatric Infection and Vaccine
• /
• v.27 no.3
• /
• pp.184-189
• /
• 2020

Lyme disease is a common vector-borne disease caused by Borrelia burgdorferi. Erythema migrans represents the most common manifestation during the early phase of this disease; however, systemic manifestations involving the nervous system, joints, or heart are known to occur. We report a case of Lyme disease accompanied by cardiac complications in a 13-year-old Korean male adolescent. The patient developed annular erythematous lesions on his lower extremities after a field trip during his visit to Connecticut, USA, for a boarding school camp, and his skin lesions were consistent with erythema migrans. Indirect immunofluorescence assay and Western blot analysis for Lyme immunoglobulin M showed positive results. Electrocardiography revealed a first-degree atrioventricular block, and he was diagnosed with Lyme carditis and received a 4-week course of oral doxycycline. Follow-up electrocardiography performed a week later revealed normal findings, and the patient showed an uneventful recovery. Lyme carditis often presents as an asymptomatic heart block that can progress to an advanced heart block; however, this condition is reversible with appropriate antibiotic treatment.

• Korean Journal of Acupuncture
• /
• v.37 no.4
• /
• pp.253-261
• /
• 2020

Objectives : This study aimed to evaluate adverse outcome associated with acupotomy and compare it with that of acupuncture. Methods : We retrospectively analyzed the chart records of 71 patients who received acupotomy at Daemyung Korean medical clinic from January 7, 2020 to March 6, 2020. We divided the acupotomy treatment area into 10, including the head, hand, chest, knees, shoulders, low back, neck, upper extremities, thighs, and feet. Furthermore, we investigated the adverse effect of acupotomy on those areas after treatment. Data were analyzed using descriptive statistics, and frequency analysis. Results : 'Bruise of specific region' accounted for the largest portion with 29 cases, followed by 24 cases of 'feeling tired and sleepy' and 17 cases of 'itch'. There were 16 cases of 'sustained pain' at the area of treatment, 11 cases of 'fatigue', 5 cases of 'swelling', 5 cases of 'dizziness', 4 cases of 'hematoma'. There were 3 cases of 'vertigo' and 2 cases of 'parathesia' and 'wide bruises', 'headache', 'gastric discomfort', 'bleeding', and 'skin rash' each. There was one case each that experienced 'unclear pronunciation', 'nausea', 'abnormal sweating', 'vomiting' and 'emotional/psychological reactions'. Conclusions : Adverse outcomes associated with acupotomy were mostly 'bruise of specific region', 'feeling tired and sleepy', 'itch', 'sustatained pain', and 'fatigue'. However, no adverse outcome or irreversible damage that have a serious effect on the body were observed.