• Archives of Plastic Surgery
• /
• 제50권3호
• /
• pp.311-314
• /
• 2023

In lower extremity reconstruction, the recipient vessel often requires long-range mechanical dilation because of extensive vasospasm or plaque formation induced by concomitant atherosclerosis. While a forceps dilator can be used to manipulate and dilate vessels approximately 1 cm from their end, a DeBakey vascular dilator can dilate long-range vessels. The authors successfully performed free flap reconstruction of the lower extremity using the DeBakey vascular dilator. Of the two patients who underwent lower extremity reconstruction, one had extensive vasospasm, and the other had plaques in the recipient arteries. Irrigation with 4% lidocaine and dilation of the lumen with a forceps dilator were insufficient to restore the normal arterial blood flow. Instead, a DeBakey vascular dilator with a 1-mm diameter tip was gently inserted into the lumen. Then, to overcome vessel resistance, the dilator gently advanced approximately 10 cm to dilate the recipient artery. Normal arterial blood flow was gushed out after dilating the vessel lumen using a DeBakey vascular dilator. The vascular anastomosis was performed, and intravenous heparin 5000 IU was administered immediately after anastomosis. Prophylactic low-molecular-weight-heparin (Clexane, 1 mg/kg) was administered subcutaneously to both patients for 14 days. The reconstructed flap survived without necrosis in either patient.

• 한국경영과학회:학술대회논문집
• /
• 대한산업공학회/한국경영과학회 1992년도 춘계공동학술대회 발표논문 및 초록집; 울산대학교, 울산; 01월 02일 May 1992
• /
• pp.358-363
• /
• 1992

A two-dimensional static biomechanical model of lower extremity in the seated posture was developed to assess muscular activities of lower extremity required for a variety of foot pedal operations. Muscle forces of the model were predicted using the double linear optimization scheme. For the model validation, three subjects performed the experiments which measured EMG activities of six lower extremity muscles. Predicted muscle forces were compared with the corresponding rectified intergrated EMG amplitudes and it showed reasonable results.

• Archives of Plastic Surgery
• /
• 제36권6호
• /
• pp.720-726
• /
• 2009

Purpose: Fasciocutaneous flap with random pattern flap has limitation in mobility and length - width ratio. This characteristic is more pronounced in lower extremity which has relatively poor vascularity. Perforator based flap in lower extremity reconstruction has various advantages as a axial flap, allowing abundant blood supply and widening of mobility range. So if it is not a case of wide defect, free flap can be replaced by perforator based flap. Methods: From April 2007 to March 2009, 18 cases of perforator flap were performed. 8 had defect in upper 1/3 of calf, 6 in middle 1/3, and 4 in lower 1/3. In 10 cases island flap were used, 3 case had transposition flap, 2 cases used advancement flap, 2 case had propeller flap and 1 case had rotation flap. Results: 17 cases survived without flap necrosis. Partial flap necrosis occurred in 1 case, so secondary split thickness skin graft was done. Chronic wound with pseudomonas infection occurred in 1 case, but it was completely cured with conservative treatment. Conclusion: Perforator based flap is useful in lower extremity reconstruction because of relative freedom in changing the size and thickness of the flap depending on the recipient site, good mobility, and abundant vascularity. And donor site morbidity can be minimized. Lower extremity reconstruction using perforator based flap is a good method because it can minimize the complication and obtain effective result.

• Archives of Plastic Surgery
• /
• 제40권5호
• /
• pp.575-583
• /
• 2013

Background The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. Methods We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications. Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years). The sites of defects included the dorsum of the foot (19), pretibial area (17), ankle (7), heel (5) and other sites (4). The types of free flap included latissimus dorsi muscle flap (10), scapular fascial flap (6), anterolateral thigh flap (6), and other flaps (30). There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52). There were 19 cases of other complications at recipient sites such as partial graft loss (8), partial flap necrosis (6) and infection (5). However, these complications were not notable and were resolved with skin grafts. Conclusions The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

• 한국운동역학회지
• /
• 제14권3호
• /
• pp.259-270
• /
• 2004

The purpose of this study was to analysis of pelvis and lower extremity using orientation angles during a developpe a la seconde. Data were collected by Kwon3D program. Two females professional modem dancer were participated in this experiment. Subjects performed a developpe a la seconde in meddle heights(about 90 dog.) The results were as follows. The orientation angles of pelvis were, in most cases, caused by the movement of trunk and thigh. It was restricted the movement of pelvis within narrow limits because the movement of pelvis was very important to lower extremity alignment. The orientation angle of shank against thigh showed a change of angle about $3-6^{\circ}$ in internal external rotation. The orientation angle of foot against shank showed a change of angle about $6-7^{\circ}$ in internal external rotation.

• Investigative Magnetic Resonance Imaging
• /
• 제12권1호
• /
• pp.55-59
• /
• 2008

37세 여자 환자의 하지에 연부 조직 악성 종양 형태로 발생한 Kimura 병을 보고 하고자 한다. 하지에 발생하는 경우는 매우 드물지만 피하 지방층에 경계가 안 좋은 고형 종괴가 임파선 형태를 유지하며 주위 조직으로 침윤이 있다면 Kimura 병을 감별진단에 포함시켜야 하며 말초 혈액검사와 혈청 IgE 수치 측정을 권유하여야 할 것으로 생각된다.

• The Korean Journal of Pain
• /
• 제9권1호
• /
• pp.283-287
• /
• 1996

Recently, continuous epidural catheter insertion is usually employed in operation and chronic pain control. Delayed migration of an extradural catheter into subdural space or subarachnoid space is a rare but life threatening complication of continuous epidural catheter insertion, especially with out patients. The symptoms may include lower extremity weakness, hypotension, drowsy and respiratory depression. We experienced two cases of lower extremity paralysis due to delayed migration into subdural or subarachnoid spaces at our pain clinic. The tecnical procedures for continuous epidural catheterization went smoothly without any complications. However, clinical signs of lower extremity paralysis and sensory loss developed gradually, about 2 hours and 30 minutes after the continuous epidural injection. Two cases were confirmed by subdurogram and myelogram.

• 대한물리치료과학회지
• /
• 제24권2호
• /
• pp.27-35
• /
• 2017

Purpose: This study aimed to investigate the effect of shoes sole form on fatigue of lower extremity during treadmill gait. Method: Thirty healthy young adults (15 males and 15 females) were recruited. They performed treadmill gait in two different conditions: double sole(DS) and flat sole(FS). Result: lower extremity fatigue were signficantly decreased in double sole condition(p<.05). Conclusion: These findings suggest that double sole contributes to reduction of lower extremity muscle fatigue.

• 한국전문물리치료학회지
• /
• 제4권1호
• /
• pp.20-29
• /
• 1997

The purpose of this study was to determine the effects of pelvic and lower extremity exercise on the gait in 25 patients(11 men, 14 women) with hemiplegia. Their mean age was 65.2 years and the mean post-onset duration was 8.7 months. Each participant received a total of 15 sessions of PNF(five times per week), and each session lasted 40 minutes and consisted of 2 procedures(20 minutes each). The first procedure was pelvic anterior elevation and posterior depression pattern. And the second procedure was lower extremity flexion-adduction with knee flexion pattern. Results showed significant progressive improvement in gait speed and cadence after each 5 session period(5th, 10th, 15th session) compared with pre-treatment data(P<0.05). Furthermore improvements were noted in stride length.

• 대한의용생체공학회:의공학회지
• /
• 제24권6호
• /
• pp.509-514
• /
• 2003

보행시 하지 주요 근육내의힘의 변화를 계산하기 위한 수학적 모델을 개발하였다. 인체는 7개의 운동 분절로 모델링 하였으며, 하지 당 8개의 수요 근육을 고려한 모델을 사용하였다. 보행시 하지 근육의 발생되는 힘의 변화는 최적화 기법을 적용하여 계산하였으며, 계산 결과는 기존의 EMG 데이터와 비교 검토하여 모델의 타당성을 확인하였다. 또한 보행시 각 운동 분절의 운동 데이터를 이용하여 역동력학적 기법으로 구해진 하지 관전내의 토크량의 변화와 비교에서도 본 연구에서의 계산 결과는 만족할 만한 일치를 보이고 있었다.