• 대한임상검사과학회지
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• 제50권3호
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• pp.370-374
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• 2018

빗장밑혈류빼앗김증후군은 왼쪽 근위부 빗장밑동맥이나 오른쪽 팔머리동맥에 심한 협착 혹은 폐색으로 인해 반대쪽 척추동맥으로부터 관류압이 감소된 병변쪽 빗장밑동맥으로 혈류가 역으로 유입되는 현상이 나타나게 되고, 그 결과로 척추-뇌바닥혈류부전이나 허혈성 말초동맥질환 증상이 동반되는 경우를 말한다. 빗장밑동맥을 포함한 뇌혈관 협착증에서 신경중재술을 이용한 혈류의 회복 및 방향 교정은 환자의 증상과 예후를 좋게 한다고 알려져 있다. 저자는 오른팔에 비해 왼팔 혈압이 12 mmHg 낮은 환자에서 이중초음파검사를 시행하였고, 왼쪽 척추동맥에서 빗장밑혈류빼앗김증후군의 특징적인 혈류파형이 관찰되어 혈관성형술 및 스텐트 설치술을 통해 성공적으로 치료된 증례를 보고하고자 한다. 6개월 후 추적검사에서 왼쪽 척추동맥의 혈류파형은 정상으로 회복되었고, 양팔의 혈압 차는 5 mmHg로 감소하였다.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.370-374
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• 2014

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

• 대한족부족관절학회지
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• 제6권1호
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• pp.21-27
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• 2002

Pressure sores are an ulceration and necrosis of the skin and underlying tissue usually occur after prolonged or repeated pressure by interruption of blood flow from the small. vessels to the skin and deep tissue. The management of pressure sores is mostly difficult and requires prolonged hospitalization or repeated surgical interventions with a high recurrence rate. In this article we reviewed 14 cases of National Pressure Ulcer Advisory Pannel staging III, IV over the lateral malleolar area of the ankle in 2 years period from January 1999 to October 2001. The pressure over lateral malleolar area was mainly due to unique Korean sitting position with cross legs at flexed hips and knees or supine position of patient with external rotation of low extremity. Male to female ratio was 11: 3 and ages were between 36 and 83 (mean age: 67.1 years). Associated diseases were DM(7 cases), Hemiparesis caused by CVA(2 cases), Liver cirrhosis(2 cases), disarticulation of opposite hip due to squamous cell ca.(1 case), Intertrochanteric Fx.(1 case). Wound cultures reported Staphylococus, Pseudomonas and others. Abnormally elevated ESR and CRP were seen in 6 cases. Operative treatments were irrigation and debridement, direct closure with gravity drainage and skin grafting. The most important aspect of pressure sore treatment is pressure relief of the lateral malleolar area. Pressure-relieving Cast or Brace was helpful for local management and preventing recurrence.

• Journal of Acupuncture Research
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• 제19권6호
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• pp.205-213
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• 2002

Objective : This study was to investigate on the Korean Bee-Venon acupuncture of Cauda equina syndrome which has been described as complex of low back pain, bilateral sciatica, saddle anesthesia and motor weakness in the lower extremity that progress to paraplegia with bladder and bowel incontinence. Methods : Clinical observation was done on Cauda equina syndrome in the Department of Acupuncture & Moxibustion, Kyungwon Inchon Oriental Medical Hospital from may 25 to June 24. The patients was treated with Korean Bee-Venon acupuncture at Samchosu(B22), Shinsu(B23), Taejangsu(B25), Pang-gwangsu(B28) and Yo-yang-gwan(Gv3) with oriental medicine treatment. We evaluated the bladder incontinence, duration of urination and area of anesthesia before and after treatment. Conclusions : 1. At the early time, gait disturbance was treated well, but discomfort bladder incontinence was remained. 2. The symptoms of Cauda equina syndrome especially bladder incontinence was recurred in short duration by Korean Bee-Venon acupuncture and oriental medicine treatment. 3. There was no significant changes in GOT/GPT before and after treatment.

• 한국의류학회지
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• 제18권3호
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• pp.387-394
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• 1994

Journal of the Korean Society of Clothing and Textiles Vol. 18, No. 3 (1994) p. 387∼394 In this study, the restriction of slacks (blue jean) versus box pleats skirt was investigated, from the view point of peripheral blood flow at the toe according to motion variation and E.M.G. analysis of leg muscles after walking on the flat or going up and down stairways. Besides, the pressure of slacks on the lower extrimity was measured statically and dynamically. The main results were summerized as follows; 1. The clothing pressure applied by slacks was; each one of thigh and lower leg was 18.2 g/ cm2 and 22.1 g/cm2 in upright, 63.4 g/cm2 and 26.6 g/cm2 in sitting on the chair, on both sides of thigh and lower leg 272.0 g/cm2 over in squatting. 2. When the motion starts from upright, the dynamic clothing pressure reach their peak before the motions end. When the motion ends and the body comes to a still condition, the clothing pressure grow lower and indicate a constant value. but when the body starts moving again to return to upright, the pressures once grow higher and go to zero value after reaching the peak. The pressure on the knee show much greater than those on the hip. This can be because these pressures depend on the degree of skin stretching motion and of its curvature. 3. The surface E.M.G. in leg muscles M. rectus femoris and M. gastrocnemius were recoreded. In the case of wearing slacks, two muscles were activated much more than wearing skirt. 4. The peripheral blood flow at the toe by wearing slacks was lower than wearing skirt. Also the case when squatting, the peripheral blood flow at the toe was low.

• 대한물리의학회지
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• 제9권3호
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• pp.243-248
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• 2014

PURPOSE: This study was aim to the change of muscle activities of lower extremity and waist during lifting a small object on the floor according to different foot position of women in their twenties wearing a skirt. METHODS: 9 women in their twenties wearing a skirt were selected and were measured the muscle activities of medial gastrocnemius (MG), tibialis anterior (TA), vastus lateralis (VL) and iliocostalis (IC) when they lifted a small object on the floor. The two different foot position employed were "both feet posed straight side by side" (condition 1) and "both feet posed diagonally to 45 degree" (condition 2) used. The order of feet position was selected randomly and the subject took a rest for 30 min between tests to prevent muscle fatigue. We calculated the mean and standard deviation of muscle activities and used Mann-Whitney U test to compare the difference between the two foot positions with SPSS(IBM Korea) RESULTS: The muscle activity of condition 2 was greater than that of condition 1 in right side of TA, VL, and IC and left side of TA, VL, MG and IC. The right side of TA, VL and left side VL were significant difference between condition 1 and condition 2(p<.05). CONCLUSION: We suggest "both feet posed straight side by side" position is better if a woman wearing a skirt lift the small object and it will help prevent the low back and lower limb problems in the future.

• Journal of Korean Neurosurgical Society
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• 제50권5호
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• pp.434-440
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• 2011

Objective : The goals of surgical intervention for metastatic spinal cord compression (MSCC) are prolonging survival and improving quality of life. Non-ambulatory paraplegic patients, either at presentation or after treatment, have a much shorter life expectancy than ambulatory patients. We therefore analyzed prognostic factors for survival and postoperative ambulation in patients surgically treated for MSCC. Methods : We assessed 103 patients with surgically treated MSCC who presented with lower extremity weakness between January 2001 and December 2008. Factors prognostic for overall survival (OS) and postoperative ambulation, including surgical method, age, sex, primary tumor site, metastatic spinal site, surgical levels, Tokuhashi score, and treatment with chemo- or radiation therapy, were analyzed retrospectively. Results : Median OS was significantly longer in the postoperatively ambulatory group [11.0 months; 95% confidence interval (CI), 9.29-12.71 months] than in the non-ambulatory group (5.0 months; 95% CI, 1.80-8.20 months) ($p$=0.035). When we compared median OS in patients with high (9-11) and low (0-8) Tokuhashi scores, they were significantly longer in the former (15.0 months; 95% CI, 9.29-20.71 months vs. 9.0 months; 95% CI, 7.48-10.52 months; $p$=0.003). Multivariate logistic regression analysis showed that preoperative ambulation with or without aid [odds ratio (OR) 5.35; 95% CI 1.57-18.17; $p$=0.007] and hip flexion power greater than grade III (OR 6.23; 95% CI, 1.29-7.35; $p$=0.038) were prognostic of postoperative ambulation. Conclusion : We found that postoperative ambulation and preoperative high Tokuhashi score were significantly associated with longer patient survival. In addition, preoperative hip flexion power greater than grade III was critical for postoperative ambulation.

• Archives of Plastic Surgery
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• 제39권3호
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• pp.227-231
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• 2012

Background : The ankle brachial pressure index (ABI) is a simple, useful method for diagnosing peripheral artery disease (PAD). Although the ABI is an objective diagnostic method, it has limited reliability in certain scenarios. The aim of the present study was to determine the accuracy and reliability of the toe brachial index (TBI) as a diagnostic tool for detecting stenosis in PAD, associated with normal or low ABI values. Methods : ABI and TBI values were measured in 15 patients with diabetic gangrene who were suspected of having lower extremity arterial insufficiency. The ABI and TBI values were measured using a device that allowed the simultaneous measurement of systolic blood pressure in the upper and lower extremities. In addition, the ABI and TBI values were compared pre- and post-angiography. Results : Patients with an ABI of 0.9-1.3 showed almost no difference between the 2 measurements. The patients with TBI >0.6 had no arterial insufficiency. The patients with TBI <0.6 required vascular intervention with ballooning. After the angiography, the gangrenous wounds decreased in size more rapidly than they did prior to the intervention. Conclusions : Our findings suggest that TBI is the method of choice for evaluating lower limb perfusion disorders. This result requires further studies of TBI in a larger number of patients. Future long-term studies should therefore evaluate the utility of TBI as a means of screening for PAD and the present findings should be regarded as preliminary outcomes.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.41-48
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• 2009

There are several advantages for groin flap, but its small and unpredictable vessels of pedicle have made it to lose its initial popularity. Although it would be ideal flap when it is focused on its useful advantages such as relative larger size, low donor site morbidity and possible bone graft, there have been few studies for prognostic factors for successful groin flap. Authors intended to determine prognostic factors which are relative with success of free groin flap. From January 1985 to December 2007, 107 patients who underwent groin flap for reconstruction of extremities were selected consecutively. Univariate and multivariate analysis were performed to determine prognostic factors which were related with success of groin flap. Eighty of 107 (74.8%) flaps survived. There was significant difference in success rate according to the recipient site. Nineteen of 20 cases (95%) survived in upper extremities, but 61 of 87 cases (70.1%) survived in lower extremities, which was statistically significant (p=0.022). Univariate analysis showed that mean diameter of donor veins was significantly larger in success group (p=0.021). Groin flap is recommended for reconstruction of upper extremities than lower extremities. It is thought to be critical that surgeons try to match vessel diameters between donor and recipient site.

• 디지털융복합연구
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• 제13권7호
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• pp.373-380
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• 2015

본 연구는 테니스 한손과 양손 백핸드 스트로크 동작에서 하지관절 움직임의 차이를 확인하여 유형별 특성을 밝히는데 그 목적이 있으며 그 결과는 다음과 같다. 볼의 속도를 결정하는 중요한 요인인 라켓헤드의 합성 속도는 양손 백핸드 스트로크 동작이 한손보다 빠른 속도를 나타냈다. 양손 백핸드 스트로크는 하체의 움직임을 최소화시키고 몸통 회전을 통한 스트로크를 하는 반면 한손 백핸드 스트로크는 몸통을 이용한 스트로크를 하기 보다는 공을 쫓아가듯이 스트로크 하는 것으로 나타났다. 슬관절의 신전모멘트는 한손 백핸드 스트로크가 큰 것으로 나타났지만, 내번모멘트와 회내모멘트 그리고 굴곡모멘트는 양손 스트로크에서 크게 나타났다. 고관절의 경우 신전, 내번, 회내 모멘트가 양손 백핸드 스트로크가 한손 보다 모두 큰 것으로 나타났는데 특히 내번모멘트의 경우 큰 차이를 나타난 반면, 외번모멘트는 한손 백핸드 스트로크가 큰 것으로 나타났다.