• 제목/요약/키워드: Foot type

검색결과 541건 처리시간 0.026초

Differential Subsampling with Cartesian Ordering Contrast-Enhanced Magnetic Resonance Angiography for the Preoperative Assessment of Anterolateral Thigh Flap

  • Yunfeng Shen;Xiucun Li;Chao Zhang;Hai Zhong;Weiqiang Dou
    • Korean Journal of Radiology
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    • 제23권8호
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    • pp.803-810
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    • 2022
  • Objective: To investigate the clinical application of differential subsampling with Cartesian ordering (DISCO) contrast-enhanced (CE) magnetic resonance angiography for anterolateral thigh (ALT) flap transplantation, using operative findings as a reference. Materials and Methods: Thirty patients (21 males and nine females; mean age ± standard deviation, 45.5 ± 15.6 years) who were scheduled to undergo reconstruction with ALT flaps between June 2020 and June 2021 were included in the prospective study. Before ALT flap transplantation, patients were scanned using CE-DISCO imaging. All acquired DISCO images of the 60 lower limbs (both sides from each patient) were analyzed using maximum intensity projection and volume rendering methods. Two experienced radiologists were employed to examine the patterns of the lateral circumflex femoral artery (LCFA), its branches, and perforators and their skin termini, which were compared with the operative findings. Results: Using CE-DISCO, the patterns of the LCFA and its branches were clearly identified in all patients. Four different origins of the LCFA were found among the 60 blood vessels: type I (44/60, 73.3%), type II (6/60, 10.0%), type III (8/60, 13.3%), and type IV (2/60, 3.3%). Owing to a lack of perforators entering the skin, two patients did not undergo ALT flap transplantation. For the remaining 28 patients, the ALT flaps in 26 patients were successfully operated without flap reselection during the operation, while the remaining two patients underwent other surgical procedures due to the thin diameter of the perforator or injury of the perforator during the operation. The success rate of flap transplantation was 92.8% (26/28). All transplanted flaps exhibited good blood supply and achieved primary healing without infection or delayed healing. Conclusion: CE-DISCO imaging can be an effective method for preoperative perforator imaging before ALT flap transplantation.

해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료 (Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture)

  • 정형진
    • 대한족부족관절학회지
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    • 제17권2호
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

급성 전방십자인대 손상 시 자기공명영상에서 나타나는 골멍과 전방십자인대 손상 정도의 관계 (The Relationship between Bone Bruise in MR-Imaging and the Degrees of Acute Anterior Cruciate Ligament Injury)

  • 정화재;신헌규;고천석;김장환
    • 대한관절경학회지
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    • 제16권1호
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    • pp.17-25
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    • 2012
  • 목적: 급성 전방십자인대 손상 환자의 자기공명영상(magnetic resonance imaging, MRI)에서 나타난 골멍의 형태 및 크기와 전방십자인대의 손상 정도와의 관계를 알아보고 골멍의 발자취(footprint)를 조사해 손상기전을 알아보고자 하였다. 대상 및 방법: 급성 전방십자인대 손상 6주 이내의 급성기에 자기공명영상을 촬영하여 골멍이 나타나는 65명을 대상으로 하였다. 골멍의 형태는 Costa-Paz 분류에 따라, 골멍의 크기는 Kornaat의 방식으로 측정하였다. 자기공명영상의 전방십자인대 관상사면영상(anterior cruciate ligament [ACL] oblique coronal view)에서 손상 정도를 등급화 하였다. 결과: Costa-Paz 분류에 따른 대퇴골 외과의 골멍 형태와 전방십자인대 손상 정도의 관계를 알아본 결과, 부분 파열군(1, 2 등급)에서 제2형이 많고, 완전 파열군(3 등급)에서 제3형이 많았다(P=0.037). Kornaat 총 골멍 점수는 전방십자인대 손상 등급에 따라 차이를 보였으며(P=0.014), 손상기전은 축회전 손상(pivot shift injury)이 가장 많았고 편타 외반 손상 (clip valgus injury) 등이 뒤를 이었다. 결론: 급성 전방십자인대 손상 시 골멍의 형태와 크기는 전방십자인대의 손상 정도와 관련이 있었고, 골멍의 발자취를 통해 손상기전을 유추할 수 있어 급성 전방십자인대 손상의 진단 및 치료에 도움이 되리라 사료된다.

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양측 종골 골절 환자의 치료 후 임상적 및 방사선학적 결과 (Clinical and Radiological Results of Treatment in Bilateral Calcaneal Fracture)

  • 이정길;김갑래;현윤석;구본재;이효범;이재희
    • 대한족부족관절학회지
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    • 제16권4호
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    • pp.229-234
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    • 2012
  • Purpose: The purpose of this study is to find out clinical and radiological outcomes in 70 patients of both calcaneal fracture. Materials and Methods: From March 1993 to March 2011, 70 patients underwent non-operative management or operative management at our hospital. Conservative management was performed in 15 cases of undisplaced fracture (Group A). Operative management was performed in 125 cases including 32 cases of undisplaced fracture (Group B), 60 cases of joint depression type fracture (Group C), 33 cases of tongue type fracture (Group D). Results were evaluated by VAS score, AOFAS score, circle draw test, Bohler angle (BA), Gissane angle, width & height of calcaneus. Results: VAS scores were 2.0 in group A, 2.0 in group B, 2.2 in group C, 2.7 in group D. AOFAS scores were 90.4 in group A, 91.9 in group B, 72.2 in group C, 79.2 in group D. Circle draw tests were 8.4 cm in group A, 10.1 cm in group B, 7.6 cm in group C, 7.9 cm in group D. Bohler angles (BA) and Gissane angles were $19.1^{\circ}$, $96.7^{\circ}$ in group A, $21.8^{\circ}$, $119.1^{\circ}$ in group B, $26.3^{\circ}$, $121.2^{\circ}$ in group C, $19.7^{\circ}$, $119.7^{\circ}$ in group D. Calcaneal widths and heights were 39.5 mm, 31.6 mm in group A, 32.7 mm, 37.0 mm in group B, 34.4 mm, 39.2 mm in group C, 35.2 mm, 38.7 mm in group D. Conclusion: The main cause of bilateral calcaneal fracture is an injury from a fall, and the cases were more frequently occurred in men than women. Also the fracture in the right side tend to occur more severely compared to the left side. The surgical treatment shows better results than conservative treatment in bilateral calcaneal fracture.

제2형 당뇨병 노인의 성격유형과 당뇨병 관련 스트레스에 따른 당뇨병 자기관리 행위 (Diabetes Self-management According to the DISC Personality Type and Diabetes-related Distress in Older Adults with Type 2 Diabetes)

  • 이수진;송미순
    • 한국노년학
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    • 제34권2호
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    • pp.229-246
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    • 2014
  • 본 연구는 지역사회 내 제2형 당뇨병 노인을 대상으로 성격유형과 당뇨병 관련 스트레스에 따른 당뇨병 자기관리 행위 간의 관계를 규명하는데 목적을 두고 시행되었다. 본 연구는 서술적 조사연구로 노인복지관을 이용하는 65세 이상 노인 중 제2형 당뇨병이 있는 180명을 대상으로 실시하였다. 연구 결과, 일반적 특성과 질병 관련 특성에 따라 당뇨병 자기관리 행위의 차이가 있는 것으로 나타났다. 그리고 대상자 성격유형에 따라 당뇨병 자기관리 행위에는 유의한 차이가 있었고(p<.001), 주도형이 안정형과 신중형보다 자기관리 행위 이행수준이 낮았다. 특히, 자기관리 행위 하위영역 중 발 관리 영역에서 성격유형별 차이가 있었는데(p<.001), 주도형이 안정형과 신중형보다 유의하게 낮았다. 그리고 주도형 성격유형, 경구 혈당강하제를 투약하는 경우, 음주를 하는 경우가 당뇨병 자기관리 행위에 영향을 미치는 주요변수로 나타났다(수정된 R2=16%). 따라서 제2형 당뇨병 노인을 대상으로 하는 자기관리 교육 중재 시 성격유형, 경구 혈당강하제 투약 여부, 음주 여부가 고려되어야 하고, 자기관리 행위 이행이 상대적으로 낮은 주도형 성향을 가지고, 경구 혈당강하제 투약을 하며, 음주를 하는 당뇨병 노인을 위한 효과적인 교육중재 프로그램 개발이 필요하다.

Application of a paste-type acellular dermal matrix for coverage of chronic ulcerative wounds

  • Jeon, Minseok;Kim, So Young
    • Archives of Plastic Surgery
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    • 제45권6호
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    • pp.564-571
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    • 2018
  • Background Chronic wounds occur due to failure of the normal healing process, associated with a lack of deposition of cellular components and a suitable microenvironment such as the extracellular matrix (ECM). Acellular dermal matrix (ADM) is viewed as an ECM substitute, and a paste-type ADM has recently been introduced. We hypothesized that CGPaste, an injectable paste-type ADM, could serve as a scaffold and promote wound healing. Methods We retrospectively studied seven patients in whom CGPaste was applied between 2017 and 2018, who had pressure ulcers, necrotizing fasciitis, diabetic foot ulcers, traumatic defects, and osteomyelitis. The goal of applying CGPaste was to achieve complete wound healing with re-epithelialization or growth of granulation tissue, depending upon the wound bed status. CGPaste was injected based on the wound size along with the application of a dressing. Results Four of the seven patients showed granulation tissue on their wound bed, while the other three patients had a bony wound bed. The mean wound area was $453.57mm^2$ and the depth was 10.71 mm. Wound healing occurred in five of the seven patients (71.43%). The mean duration of complete healing was 2.4 weeks. Two patients showed failure due to paste absorption (29.57%); these patients had wound beds comprising bone with relatively large and deep wounds ($40{\times}30$ and $30{\times}20mm^2$ in area and 15 and 10 mm in depth). Conclusions CGPaste is an effective option for coverage of small and deep chronic wounds for which a flap operation or skin grafting is unfeasible.

건강한 성인의 슬개건 반사 시 무릎 감쇠효과를 고려한 대퇴사두근의 근력 및 근활성도 예측 (Identification of Muscle Forces and Activation of Quadriceps Femoris Muscles of Healthy Adults Considering Knee Damping Effects during Patellar Tendon Reflex)

  • 강문정;조영남;유홍희
    • 대한기계학회논문집B
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    • 제38권1호
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    • pp.57-62
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    • 2014
  • 인체 해석모델은 주로 인간이 의식적으로 행하는 운동을 중심으로 발전해 왔다. 의식적 운동과 달리 슬개건 반사는 뇌를 거치지 않고 일어난다. 본 연구는 건강한 성인의 슬개건 반사로 인한 대퇴부의 근력과 근활성도를 해석적으로 예측하고자 하였다. 해석 모델은 시상면에서 평면운동을 하고, 앉은 자세에서 상체와 허벅지를 고정시켜 종아리만 진자 운동이 가능하도록 모델링 하였다. 무릎은 레볼루트 조인트로 모델링 하였고, 발목관절은 고정시켜 종아리와 발을 하나의 강체로 가정하였다. 근력은 Mamizuka 의 실험 결과로부터 얻은 운동학 정보를 이용하여 역동역학 해석을 통해 구하였으며, 근활성도는 Hill-type 근육 모델을 이용하여 예측하였다. 해석 결과는 실험결과를 통해 검증되었다.

위령선약침이 Collagen, Adjuvant, LPS 및 PLA2 유발 류머티스성 관절염에 미치는 영향 (The Effect of $Clematidis$ Radix Herbal-acupuncture Solution, on Collagen, Adjuvant, Lipopolysaccharide and Phospholipase $A_2$ Induced Rheumatoid Arthritis in Mice)

  • 이진석;김경호;이승덕;김갑성
    • Journal of Acupuncture Research
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    • 제29권1호
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    • pp.127-137
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    • 2012
  • Objectives : The purpose of this study is to investigate the effect of $Clematidis$ radix herbal-acupuncture solution, on collagen, adjuvant, lipopolysaccharide and phospholipase A2 induced rheumatoid arthritis in mice. Methods : Arthritis index was measured for mouse that was injected subcutaneously in solution mixed chicken type II collagen with Freund's complete adjuvant. We injected Freund's complete adjuvant into right posterior part of the sole of a ICR mouse foot, which was measured by plethysmometer. The solution mixed $CRHS$ with Tris-HCI, $CaCl_2$, substrate, enzyme was done a chemical action for thirty minutes, and then inhibitory activity of PLA2 enzyme was expressed with inhibition percentage by utilizing isolated arachidonic acid. COX-2 was induced by adding LPS to RAW 264.7 cell, and COX-2 activity was measured by western blot analysis and $PGE_2$ Biotrak kit. Results : $CRHS$ also inhibited Freund's complete adjuvant induced chronic rheumatoid arthritis in mice. $CRHS$ showed significant inhibition of type I and type II $PLA_2$ activities in a dose dependent manner. Furthermore, $PGE_2$ production was decreased with $CRHS$ and lipopolysaccharide-induced COX-2 protein expression was significantly inhibited by $CRHS$. Conclusions : These results suggest that $CRHS$ has an therapeutic effect on drug induced-rheumatoic arthritis by inhibiting $PLA_2$ and COX-2 activities.

방풍통성산(防風通聖散)의 문헌(文獻) 및 형상의학적(形象醫學的) 고찰(考察) (Documentational Study and Observation from the View of Hyungsang Medicine on Bangpungtongseong-san)

  • 석민희;김준홍;이용태
    • 동의생리병리학회지
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    • 제22권1호
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    • pp.51-59
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    • 2008
  • The following conclusions were obtained from the studies on Bangpuntongseongsan both from the documents and Hyungsang medicine. Bangpungtongseong-san was created by Yu Wan-so to relieve both interior and exterior of disease from the pathogenic fire, and it cures wind syndrome and dry syndrome. Bangpungtongseong-san is of light herbal combination and it works in the upper part of the body and is mainly applied to skin disease. Perspiration without harming the exterior and purgation without hurting the interior shows that it is not a severe prescription belonging to meditation therapy. It is mostly used for curing the disease of internal heat caused by over drinking and consuming heavy food, and it has special relationship with Yangmyung meridian. It is mentioned in the chapters of spirit, head, face, eye, ear, nose, throat, skin, hair, prescription, wind, dryness, fire, internal damage, epidemic infectious disease, carbuncle and cellulitis, ulceration, and pediatrics of ${\ulcorner}$Donguibogam${\lrcorner}$. It is usually applied to those who belong to Yangmyung type of the six meridian types or wind type, who has excessive heat, people with red complexion, reddened nose, pimples over the face and nose, coarse heel, loss of hair due to wind-heat, and to those who tend to have dandruff. Through examination over the cases treated with Hyungsan medicine, Bangpungtongseong-san was found efficacious in bloodshot eyes, brandy nose, loss of hair, various skin problems, tetanus, acute alcoholism, paralysis of hand and foot, deafness, and tinnitus.

Adjustment of Lactation Number and Stage on Informal Linear Type Traits of Holstein Dairy Cattle

  • Do, Chang-Hee;Jeon, Beong-Soon;Sang, Byung-Chan;Lee, Dong-Hee;Pearson, Ronald E.
    • Journal of Animal Science and Technology
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    • 제52권6호
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    • pp.467-473
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    • 2010
  • A total of 4,323,781 records for informal 16 primary linear descriptive traits of dairy cows in Holstein breed from 1988 to 2007 in USA were analyzed to estimate adjustment factors for lactation number and stage. While all factors in the model were highly significant (P < 0.01), major influences on linear type traits were due to lactation number and stage. The frequencies of lactation number 1 through 6 were 58.6, 22.0, 11.8, 4.8, 2.1, and 0.8%, respectively. Further, the frequencies of lactation stage were 0.7, 76.9, 15.3, 4.9, and 2.1%, respectively, for springing, early, medium, late, and dry. To adjust 16 linear traits (stature, dairy form, strength, body depth, rump width, rump angle, legs rear view, leg set, foot angle, fore udder, rear udder height, rear udder width, udder support, udder depth, and front teat placement), additive and multiplicative adjustment factors of lactation number (lactations 2 to 4) and stage (springing, medium, late and dry) were estimated with the solutions in the generalized linear model, assigning lactation 1 and stage early as base class. Additive adjustment factors of lactation number ranged from -1.23 to 2.908, while multiplicative factors ranged from 0.853 to 2.207. Further, additive and multiplicative adjustment factors for lactation stage ranged from -0.668 to 0.785, and from 0.891 to 1.154. Application of adjustment factors to 20 randomly sampled sub-data sets produced the results that additive adjustment factors for both lactation number and stage reduced more mean square of lactation number and stage over 16 linear traits than any combination of adjustments, and leaded additive adjustment factors for both lactation number and stage as a choice of methods for adjustment of informal 16 primary linear type traits collected by classifiers of AI studs.