• Title/Summary/Keyword: Extremities

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The Clinical Study on Spinocerebellar Ataxia with Cerebellar Atrophy (Cerebellar Atrophy로 인해 유발된 Spinocerebellar Ataria 환아(患兒) 1례(例) 보고(報告))

  • Ha, Kwang-Su;Kim, Sun-Mi;Ha, Su-Yun;Song, In-Sun;Lee, Jeong-Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.19 no.2
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    • pp.41-50
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    • 2005
  • Objective : The autosomal dominent cerebellar ataxia(ADCA) is an unusal familial herediatary disorder that has been called olivopontoerebellar atrophy. Recently ADCA referred to as spinocerebellar ataxia(SCA) by molecular genetic characteristics. The purpose of this study is to focus on the improvement of clinical symptoms in SCA patient by oriental medical treatment. Materials & Methods : We experienced a case of the 6-year-old female patient with SCA and the MRI showed atrophy of cerebellum. The patient's chief symptoms come within the purview of five kinds of retardation and five kinds of flaccidity. We treated her with herb medicine (Yukmijihwang-tang gamibang), acupuncture, scalp acupuncture. After we measured the progress of general condition by MBI(Modified Bathel Index). Results : After oriental medical treatment, chief symptoms (ataxia, weakness of low extremities, dysarthria, etc.) and general condition were improved. Conclusion : We suggest that oriental medical therapy is effective to the possibility of treatment on SCA, but more clinical study and observation should be needed.

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Ergonomic Design of Medic Work Table (MWT) for Medical Technologist

  • Choi, Kyeong-Hee;Lee, Sung-Yong;Lee, Jun-Hyub;Kong, Yong-Ku
    • Journal of the Ergonomics Society of Korea
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    • v.35 no.6
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    • pp.595-609
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    • 2016
  • Objective: The purpose of this study was to develop and validate the guidelines for Medic Work Table (MWT) based on the anthropometric data of medical technologists. Background: Users' anthropometric data such as sitting height, sitting elbow height, knee height, and so on are significant factors for designing comfortable and useful furniture. Thus, many guidelines for different types of desks and chairs based on the users' anthropometric data have been suggested to many researchers. However, few researches have been conducted to provide design guidelines for MWT for blood collecting task. Medical technologists often use their upper extremities to perform blood collecting task with high repetitions. These repeated motions could be a critical factor in the prevalence rate of Work-related Musculoskeletal Disorders (WMSDs). Therefore, a study on ergonomic design of MWT would be essential in preventing the WMSDs and improving the quality of the working environment of medical technologists. Method: This study suggested design guidelines for ergonomic MWT by focusing on the heights of the upper side and underside, depths of the inside and outside, and width of MWT through anthropometric studies and literature reviews. Afterwards, a new MWT was made using the suggested design guidelines for this study. Five healthy medical technologists participated to evaluate the original MWT and new MWT. All participants took part in the range of motion (ROM) test, electromyography (EMG) muscle activity test, and usability test to validate the suggested guidelines in this study. EMG signals of related muscles (Flexor Carpi Ulnaris, Extensor Carpi Ulnaris, Deltoid Anterior, and Biceps Branchii) were recorded through the surface electromyography system from both the original MWT and the new MWT. The ROM test of the shoulder and elbow flexion was also assessed using motion sensors. Results: The newly designed MWT showed decreased ROMs of the shoulder and elbow up to 22% and 18% compared to the original MWT. The muscle activities in the new MWT also showed a decrease of 13% in Anterior Deltoid, 6% in Biceps Brachii, 5% in Flexor Carpi Ulnaris, and 8% in Extensor Carpi Ulnaris muscle groups, compared to the original MWT. In the usability test, the satisfaction score of the new MWT was also 56.1% higher than that of the original MWT. Conclusion: This study suggested guidelines for designing MWT and validating the guidelines through qualitative and quantitative analyses. The results of motion analysis, muscle activity, and usability tests demonstrated that the newly designed MWT may lead to less physical stress, less awkward posture, and better physical user interface. Application: The recommended guidelines of the MWT would be helpful information for designing an ergonomic MWT that reduces physical loads and improves the performance of many medical technologists.

Case Study on Design, Manufacture and Application of Customized Assistive Device for the ADL of Person with Brain Lesions (뇌병변장애인의 일상생활을 위한 맞춤형 보조기구의 설계·제작·적용 사례 연구)

  • Lee, J.H.;Choi, M.N.;Yim, S.B.;Rhee, G.M.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.4 no.1
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    • pp.81-86
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    • 2010
  • This paper is case study on design, manufacture and application of customized assistive device for the ADL of person with brain lesions. The study had carried out from October 2010 to November 2010 and 2 clients from Assistive device case management demonstration project which is performed by Daegu assistive and rehabilitation center had participated. Case A, a 47-year-old man with brain lesions, stays only on the floor and could not get close to the usual toilet by himself because of the poor low extremities muscle strength and function. The moveable-toilet and customized ramp had applied to Case A. He clambers up the ramp and reach to the toilet easily. Case B, a 8-year-old boy with brain lesions, had difficulties with self-feeding because of his clumsy hand. Several existing feeding aids were applied but not appropriated. A customized feeding aid was designed and manufactured out of regard of Case A's ROM and right hand size. And his occupational therapist works together continuously to make him feed himself in the near future. Already-made assistive devices were not appropriate to Case A and B and to solve this problem, customized assistive devices were applied. The importance and needs of design and manufacture of assistive device were recognized through these case study.

A CLINICAL AND STATISTICAL STUDY OF MAXILLOFACIAL FRACTURE IN THE UIJUNGBU AREA (의정부지역의 악안면 골절에 대한 임상 통계적 연구)

  • Kim, Hyoun-Tae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.63-68
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    • 1991
  • The author has arrived at the following result after having carried out multilateral study based on a total of 282 maxillofacial fracture patients who have receive treatment at the Euijeongbu general hospital and Shinchun general hospital in the northern district of Kyunggido from march 1988 to august 1990. 1. Sex distribution of Mx. facial fx. patient was higher in male by 4.6:1 and was predominant in the 3rd decade with 40.4% followed in decreasing order by the 2nd decade and the 4th. 2. A majority were in the Mn. with 40.2% followed in decreasing order by zygoma. nasal bone and maxilla. 3. For the sex distribution according to anatomy, make to female ratio was 6.2:1 in the mandible, followed in decreasing order by zygoma, and nasal bone with predominance in male. 4. Car accident with 42.8% was the most common cause of fx. followed in decreasing order by violence, workmen's accident, and fall down. 5. The involvement of other trauma areas are head. 79.0%, abdomen-thorax, and the extremities in decreasing order. 6. In the mandibular fx. a majority were in the symphysis with 73.9% followed in decreasing order by angle, Condyle, and body. 7. Maxillary fx. of the type LeFort II was estimated to be 41.2% 8. Fracture in the zygoma including zygomatic arch was estimated to be 72.5%

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A CASE OF AGGRESSIVE FIBROMATOSIS INVADED MANDIBULAR BODY ON THE PAROTID REGION (이하부에 발생한 침습성 섬유종증이 하악체에 침범한 증례 보고)

  • Kim, Young-Jo;Lee, Dong-Keun;Um, In-Woong;Min, Seung-Ki;Chung, Chang-Joo;Kim, Eun-Cheol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.186-195
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    • 1994
  • Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

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Effects of Joint Mobilization Techniques on the Joint Receptors (관절 가동운동이 관절 감수기에 미치는 영향)

  • Kim, Suhn-Yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.2 no.1
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    • pp.9-19
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    • 1996
  • Type I, II, III are regarded as "true" joint receptors, type IV is considered a class of pain receptor. Type I, II and III mechanoreceptors, via static and dynamic input, signal joint position, intraarticular pressure changes, and the direction, amplitude, and velocity of joint movements. Type I mechanoreceptor subserve both static and dynamic physiologic functions. Type I are found primarily in the stratum fibrosum of the joint capsule and ligaments. Type I receptors have a low threshold for activation and are allow to adapt to changes altering their firing frequency. Type II receptors have a low threshold for activation. These dynamic receptors respond to joint movement. Type II receptors are thus termed rapidly adapting. Type II joint receptors are located at the junction of the synovial membrane and fibrosum of the joint capsule and intraarticular and extraarticular fat pads. Type III receptors have been found in collateral ligaments of the joints of the extremities. Morphologically similar to Golgi tendon organ. These dynamic receptors have a high threshold to stimulation and are slowly adating. Type IV receptors possess free nerve ending that have been found in joint capsule and fat pads. They are not normally active, but respond to extreme mechanical deformation of the joint as well as to direct chemical or mechanical irritation. Small amplitude oscillatory and distraction movements(joint mobilization) techniques are used to stimulate the mechanoreceptors that may inhibit the transmission of nociceptors stimuli at the spinal cord or brain stem levels.

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A CASE OF CORENELIA DE LANGE SYNDROME WITH MENTAL RETARDATION AND AUTISTIC DISORDER (정신지체와 자폐장애를 보이는 Cornelia De Lange 증후군 1예)

  • Kim, Se-Joo;Choi, Nak-Kyoung;Song, Jung-Eun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.123-127
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    • 2003
  • Cornelia de Lange syndrome is a dysmorphogenic disorder characterized by multiple congenital abnormalities, mental retardation, growth retardation and neurodevelopmental abnormalities. Diagnosis for the Cornelia de Lange syndrome is dependent on the clinical observation because neither definite biological marker nor definite chromosomal abnormality have been investigated. Clinical observation is important for the diagnosis, so we report a case of Corenelia de Lange syndrome with mental retardation and autistic disorder. The patient is a 6-year old girl. Her motor development and language development have been delayed. She could say no meaningful word and understood simple command partially. She showed poor eye contact and poor emotional interaction. Social interaction was impaired and she Showed stereotypic behaviors. Thus we diagnosed her as mental retardation with autistic disorder. She had vesicoureteral reflux, frequent upper respiratory infection and pneumonia. She had experienced febrile convulsions 4 times. She had short stature, confluent eyebrows, long eyelashes, and upturned nose with anteverted nostrils. She also showed low hairline and hypertrichosis in body and extremities. Her finger was short. In this case, we diagnosed Cornelia de Lange syndrome by her characteristic face, hypertrichosis and medical and behavioral problems that were frequently showed in this syndrome.

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The Comparison of Sleep Characteristics According to the Sleep Positions in Healthy Newborns (정상 신생아의 체위에 따른 수면양상 및 행동변화 비교)

  • Lee Ae Ran;Ahn Hae Young;Lee Jong Soon
    • Child Health Nursing Research
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    • v.5 no.3
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    • pp.281-291
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    • 1999
  • The purpose of this study was to compare the sleep characteristics between the prone and the supine position in healthy newborns. The 48 newborns were observed in the prone position and the supine position respectively on the 2nd day after birth. The data were collected from January to May, 1999. The state of a newborn was classified and categorized to 6 states (deep sleep. light sleep, drowsy, quiet alert, active alert, crying) by Barnard. The movements of eyes, face and extremities, pulse and arterial oxygen were observed and recorded continuously from the start of sleep after feeding until the time of being woken for the next feeding by a trained nurse The data was analyzed by using paired t-test. The results of this study were as follows; 1. There was no significant difference in the length of sleeping time between the prone and the supine position. 2. There was no significant difference in the length and frequencies of each states(deep sleep, light sleep, drowsy, quiet alert, active alert, crying) between the prone and the supine position But the frequency of light sleep in the supine position was significantly higher than that of the prone position. 3 There was no significant difference In the numbers or eyes movements between the prone and the supine sleep position. But the amount of facial and extremity movement in the supine position was significantly higher than those in the prone position 4. There was no significant difference in the arterial oxygen content between the prone and the supine sleep position. 5. There was no significant difference in the heart rates between the prone and the supine sleep position. The above results indicated that the newborns in the prone Position moved less and slept deeper than those in the supine position. though there was no difference in the length of sleep or arterial oxygen content between the prone and the supine sleep Position. But. Nurses and mothers should consider the relationship between the sleep Position and SIDS suggested by previous researches. The infant's 'awakening' during sleep is a normal process and rather valuable because it can provide an opportunity to promote a stronger relationship between mother and baby. So, It is suggested that the supine sleep position is better than the prone sleep position for infants.

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Resection and Reconstruction for Liposarcoma Involving Popliteal Fossa and Antero-lateral Compartment of Lower Leg - A Case Report - (하퇴 슬와부 및 전외측 구획을 침범한 지방육종 환자의 절제 및 재건술 - 증례보고 -)

  • Won, Ho-Hyun;Hong, Youn-Seok;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.69-74
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    • 2009
  • Soft tissue sarcomas of popliteal fossa are rare, accounting for less than 5% of all soft tissue sarcomas of the extremities. In an extracompartmental space such as the popliteal, cubital fossa and inguinal space, where major vessels and nerves traverse, performing resections with wide margin is difficult and sometimes marginal margin is inevitable for limb salvage. For popliteal tumor resection, posterior approach would be a classic method. For tumors with small size and not adherent to surrounding structures, tumor is easily resected by this approach and dissection of nerve sheath or adventitia of vessel. On the contrary, tumors of large size and infiltrating the posterior structure of knee joint may show difficulty in en-bloc resection itself. These cases were candidates for amputation. Furthermore, tumors involving both popliteal fossa and anterior compartment usually had no choice but to have an amputation to prevent local recurrence. We regarded soft tissue sarcoma showing this kind of presentation as bone tumor having extraosseous mass. We performed wide en-bloc resection of proximal tibia and fibula along with sarcoma involving both compartment on liposarcoma of 47-year old man.

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Epidemiological and Lumbar x-ray Studies on the Low Back Pain of the Workers in an Automobile Industry (자동차 제조업체 근로자들의 요통에 대한 역학적 요추 x-선학적 고찰)

  • Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.319-334
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    • 1995
  • To investigate the risk factors of low back pain, an epidemiological study was carried out among male workers aged 20-55 employed in an automobile industry in Korea during the time period from February 1993 to October 1995. Workers participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionnaires. General characteristics, medical history, work related factors, fatigue, and MMPI were compared between two groups. To clarify the relationship between job related low back pain and radiologic features of lumbar spine, radiographic study was carried out. The resultant data were processed for $x^2-test$, t-test, and stepwise logistic regression to confirm the adjusted odds ratios. The results were as follows: 1. History of back disease, lifting and carrying work, excessive physical fatigue, and weakend back strength of individual workers were directly associated with low back pain. Odd ratios of these 4 risk factors of low back pain were 5.07, 3.34, 1.49, and 1.22 respectively. 2. The frequency of low back pain history was significantly higher in LBP group. 3. Back muscle strength of lumbar spine of LBP group were significantly lower than control group. 4. The workers in LBP group revealed high fatigue symptoms. 5. In MMPI test LBP group showed higher scales in hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania. 6. LBP group were more frequently involved in lifting and carrying, working in awkward position, bending, twisting and using lower extremities. 7. LBP group were exposed more to vibration during working. 8. In the Analysis of radiographs of lumbar spine, Jacob's line not crossing fourth lumhar disc space, transitional vertebrae and lumbar displacement more than 4.4mm in standing lateral view were more frequently observed in LBP group than control group. Through these results, it is concluded that identification of previous history of back problem, change of work or working environment for workers with previous back problem and measures to relieve both physical and psychological fatigue of the workers are required for optimal management of work-related back problems among workers. In the present study, several results were different from the previous reports: Jacob's line not corssing fourth lumbar disc space, lumbarization, and vertebral slipping (spondylolisthesis) more than 4.4mm are related to backache. Meticulous studies are required to elucidate the difference.

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