• Archives of Plastic Surgery
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• v.38 no.5
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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.

• Journal of Trauma and Injury
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• v.21 no.1
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• pp.1-7
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• 2008

When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor's specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

• The Journal of Internal Korean Medicine
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• v.24 no.2
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• pp.283-289
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• 2003

Background and Purpose : Hemiplegic upper extremity is a problem frequently encountered in the rehabilitation of patients with stroke. In Korean traditional medicine, moxibustion has been used clinically in treatment of stroke patients with hemiplegia. So far, its efficacy has not been proven clinically. The purpose of this study was to evaluate the efficacy of the moxibustion in treating hemiplegic upper extremity in stroke patients. Design : Randomized Control Trial. Subjects and Methods : Forty hemiplegic stroke patients admitted to Kyunghee oriental medicine hospital were randomized into the treatment with standard physiotheraphy combined with Moxibustion-group or Control-group with standard physiotherapy alone. It took them 2-5 weeks from the onset to start this study. Moxibustion was applied at LI4(合谷), LI11(曲池), TE3(中渚), TE5(外關) in hemiplegic hand, once a day for 2weeks. The effect of treatment on hemiplegic upper extremity was assessed using Fugl-Myer motor scale, Motricity Index and Modified Barthel Index(drinking/feeding, dressing upper body, grooming) Results : These 2 groups had comparable clinical characteristics; sex, age, plegic side (Rt., Lt.), pretreatment impairment. After two weeks, patients in the moxibustion group perfomed better on Fugl-Myer test and Motricity index test. The differences were significant.(P=0.038, 0.002) But Results on the Modified Barthel Index revealed no effect.(P=0.348) Conclusion : This results suggest that moxibustion is an effective treatment for improvement of motor function of hemiplegic upper extremity.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.2
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• pp.193-200
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• 2014

PURPOSE: This study examined the effects of treadmill exercise of diverse intensities on the expression of IL-$1{\beta}$ (interleukine-$1{\beta}$) in the spinal cord in osteoarthritis rats. METHODS: The authors applied treadmill exercise of diverse intensity for 4 weeks to Sprague-Dawley rats to which intra-articular injection of monosodium iodoacetate(MIA, $3mg/50{\mu}l$, diluted in saline) was applied in the right knee joint to induce osteoarthritis. The four-week exercise was not applied to the control group(CG, n=15), while exercise of applicable intensity was applied to the low-intensity exercise group(LEG, n=15), moderate-intensity exercise group (MEG, n=15), and high-intensity exercise group(HEG, n=15) for four weeks. Observations were made of expression of IL-$1{\beta}$ in the spinal cord in osteoarthritis rats using western blot analysis. RESULTS: There were significant differences(p<.05) in the comparison of expression of IL-$1{\beta}$ in the spinal cord between the four groups involved. And the LEG and MEG had reduced expression of IL-$1{\beta}$ significantly than the CG(p<.05); in particular, the MEG showed the lowest expression. On the other hand, the HEG had more elevated expression of IL-$1{\beta}$ significantly than the CG(p<.05). CONCLUSION: As a result, factors that induce neuropathic pain such as IL-$1{\beta}$ are reduced; thus, the recovery of damaged neurons is improved and neuropathic pain is reduced. Further, when prescribing exercise to treat osteoarthritis patients, exercise of moderate intensity suitable for patients' physical conditions, rather than high intensity, maximizes the effects of this therapy.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.19-32
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• 2015

Purpose: This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods: Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Imaging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the motion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), and were analyzed with SPSS 18.0. Results: The angle of the elbow joints was significantly reduced (p < .05). The trunk angle was statistically significantly (p < .01, p < .001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced (p > .05). The angular velocity of the trunk was significantly reduced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly (p > .05). The positive airway pressure was reduced (p > .05). Conclusion: The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.199-203
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• 2019

Purpose: This study investigated the effects of shoulder protraction exercise according to weight by examining the surface electromyography (EMG) amplitude in the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM) as well as the activity ratio of each muscle. Methods: Twenty three winging scapula subjects participated in the study. The subjects performed scapula protraction at shoulder $90^{\circ}$ flexion and $60^{\circ}$ horizontal abduction with up to four (none, 1kg, 1.5kg, and 2kg) dumbbells in the supine position. The EMG data were collected from the dominant side muscles during a shoulder protraction exercise according to weight in the supine position. One way repeated measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA, UT, and PM and the ratios of PM/SA and UT/SA. Results: The results showed that the activities of both the SA and UT were highest for the shoulder protraction exercise at 2kg in the supine position. The UT/SA ratio also was the lowest for exercise at 2kg. On the other hand, the activities of both the UT and PM/SA ratio were similar under all conditions. Conclusion: These results show that there is a need to selectively strengthen the SA muscle in the case of patients with the shoulder dysfunction. In particular, it is necessary to weigh 2kg when performing shoulder protraction exercises in the supine position to activate the SA muscle in patients with a winging scapula.

• The Journal of the Korea Contents Association
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• v.18 no.11
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• pp.455-461
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• 2018

This paper presents experimental investigations about flexural strength and durability of reinforced concrete beams repaired using ductile fiber reinforced cementitious composite (DFRCC) and carbon fiber sheet through freezing and thawing test. Total 14 RC beams of $100{\times}100{\times}400mm$ size were tested by 3-point bending and freezing and thawing test by KS F 2456. The beams were reinforced using 3D10 steels on both the tensile and compressive sides, and repaired on 3 sides expect on top cycle. Test results showed that the beams repaired using fiber carbon sheet revealed about 15% higher values of flexural strength compared than the cases of DFRCC motar. On the other hand, the results did not showed meaningful differences in the aspect of durability. For further research, consideration of the steel interference effect and real old specimens such as taken from real deteriorated structures are needed to be tested after repairing with DFRCC and carbon fiber sheet.

• Proceedings of the Korea Information Processing Society Conference
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• 2013.11a
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• pp.1661-1664
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• 2013

본 연구는 만성 뇌졸중 환자 5 명을 대상으로 상지 운동(Affected hand의 주먹 쥐기/펴기운동)시 참가자의 운동의지와 운동 수행의 유무에 따라 차이가 있을 것을 가정하고, 운동 수행 및 운동의지가 존재하는 Active movement와 운동 수행을 하지만 운동의지가 없는 Passive movement, 운동 수행은 없지만 운동의지가 있는 Motor Imagery(MI)의 세가지 task에 따른 뇌파의 연결성을 비교하고자 한다. 이 때 EEG 영역 간의 연결성을 보기 위한 분석 방식 중 하나인 Phase locking value(PLV)를 통해 각 task 간의 차이를 비교 및 분석했다. 운동 수행은 동일하지만 운동의지 유무에 따른 차이는 Passive movement가 전반적으로 뇌 영역간 연결이 감소하고 Active movement가 motor task 시작 후 375ms를 기점으로 급격히 증가함을 보이는 데에서 발견할 수 있었으며, 운동 수행 유무에 따른 차이는 687.5ms 이후 Active movement에 비해 MI에서 뇌 영역 간 연결 수가 확연히 감소하는 데에서 큰 차이를 나타내었다. 이에 따라 본 연구에서는 만성 뇌졸중 환자의 상지운동 시의 motor task에 따른 EEG 영역간의 연결성을 토대로 운동의지 검출이 가능성이 있음을 밝혔다.

• PNF and Movement
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• v.18 no.3
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• pp.333-341
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• 2020

Purpose: The purpose of this study was to investigate the effect of open and closed kinetic chain exercises with a sling on neck flexor thickness during chin-in movement in office workers with forward head posture. Methods: Thirty-one selected subjects randomly performed chin-in movement in open kinetic chain and closed kinetic chain exercises using a sling. All subjects were measured for their neck flexor thickness using ultrasound measurement equipment during the performance of chin-in movement in open and closed kinetic chain exercised. A paired t-test was used to compare the thickness of the total neck flexor, superficial, and deep neck flexor, respectively, between open and closed kinetic chain exercises with chin-in movement. Results: The thickness of the superficial neck flexor diminished in size more greatly during the chin-in movement with the closed kinetic chain than the open kinetic chain, but this was not a statistically significant difference (p > 0.05). On the other hand, the thickness of the total neck flexor and deep neck flexor had more greatly increased during the chin-in movement with the closed kinetic chain than the open kinetic chain, and this was a statistically significant differences (p < 0.05). Conclusion: This study suggested that chin-in movement with a closed kinetic chain is more effective in activating the deep neck flexor than the open kinetic chain. Thus, we believe that the closed kinetic chain exercise using a sling is an effective intervention to correct the postural alignment of individuals with forward head posture.

• Physical Therapy Korea
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• v.28 no.3
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• pp.194-199
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• 2021

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.