• Archives of Plastic Surgery
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• 제42권3호
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• pp.295-301
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• 2015

Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.139-148
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• 1999

Since Nakayama's first report about venous flap, many experimental and clinical studies were done about this new type of flap. And due to its various benefits, its applications as arterialized venous free flap type have increased recently. In this study we have attempted to reconstruct composite of defects of the hand with new modification of arterialized venous free flap and simultaneous reconstruction of skin, nerve, tendon were performed successfully. From 1994 to 1999, the defects of the hands in 35 patients were reconstructed with various modifications of arterialized venous free flaps. The range of age was from 19 to 55 years and size of flap ranged from $1{\times}2cm\;to\;14{\times}9cm$. Among them, 12 cases of flap over 20cm in size were included. Indications of flaps were as follows: resurfacing of the defects of the skin (9 cases), simultaneous reconstruction of extensor, skin and digital nerve(2 cases), reconstruction of the skin with extensor(5 cases), as a flap-through type vascular reconstruction(6 cases), for digital nerve reconstruction(2 cases), contracture release(3 cases), and finger tip reconstruction(9 cases). All of the cases except one survived with marginal skin necrosis less than 10%. And relatively large flaps over 20cm in size successfully survived without any delay procedures. Composite reconstructions including tendon and nerve were successful with new modifications of this flap. Arterialized venous free flap is one of the useful procedure in reconstruction of the hand because it has many advantages such as non-bulky and good quality of flap, variable length of pedicle, preservation of major vascular pedicle, less operation time, single operative field and in addition possibility of various modifications.

• 한국전문물리치료학회지
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• 제13권4호
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• pp.23-29
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• 2006

The purpose of the present study was to examine gaze effects on spatial and kinematic characteristics during a pointing task. Subjects were asked to watch and point to an aimed target (2 mm in diameter) displayed on a vertically mounted board. Four gaze conditions were developed as combinations of "seeing-aiming" in terms of the eye movements: Focal-Focal (F-F), Focal-Fixing (F-X), Fixing-Focal (X-F), and Fixing-Fixing (X-X). Both the home target and an aimed target were presented for 1 second and then were disappeared in F-F and X-F. In X-F and X-X, only an aimed target disappeared after 1 second. Subjects were asked to point (with index finger tip) to an aimed target accurately as soon as the aimed target was removed. A significant main effect of gaze was found (p<.01) for normalized movement time. Peripheral retina targets had significantly larger absolute error compared to central retina targets on the x (medio-lateral) and z (superior-inferior) axes (p<.01). A significant undershooting to peripheral retina targets on the x axis was found (p<.01). F-F and X-F had larger peak velocities compared to F-X and X-X (p<.01). F-F and X-F were characterized by more time spent in the deceleration phase compared to F-X and X-X (p<.01). The present study demonstrates that central vision utilizes a form of on-line visual processing to reach to an object, and thus increases spatial accuracy. However, peripheral vision utilizes a relatively off-line visual processing with a dependency on proprioceptive information.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.9-19
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• 1993

The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).

• 센서학회지
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• 제15권4호
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• pp.277-283
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• 2006

We presented that fabrication process and characteristics of 3 axes flexible tactile sensor available for normal and shear force fabricated using Si micromachining and packaging technologies. The fabrication processes for 3 axes flexible tactile sensor were classified in the fabrication of sensor chips and their packaging on the flexible PCB. The variation rate of resistance was about 2.1 %/N and 0.5 %/N in applying normal and shear force, respectively. The flexibility of fabricated 3 axes flexible tactile sensor array was good enough to place on the finger-tip.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.642-648
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• 2011

Purpose: The recent advances in microsurgical techniques and their refinement over the past decade have greatly expanded the indications for digital replantations and have enabled us to salvage severed fingers more often. Many studies have reported greater than 80% viability rates in replantation surgery with functional results. However, replantation of multi-level amputations still remain a challenging problem and the decision of whether or not to replant an amputated part is difficult even for an experienced reconstructive surgeon because the ultimate functional result is unpredictable. Methods: Between January of 2002 and May of 2008, we treated 10 multi-level amputated digits of 7 patients. After brachial plexus block, meticulous replantation procedure was performed under microscopic magnification. Postoperatively, hand elevation, heat lamp, drug therapy and hyperbaric oxygen therapy were applied with careful observation of digital circulation. Early rehabilitation protocol was performed for functional improvement. Results: Among the 19 amputated segments of 10 digits, 16 segments survived completely without any complications. Overall survival rate was 84%. Complete necrosis of one finger tip segment and partial necrosis of two distal amputated segments developed and subsequent surgical interventions such as groin flap, local advancement flap and skin graft were performed. The overall result was functionally and aesthetically satisfactory. Conclusion: We experienced successful replantations of multi-level amputated digits. When we encounter a multi-level amputation, the key question is whether or not it is a contraindication to replantation. Despite the demand for skillful microsurgical technique and longer operative time, the authors' results prove it is worth attempting replantations in multi-level amputation because of the superiority in aesthetic and functional results.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.62-68
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• 2018

Background Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Methods Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated $90^{\circ}$ cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. Results The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. Conclusions While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

• 한국생활환경학회지
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• 제16권2호
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• pp.89-100
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• 2009

본 연구는 최대하 부하 트래드밀 운동과 간헐적 부위별 인체 냉각 시 심부와 말초 부위의 동적 체온조절을 관찰하기 위해 고안되었다. 이를 위해 총 다섯명의 남자 피험자가 세 가지 실험 조건, 머리와 손 냉각 조건(HH cooling), 다리 냉각 조건(Leg Cooling), 냉각하지 않는 대조군(Control)에 참여하였고, 모든 실험은 기온 24±1℃와 습도 50±5%RH로 유지되는 인공기후실에서 수행되었다. 피험자들은80%HR_max의 트래드밀 운동과 이어지는 회복 스케쥴을 두 번 반복하였고, 인체 부위별 냉각은 15℃의 물이 순환하는 액체 냉각모자, 장갑, 다리를 덮는 형태의 담요를 이용하여 회복 시에만 적용되었다. 본 연구 결과, (1) 직장온도(T_re)는 세 조건 간에 유의한 차이를 보이지 않았다; (2) 피부온도는 부위별로 특징되어지는 다양한 체온조절 현상을 보였다. 특히, 운동의 시작 시점에서 보이는 피부온도의 초기 하강은 주로 가슴, 넓적다리, 종아리, 손가락 피부 온도에서 관찰되었으며, 이 중 손가락 온도(T_fing)에서의 초기 하강 현상은 매우 현저했다. (3) 피부 온도가 초기 하강을 보이는 동안 T_re는 점점 증가했다. (4) 두 번째 운동 시작 시 T_fing에서의 초기 하강 규모는 Control 조건에서 평균 4.8℃, HH cooling 조건에서는 5.1℃, Leg cooling 조건에서는 3.4℃로, 통계적으로 유의한 차이를 보였다(p<0.05). 초기 하강 현상을 보인 시간은 Control 조건에서 평균 8.1분으로 HH cooling 조건에서는 7.9분, Leg cooling 조건에서는 6.3분보다 길었으나 통계적 차이는 발견되지 않았다. 결론적으로, 트래드밀 운동의 개시기에 관찰된 피부온도 하강 현상은 인체 심부의 온열 상태의 진행과는 반대되므로, 비 온열적 요인을 반영한다. 특히, T_fing에서 초기 하강의 규모는 인체 부위별 냉각에 의해 영향을 받았다. 따라서, 말초 부위의 피부온도 하강 현상은 운동 중 피부면의 온열 상태 예측 시 주의깊게 고려되어져야 한다.

• 대한물리치료과학회지
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• 제16권3호
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• pp.19-27
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• 2009

Background: To study the effect of the home exercise program on pain, flexibility, endurance of extensor in chronic back pain patients, and suggest optimal method for home exercise program. Methods: I divided into two groups who has chronic back pain; one is control group who was given a treatment at the hospital only and the other is experimental group who did another exercise after treatment at the hospital, and there were 10 people in each group. The manual therapy were given to all the patients in each group after applying a stupe and an electric treatment, but the experimental group conducted another exercise program at homes. All the exercise programs were applied to patients 12 times for 4 weeks totally. Result: SPSS for win version 12 was used for statistic analysis and independent t-test was used to find changes between two groups. VAS scale was used to show changes in pain between each group. The grade of pain was decreased between pre&post test to -5.60 in control group and -4.80 in experimental group but there wasn't significant difference between each group. Finger tip-to-floor test was used for the flexibility changes and it was increased between pre&post test in both groups but the change of flexibility between each groups didn't show statistical difference. Biering-Sorensen test was used to measure the endurance of extensor and it was increased between pre&post test in both groups but there wasn't significant difference between each group. Conclusion: As you read the results above, for a chronic low back pain patient, application of the manual therapy showed that it has effect on decrease of low back pain, increase of flexibility and endurance of extensor. However, the effect of home exercise treatment was not sure about improvements for chronic low back pain patient. So I think there should need further study about the effect of home exercise treatment except the treatments at hospital and the thorough education for the exercise of lumbar should be done before the study for the accurate experiment.

• Journal of Nutrition and Health
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• 제5권4호
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• pp.151-159
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• 1972

Protein malnutrition of children is one of the most serious nutritional deficiencies in developing country. Urea nitrogen excretion in ureotelic animals is the function most sensitive to dietary protein. The 24 hours excretion of creatinine in the urine of a given subject is remarkably constant from day to day. The creatinine excretion of different individuals of the same age and sex is also quite constant. Low ratios of urinary urea to creatinine are found children low protein intake. The foregiving world-wide investigations indicate that the urea nitrogen/creatinine ratios seems to be a good biochemical indicator to distinguish among group with different levels of protein intake. The purpose of this study is to evluate an indicator of protein intake on the elementary school children ranged from 6 to 8 years of age living in rural and urban areas. Each child measured for height and weight of body. weight measured by means of a plate from scale and height by a vertical measuring rod. Biochemical test were taken from a finger-tip and urine. Hemoglobin level in the blood was measured by cyanomethemoglobin method. From the urine samples, urea nitrogen and urea creatinie were determined by Folin-Wu method and: calculate the ratio. The following result were obtained: 1) Mean of the body weight and height in urban children(Seoul) was higher and heavier than rural children(Kyunggi, Kangwon). And 12% of boys, 18% of girls in Kyunggi and 25% of boys, 22% of girls in Kangwon area weight less than 80% of Korean Physical Standard weight level. 2) The mean hemoglobin values of boys and girls in Seoul are children were 13. 3g/100ml, 13.1g/100ml and the mean of hemoglobin values in Kyunggi 12.9g/100ml of boys, 12.4g/100ml of girls, and 12.4g/100ml of boys, 12.9g/100ml of girls in Kangwon children. It is found that 22% to 24% children inrural area (Kyunggi, Kangwon) had hemoglobin level less than 12g/100ml which means anemia. 3) The mean of hematocrit level of Seoul, boys and girls children were 33.5%, 34.1% and 33.4%, 33.1%, in Kyunggi area and 33.1%, 32.9% in Kangwon area. 4) Urea nitrogen/creatinine ratios in Seoul children were 9. 0, 10. 0 of boys and girls, the ratio were 8.2, 8.0 in Kyunggi boys and girls children, and 7.5 and 7.4 in Kangwon boys, girls children. Low-income rural and upper-income urban background large differences between two groups in the urea nitrogen/creatinine ratio(Seoul: Kangwon in male, female children. p<0.05, p<0.001). The urea nitrogen/creatinine ratio definetly seems to be a good indicator of the quantity of the protein intake. However, whether or not it is an indicator of the quality of the ingested protein ramains to be seen.