• Title/Summary/Keyword: Limb Size

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Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases) (전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)))

  • Park, Wook;Ok, See-Young;Song, Hoo-Bin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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The Effects of Object Size and Reaching Distance on Upper Extremity Movement (물체 크기와 뻗기 거리가 상지 움직임에 미치는 영향)

  • Bae, Su-Young;Kim, Tae-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.51-61
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    • 2020
  • Objectives : The purpose of this study is to investigate the effect of object size and reaching distance on kinematic factors of the upper limb while performing arm reaching for normal subjects. Methods : The subjects of this study were 30 university students who were in D university in Busan, and the measuring tool was CMS-70P(Zebris Medizintechnik Gmbh, Germany), a three-dimensional motion analyzer. The task had six conditions. The average velocity of motion, average acceleration, maximum velocity, and the velocity definite number of movements were measured according to changes in object size(2cm, 10cm) and reaching distance(15%, 37.5%, 60%) when they performed arm reaching. The general characteristics of the subject were technical statistics. One-way ANOVA measurement was used to compare variables when the arm reaching task was performed from two object sizes to three reaching distance, and the post-test was conducted with Tukey test. In addition, an independent t-test was used to analyze the kinematic differences according to the two object sizes at three reaching distances. A two-way ANOVA measurement (3×2 Two-way ANOVA measurement) was performed to identify the interaction of the reaching distance(15%, 37.5%, 60%) and the object size(2cm, 10cm). The statistical significance level α was set to .05. Results : When the size of the object increased, the velocity and maximum velocity also increased, but the definite number of velocity decreased. When the reaching distance increased, the velocity and maximum velocity increased, whereas the definite number of velocity decreased. Conclusion : The clinical significance of this study could be utilized as the baseline data for grading object size and reaching distances when the reaching training is implemented for patients whose central nervous system was damaged.

A Study on the Remodeling of Residential Bathrooms for the Disabled - Based on 17 cases of residential bathroom remodeling in Incheon City - (장애인이 거주하는 주택의 욕실 개조에 관한 연구 - 인천시 욕실 개조 사례 17개를 중심으로 -)

  • Soh, Jun-Young
    • Korean Institute of Interior Design Journal
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    • v.21 no.1
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    • pp.258-268
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    • 2012
  • The bathroom is a space where humans fulfil certain daily needs, but for the disabled, it can be the most difficult space to use and may even be a cause of accidents and a source of danger. Previous studies on the bathroom have mostly proposed an ideal model of bathroom, but the majority of disabled people live in small homes of about $50m^2$ in size. As their bathrooms are usually very small, and existing houses have various structural limitations, more research should be conducted on the remodeling of residential bathrooms. This study analyzed a number of remodeling items in bathrooms, all of which were listed in previous studies. Based on 17 cases of residential bathroom remodeling in the homes of disabled people residing in Incheon in 2009, this study analyzed several remodeling items required according to the subject's characteristics, such as a lifestyle, gender, and family composition; and proposed the following remodeling requirements and improvement measures for ambulatory-disabled persons and sedentary-disabled people. First, as ambulatory-disabled people have lower-limb impairments, they required bathroom remodeling designed to improve their mobility in the bathroom. These subjects desired the installation of grab bars, as well as the elimination of floor level differences, the installation of non-slip flooring, a counter-top, a sink stand, and a shower holder whose height can be adjusted. Second, sedentary-disabled people move around in a sitting or crawling position, so many of them asked to eliminate floor level differences and vertically-installed bathroom furnishings. Basically, both people with ambulatory disabilities and people with non-ambulatory impairments requested the elimination of floor level differences and the installation of non-slip flooring and grab bars for the toilet and bathtub. They also asked for the heights of sinks, faucets, mirrors, shower holders, and cabinets to be adjusted to suit their needs.

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Effects of Strengthening Exercise on Gait Ability and GMFM in Cerebral Palsy : A Systematic Review and Meta-Analysis (근력강화훈련이 뇌성마비 아동의 보행능력과 대동작 기능에 미치는 영향에 대한 체계적 고찰과 메타분석)

  • Heo, Seong-Gyeong;Lee, Han-Suk;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.3
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    • pp.39-47
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    • 2018
  • PURPOSE: The purpose of this investigation was to conduct a systemic review of studies that examine the effects of strengthening exercise on gait ability and GMFM in children with cerebral palsy and propose a standard for cerebral palsy therapy based on a meta-analysis of the studies. METHODS: An extensive literature search was conducted using databases including the KISS (Korean studies Information Service System), RISS, DBpia, PubMed and ScienceDirect, with the following search terms: 'Strengthening Exercise,' 'Resistance Exercise,' 'Gait ability,' 'GMFM' or 'cerebral palsy'. RESULTS: Eleven studies were included in this review and the duration of the intervention varied from 5 to 24 weeks. The number of application per week was mostly 2-3 times, while 5 intervention per week was adopted in a few cases. The total number of intervention applied varied from 18 to 36 and the respective effect sizes of GMFM on crawling and sitting were very high (1.075 and .881) while those of GMFM on standing and walking were very low(.206 and .125). The effect size was for gait speed was only .221. CONCLUSION: Trunk exercise and lower limb exercise effectively improved GMFM in children with cerebral palsy, resulting in improved outcomes in sitting and crawling. The results of this study will be useful for designing evidencebased cerebral palsy therapy programs.

Franchisees' Entrepreneurship and Business Performance (프랜차이즈 가맹점주의 기업가정신과 성과)

  • Jeon, Yoonchul;Choo, Seungyoup;Limb, Seong-Joon
    • The Journal of the Korea Contents Association
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    • v.17 no.3
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    • pp.408-420
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    • 2017
  • A franchisee owner, as an entrepreneur who is independent from a franchisor, has the greatest influence on the success of franchisee business. The effect of the franchisees' entrepreneurship on their performance can be different from that of self-employed business owners, due to the fundamental nature that the franchisor and franchisees share a standardized operation and business risks. Therefore, the purpose of this study is to demonstrate whether or not the relationship between the entrepreneurship and the performance, which has been popularized in general, is displayed in franchised stores as well. The current study analyzed the influence of innovativeness, risk-taking, and proactiveness on franchisees' performance based on the samples from 109 Small Size Educational Services franchisees. The results show that the franchisees' proactiveness is the only variable that affects the performance while the effect of the other variables was not significant. These results make implications that, for their business success, franchisee owners should be proactive in their target market, without compromising the quality of franchisor's standardized products and services by being innovative and risk-tolerant.

Pathophysiology of Articular Cartilage Injury (관절 연골 손상의 병태 생리)

  • Park, Jung-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.6-11
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    • 2005
  • Injury of articular cartilage can be classified into acute injury and chronic degenerative osteoarthritis Acute mechanical trauma on articular cartilage causes injuries that are divided into three distinct types based on the depth of injury: microdamage, chondral fracture, osteochondral fracture and each type has different potential of healing response and long-term prognosis. Articular cartilage undergoes degradation in response to a number of stimuli and eventually degenerative osteoarthritic changes will progress. The extent of initial injury to the articular cartilage is the most important factor affecting the long-term outcome of the healing response and other variables such as the size of lesion, site, age, activity level, obesity, limb alignment are also important factors. In this review, the pathophysiology that occurs within articular cartilage after different injuries and the effect of nonsurgical treatment mainly in physicochemical aspect and biological aspect will be discussed.

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IRAS OBSERVATIONS OF DARK GLOBULES

  • Lee, H.M.;Hong, S.S.;Kwon, S.M.
    • Journal of The Korean Astronomical Society
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    • v.24 no.1
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    • pp.55-70
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    • 1991
  • Infrared emission maps are constructed at 12.5, 25, 60, and $100{\mu}m$ for dark globules B5, B34, B133, B134, B361, L134 and L1523 by using Infrared Astronomical Satellite data base. These clouds are selected on the basis of their appearance in Palomar print as dark obscuring objects with angular sizes in the range of 3 to 30 arcminutes. The short wavelength(12.5 and $25{\mu}m$) maps show the embedded infrared sources. We found many such sources only in B5, B361 and B34 regions, Diffuse component at 12.5 and $25{\mu}m$, possibly arising from the stochastically heated very small dust grains(a < $0.01{\mu}m$) by interstellar radiation field, is found in B361 and L1523 regions. Such emission is characterized by the limb brightening, and it is confirmed in L1523 and in B361. Infrared emissions at the long wavelengths(60 and $100{\mu}m$) are due to colder dusts with temperature less than 20 K. The distribution of color index determined by the ratio 60 to $100{\mu}m$ intensities shows monotonic decrease of dust temperature toward the center. The black body temperature determined from these ratios is found to lie between 16 and 23 K. Such temperature is possible for small(i.e., $a\;{\lesssim}\;0.01{\mu}m$) graphite grains if the grains are mainly heated by interstellar radiation field. Thus IRAS 100 and $60{\mu}m$ emissions are arising mainly from small grains in the colud. The distribution of such dust grains implied from the emissivity distributions at 100 and $60{\mu}m$ resembles that of isothermal sphere. This contrasts to earlier findings of much steeper distribution of dusts contributing visible extinction. These dust grains are mainly larger ones(i.e., $a{\simeq}0.1{\mu}m$). Therefore we conclude that the average grain size increase, toward the cloud center.

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Usefulness of V-Y Advancement Flap for Defects after Skin Tumor Excision

  • Kwon, Ki Hyun;Lee, Dong Gwan;Koo, Su Han;Jo, Myoung Soo;Shin, Heakyeong;Seul, Jung Hyun
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.619-625
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    • 2012
  • Background After skin tumor excision on the face, extremities, or trunk, the choice of treatment for a skin defect is highly variable. Many surgeons prefer to use a local flap rather than a skin graft or free flap for small- or moderately-sized circular defects. We have used unilateral or bilateral V-Y advancement flaps, especially on the face. Here we evaluated the functional and aesthetic results of this technique. Methods All of the patients were pathologically diagnosed with squamous cell carcinoma (SCC), basal cell carcinoma (BCC), or malignant melanoma or premalignant lesion (Bowen's disease). Thirty-two patients underwent V-Y advancement flap repair (11 unilateral and 21 bilateral) from January 2007 to June 2011. We analyzed the patients' age and satisfaction, and location and size of defect. The patients were followed up for 6 months or more. Results There were 22 women and 10 men. The ages ranged from 47 to 93 years with a mean age of 66 years. The causes were SCC in 15 cases, BCC in 13 cases, malignant melanoma in 1 case, Bowen's disease in 2 cases, and another cause in 1 case. The tumor locations were the face in 28 patients, and the scalp, upper limb, and flank each in one patient. All of the flaps survived and the aesthetic results were good. Postoperative recovery was usually rapid, and no complication or tumor recurrence was observed. Conclusions The V-Y advancement flap is often used not only for facial circular defects but also for defects of the trunk and extremities. Its advantages are less scarring and superior aesthetic results as compared with other local flap methods, because of less scarification of adjacent tissue and because it is an easy surgical technique.

Carboplatin and Doxorubicin in Treatment of Pediatric Osteosarcoma: A 9-year Single Institute Experience in the Northern Region of Thailand

  • Choeyprasert, Worawut;Natesirinilkul, Rungrote;Charoenkwan, Pimlak;Sittipreechacharn, Somjai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1101-1106
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    • 2013
  • Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

Thin and superthin perforator flap elevation based on preoperative planning with ultrahigh-frequency ultrasound

  • Visconti, Giuseppe;Bianchi, Alessandro;Hayashi, Akitatsu;Cina, Alessandro;Maccauro, Giulio;Almadori, Giovanni;Salgarello, Marzia
    • Archives of Plastic Surgery
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    • v.47 no.4
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    • pp.365-370
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    • 2020
  • The ability to directly harvest thin and superthin perforator flaps without jeopardizing their vascularity depends on knowledge of the microsurgical vascular anatomy of each perforator within the subcutaneous tissue up to the dermis. In this paper, we report our experience with ultrahigh-frequency ultrasound (UHF-US) in the preoperative planning of thin and superthin flaps. Between May 2017 and September 2018, perforators of seven patients were preoperatively evaluated by both ultrasound (using an 18-MHz linear probe) and UHF-US (using 48- and 70-MHz linear probes). Thin flaps (two cases) and superthin flaps (five cases) were elevated for the reconstruction of head and neck oncologic defects and lower limb traumatic defects. The mean flap size was 6.5×15 cm (range, 5×8 to 7.5×23 cm). No complications occurred, and all flaps survived completely. In all cases, we found 100% agreement between the preoperative UHF-US results and the intraoperative findings. The final reconstructive outcomes were considered satisfactory by both the surgeon and the patients. In conclusion, UHF-US was found to be very useful in the preoperative planning of thin and superthin free flaps, as it allows precise anticipation of very superficial microvascular anatomy. UHF-US may represent the next frontier in thin, superthin, and pure skin perforator flap design.