• 대한통합의학회지
• /
• 제8권4호
• /
• pp.183-190
• /
• 2020

Purpose : The purpose of this study was to investigate the effect of increased gait function enhancement exercise in three adolescent convulsive cerebral palsy sinuses on children's large movement function, balance and gait function, self-efficacy, and guardian attitude. Methods : The purpose of this study was to conduct a program to strengthen trunk muscles and strengthen walking ability 5 times a week for 8 weeks in 3 children with convulsive cerebral palsy in adolescence. The main reinforcement of the program was 20 minutes of muscle strength and 20 minutes of walking on a treadmill five times a week. Exercises were focused on the reinforcement of the flexor muscles of the proprioceptive neuromuscular promotion (PNF) and the extension of the legs in the bridge posture exercise and squat movements. Results : The results of GMFM-88 to determine the effects of this functional enhancement program on the body of children with convulsive cerebral palsy, and PBS & TUG to determine the effects of balance and gait ability were improved. In addition, parenting attitudes of guardians, self-efficacy of children, and self-efficacy of parents increased positively due to mental consequences. Conclusion : The results of GMFM-88 to determine the effects of this functional enhancement program on the body of children with convulsive cerebral palsy, and PBS & TUG to determine the effects of balance and gait ability were improved. In addition, parenting attitudes of guardians, self-efficacy of children, and self-efficacy of parents increased positively due to mental consequences.

• Archives of Plastic Surgery
• /
• 제49권4호
• /
• pp.531-537
• /
• 2022

Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.

• Journal of Trauma and Injury
• /
• 제35권3호
• /
• pp.209-214
• /
• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• 한국전문물리치료학회지
• /
• 제29권2호
• /
• pp.124-130
• /
• 2022

Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21-24 and seven older women aged 60-63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

• 대한두개안면성형외과학회지
• /
• 제24권3호
• /
• pp.105-110
• /
• 2023

Background: Conventional radial forearm free flaps (RFFFs) are known to be safe, but can result in donor site complications. Based on our experiences with suprafascial and subfascial RFFFs, we evaluated the safety of flap survival and surgical outcomes. Methods: This was a retrospective study of head and neck reconstructions using RFFFs from 2006 to 2021. Thirty-two patients underwent procedures using either subfascial (group A) or suprafascial (group B) dissection for flap elevation. Data were collected on patient characteristics, flap size, and donor and recipient complications, and the two groups were compared. Results: Thirteen of the 32 patients were in group A and 19 were in group B. Group A included 10 men and three women, with a mean age of 56.15 years, and group B included 16 men and three women, with a mean age of 59.11 years. The mean defect areas were 42.83 cm² and 33.32 cm², and the mean flap sizes were 50.96 cm² and 44.54 cm² in groups A and B, respectively. There were 13 donor site complications: eight (61.5%) in group A and five (26.3%) in group B. Flexor tendon exposure occurred in three patients in group A and in none in group B. All flaps survived completely. A recipient site complication occurred in two patients (15.4%) in group A and three patients (15.8%) in group B. Conclusions: Complications and flap survival were similar between the two groups. However, tendon exposure at the donor site was less prevalent in the suprafascial group, and the treatment period was shorter. Based on our data, suprafascial RFFF is a reliable and safe procedure for reconstruction of the head and neck.

• 한국임상수의학회지
• /
• 제40권3호
• /
• pp.215-220
• /
• 2023

A 3-month-old Korean native cattle (Hanwoo) calf with difficulty taking normal posture and an inability to rise was referred for a definite diagnosis and active treatment, including surgery. The calf had a history of an accident in which both hind limbs were trapped in a barn structure. After admission, a "rabbit leg" posture was observed, a typical sign of gastrocnemius muscle rupture, and both digits were knuckled downward like they were trying to grip the ground. This was considered to be a result of the superficial digital flexor not rupturing but only the gastrocnemius muscle rupturing. Physical examination revealed laceration of the metatarsus and firmness behind both stifle joints which were presumed to be the sites of gastrocnemius muscle rupture. Skeletal abnormalities, including fractures, were ruled out by radiography. Based on these findings, the patient was diagnosed with bilateral gastrocnemius muscle rupture, and surgery was performed to reconnect the head of the ruptured muscle. Because the rupture occurred perpendicular to the muscle direction, the locking loop technique, a method of suturing severed tendons, was used to reduce the tension. After surgery, the cast was used to prevent further injuries and promote voluntary rehabilitation. Follow-up was completed, with the calf showing normal posture and gait 112 days after surgery. This is the first case report in the Republic of Korea describing the successful diagnosis and treatment of bilateral gastrocnemius muscle rupture in a calf.

• 운동영양학회지
• /
• 제17권2호
• /
• pp.25-34
• /
• 2013

This study was conducted to investigate the relationship between ACE gene polymorphism and muscle damage parameters after eccentric exercise. 80 collegiate males were instructed to take an eccentric exercise with the elbow flexor muscle through the modified preacher curl machine for 2 sets of 25 cycles (total 50 cycles). The maximal isometric strength, muscle soreness, creatine kinase (CK), and myoglobin (Mb) were measured before exercise, and 0, 24, 48, 72, and 96 hrs after exercise. The result showed that after the eccentric exercise, the maximal isometric strength significantly decreased by more than 50% (p < 0.001) and the muscle soreness, CK, and Mb significantly increased compared to those before the exercise (p < 0.001). The ACE gene polymorphism of the subjects was classified using real-time polymerase chain reaction (real-time PCR). The result showed that it consisted of 38 cases of type II (46.4%), 33 cases of type ID (43.4%), and 9 cases of type DD (10.2%). The Hardy-Weinberg equilibrium for ACE gene polymorphism was shown to have p = 0.653, which showed that each allele was evenly distributed. Although significant differences in the changes in the maximal isometric strength, muscle soreness, CK, and Mb were found according to time course (p < 0.001), no significant differences in the changes in the maximal isometric strength, muscle soreness, CK, and Mb were found according to ACE gene polymorphism. Furthermore, no significant difference in the changes in the muscle damage parameters was found according to interaction between ACE gene polymorphism and time course (p > 0.05). In conclusion, the level of the muscle damage parameters changed in the injured muscle after eccentric exercise, but these changes in the muscle damage parameters were not affected by ACE gene polymorphism. The result of this study indicates that ACE gene is not a candidate gene that explains muscle damage.

• 대한영상의학회지
• /
• 제82권1호
• /
• pp.194-200
• /
• 2021

신경초종은 슈반세포에서 기원하는 양성 종양이며 말초신경집에서 생기는 가장 흔한 종양이다. 신경초종은 신체 어디에서나 발견될 수 있으나, 보통 머리와 목, 그리고 사지의 굽힘 면에서 흔하게 보일 수 있는 종양이다. 췌장은 신경초종이 드물게 생기는 위치이며 적은 수의 증례가 보고되었다. 보고된 신경초종 증례의 약 3분의 2 정도에서 낭성변화를 동반한다. 따라서 적절한 진단과 치료를 위해서는 췌장에서 발견되는 낭성변화를 동반한 고형 종양의 경우 신경초종이 감별진단에 포함되어야 한다. 이에 저자들은 병리학적으로 진단된 낭성변화를 동반한 췌장의 신경초종을 문헌고찰과 함께 보고하고자 한다.

• 대한영상의학회지
• /
• 제82권1호
• /
• pp.250-254
• /
• 2021

건활막거대세포종은 이전에 색소성융모결절성 활막염으로 불리던 질환으로, 활막, 점액낭, 힘줄 등에 생기는 드문 양성 종양이다. 미만형의 건활막거대세포종은 국소형에 비해 드물고 그중에서도 관절 외에 발생하는 것은 더 드물다. 또한 대부분은 하나의 관절을 침범하기 때문에 양측을 대칭적으로 침범한 것도 매우 드물다. 이에 저자들은 64세 여자 환자에서 양측 손목의 신전건과 굴곡건을 모두 침범한 관절 외 미만형의 건활막거대세포종의 증례에 대해 초음파와 자기공명영상검사 소견을 중심으로 보고하고자 한다.

• 대한영상의학회지
• /
• 제82권6호
• /
• pp.1600-1605
• /
• 2021

힘줄의 섬유종은 천천히 자라는 양성 종양이다. 드물지만, 상지에 생길 수 있고 특히 손가락 굽힘 힘줄에 잘 생긴다. 섬유종은 대부분 경계가 좋은 원형 혹은 타원형의 종괴로 보이며, 풍부한 섬유조직에 의해 자기공명영상의 모든 영상에서 어둡게 보이는 것이 특징이다. 대부분의 섬유종은 무증상의 종괴로서 나타나지만, 드물게 증상을 야기하기도 한다. 우리는 손목의 반복적인 움직임에 의해 손목터널증후군을 유발하는 힘줄의 섬유종과, 그와 관련된 영상 소견에 대해 보고하고자 한다.