• Title/Summary/Keyword: Lower Extremities

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Clinical Approaches to Vascular Anomalies of the Lip

  • Ryu, Jeong Yeop;Lee, Joon Seok;Lee, Jeong Woo;Choi, Kang Young;Yang, Jung Dug;Cho, Byung Chae;Lee, Seok-Jong;Lee, Jong Min;Huh, Seung;Chung, Ho Yun
    • Archives of Plastic Surgery
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    • v.42 no.6
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    • pp.709-715
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    • 2015
  • Background The incidence of vascular anomalies in the head and neck is higher than in the extremities. It is especially common for vascular anomalies to involve the lip. The lips are a functionally and aesthetically important component of the head and neck area. A retrospective analysis of data from our vascular anomaly center was performed in order to understand the characteristics and treatment requirements of vascular anomalies of the lip and to establish which treatments are likely to lead to the best outcomes. Methods A retrospective review was performed of the medical records of patients diagnosed with vascular anomalies of the upper or lower lip from January 2001 to September 2013. Using clinical photographs, radiologic findings, and patient records, the diagnosis of each case and the location of the vascular anomaly were recorded, along with information about treatment and follow-up. Results A total of 1,606 patients were diagnosed with vascular anomalies over this time period, of whom 127 (7.9%) were found to have vascular anomalies in the lip only. Surgical treatment with or without embolization, sclerotherapy, laser therapy, medication only, and observation were the treatment strategies adopted in these cases. Conclusions Vascular anomalies of the lip should be diagnosed accurately. Radiologic diagnosis played a crucial role in treatment planning, and several techniques were used to treat vascular anomalies of the lip. When surgical excision is indicated for the correction of vascular anomalies of the lip, the aesthetic and functional characteristics of the lip should be considered.

A Biomechanical Analysis of Four Different Taekwondo Body Punch Types in Horseback-Riding Stance (태권도 주춤 서 몸통지르기 유형별 생체역학적 변인 비교 분석)

  • Kang, Sung-Chul;Kim, Eui-Hwan;Shin, Hyun-Moo;Kim, Sung-Sup;Kim, Tae-Whan
    • Korean Journal of Applied Biomechanics
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    • v.17 no.4
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    • pp.201-208
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    • 2007
  • The purpose of this study is to compare 4 different body punch types(type 1: a punch using a shoulder, type 2: a punch using a waist, type 3: a punch using lower extremities, and type 4: a punch with elbows by your side at chest level) in horseback-riding stance and establish suitable teaching theory and method, which would be a useful reference to Taekwondo instructors on the spot(in Taekwondo dojangs all around Korea). Five exhibition players from Korean national Taekwondo exhibition team participated in this study. Each participant was asked to perform the four different types of punches and their kinematic and kinetic data were recorded with 7 vicon cameras(125Hz) and two force plates(AMTI, 1200Hz). We analyzed displacement, time, resultant center of body mass trajectory, velocity, trunk angular velocity, and ground reaction force(GRF) from each body segment in body punch and the result. I performed 1-way ANOVA(RM) for average values of each player after standardization and statistical significance was set as p<.05. was as the following ; First, they showed a tendency to take the body punch posture with the biggest motion at a shoulder and on descending order a waist and a knee. Second, a mean time for each body punch on ascending order 0.46sec. for type 2, 0.49sec for type 3, 0.50sec. for type 4, and 0.56sec. for type 1. Third, a mean resultant center of body mass trajectory for each body punch the longest 4.07cm for type 3 and the shortest 2.458cm for type 1. Fourth, a mean of maximal velocity of a fist strike was the fastest 5.99m/s for type 3, 5.93m/s for type 4, 5.67m/s for type 2, and 5.01m/s for type 1 on the descending order. Fifth, a mean of maximal trunk angular velocity of the fastest 495.6deg./sec. for type 4 and 337.7deg./sec. for type 1 on the descending order. Sixth, strongest value was type 3, 2 for anterior-posterior ground reaction force(left -54.89N, right 60.58N), type 4 for medial-lateral GRF(left 83.59N, right -80.12N), and type 3 for vertical GRF(left 341.79N, right 426.11N).

Characteristics of Injured Pregnant Women by the Traffic Accidents (교통사고로 수상한 임산부의 특성)

  • Kim, Duk-Hwan;Cho, Young-Duck;Kim, Jung-Youn;Yoon, Young-Hoon;Lee, Sung-Woo;Moon, Sung-Woo;Choi, Sung-Hyuk
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.132-138
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    • 2012
  • Purpose: Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents. Methods: From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records. Results: The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence. Conclusion: When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.

Case of Combined Acute Poststreptococcal Glomerulonephritis and Acute Invasive Meningococcal Disease (A군 연구균 감염 후 급성 사구체 신염과 동반된 침습성 수막구균감염증 1례)

  • Jeon, Hosang;Hahn, Wonho;Park, Dongkyun;Cha, Sungho
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.126-130
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    • 2004
  • Neisseria meningitidis is a leading cause of meningitis and septicemia in children and young adults. Meningococcemia, the most severe form of infection, represents a part of the various spectrum of the illness, and its clinical manifestations varied from mild fever and occult bacteriemia to fulminant catastrophic events(e.g., sepsis, shock, and death) within a few hours after onset of symptoms. Complement deficiencies, either congenital or acqired, increase the risk for invasive meningococcal disease. Since C3 plays a critical role in the complement cascade, congenital C3 deficiency or conditions that decrease C3(e.g., systemic lupus erythematosus, cirrhosis, nephritis, C3 nephritic factor) increase the risk for invasive disease due to pyogenic bacteria including N. meningitidis. We had experienced a case of meningococcemia and meningococcal meningitis presenting with mild fever, petechiae, and purpura. The patient was a 7-year old male. He had mild fever, vomiting, headache, nuchal rigidity, petechiae and purpura on both lower extremities, which spreaded to the whole body. His blood culture grew Neisseria meningitidis. The diagnosis of meningococcal meningitis was confirmed by examination of cerebrospinal fluid. The clinical symptoms of the illness were improved after treatment of antibiotics(cefotaxime) for 12 days. However the patient had developed generalized edema, microscopic hematuria & proteinuria on the third day after admission. High ASO titer and low serum C3 level were also noted. The microscopic hematuria returned to normal about 2 months after discharge. The C3 level returned to normal range about 3~4 months after discharge. we report a case of combined acute poststreptococcal glomerulonephritis and acute invasive meningococcal disease with reference review.

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Myxofibrosarcoma Originating from Chest Wall (흉벽에서 발생한 점액성섬유육종)

  • Cha, Byung-Ki;Lee, Mi-Kyung;Lee, Sam-Youn;Choi, Chong-Bum;Choi, Soon-Ho
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.166-170
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    • 2006
  • Myxofibrosarcoma represents one of the most common soft tissue sarcomas of the extremities in adult and elderly patients. However, it only rarely occurs in the chest wall. A 58 years old woman presented with a huge painless lump (8 ${\times}$ 6.5 cm) in the right lower parasternal area which recurred a few months following excision from General surgery of our hospital. Histology showed an infiltrative deep seated dermal and subcutaneous tumor. It had a distinctive lobular growth pattern with prominent myxoid change and moderate cellularity. Tumor cells were spindleshaped with varying degrees of pleomorphism and frequent mitotic figures. Numerous blood vessels with curvilinear growth pattern were also seen. Immunostains for S-100, CD68, Mac 387, and FX IIIa were all negative, but positive for Vimentin. The histologic feature was of an intermediate grade myxofibrosarcoma. Wide excision was performed and recovered in good condition without any physical disabilities and was discharged at one month later. Currently she is waiting for the skin graft without chemotherapy and radiotherapy.

Comparison of Injuries Related with All-Terrian Vehicles (ATVs) and Motorcycles (MCs) (사륜오토바이 사고 환자와 이륜오토바이 사고 환자에 대한 비교)

  • Kim, Nam-Ho;Kim, Myung-Deok;Lee, Tae-Hun;Ahn, Moo-Eob;Seo, Jung-Yeol;Lee, Jae-Sung;Kim, Dong-Won;Lee, Jung-Ryul;Park, Sang-Heon;Kim, Yu-Min
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.128-133
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    • 2010
  • Purpose: All-terrain vehicle (ATV)-related injuries have increased since the introduction of ATVs to Korea. The purpose of this study is to compare patients with ATV-related injuries (PATV) to patients with motorcycle (MC)-related injuries (PMC). Methods: We retrospectively analyzed the clinical records of PATV and PMC who visited an emergency center in 2008. The cases of PMC were 164, and those of PATV were 52. Results: While PMC are seen evenly in the first half year and the second half year, PATV are seen mainly the first half year (from March to June: 73%). For PMC the most frequent injury mechanism was collision with another vehicle, while for PATV, it was side overturn/roll over. The injury severity score (ISS), the revised trauma score (RTS), the trauma score and the injury severity score (TRISS) were $5.6{\pm}5.6$, $7.7{\pm}0.7$, $5.0{\pm}2.1$ for PMC and $7.1{\pm}7.5$, $7.7{\pm}1.1$, $5.5{\pm}1.5$ for PATV, respectively. The most common injury sites were the lower extremities for PMC and the face for PATV. The rates of admission, surgery and the length of hospital stay were similar between PMC and PATV. Conclusion: This study shows that the risk of ATV accidents is similar to that of MC accidents. We recommend that the same safety standards and regulations that are applied to MCs should be used for ATVs. Safe and enjoyable paths have to be sought for drivers of ATVs.

An Analysis of Nerve Block for Cancer Pain Patients (암성통증환자(癌性痛症患者)의 신경차단요법(神經遮斷療法)의 분석(分析))

  • Lee, Jung-Seok;Kim, Hae-Gyu;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.53-58
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    • 1988
  • We have treated patients who have visited pain clinic and those admitted to the other departments of Pusan National University Hospital from Mar. 1987 to Feb. 1988 with complaints of severe cancer pain on both upper and lower abdomen and extremities by continuous administration of a very small amount of morphine in the lumbar subarachnoid(group I) and epidural(group II) space in 10 cases respectively. The results of analgesia obtained are as follows: 1. The average duration in onset of analgesia was 8 mins. in group I and 23 mins. in group II. 2. The average duration In maintaining analgesia was 12.4 hrs. in group I and 18.4 hrs. in group II. 3. The efficiency of analgesia in group I was excellent in 5, good in 4, and null in 1, and group II was excellent in 5, good in 2, and moderate in 3. 4. The degree of tolerance in group I was rather mild comparable ti that of pain score 4 till the 22nd. day of morphine administration. 5. The complications are: 2 of respiratory distress in group I, 2 of voiding difficulties in both group I and II, 1 of itching sensation in both group I and II, 1 of euphoria with hallucination In group I, and 1 of C.S.F leakage in group II. As results, it is thought that epidural administration is safer than subarachnoid administration in achieving analgesia with morphine among patients with malignant pain if the problem of tolerance is solved.

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Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation (승모판 폐쇄 부전증에서 발생한 국소적 폐부종 1예)

  • Yoon, Young Gul;Bang, Do Seok;Park, Bum Chul;Lee, Sung Hoon;Kim, Jae Su;Park, Yol;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Han, Sang Hoon;Park, Sang Hoon;Lim, Jun Cheol;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.432-435
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    • 2005
  • An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The $O_2$ saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

A Rationale for Instrumental Music Playing for Upper Extremity Rehabilitation in Subacute Stroke (아급성 뇌졸중 환자의 상지재활을 위한 악기 연주의 임상적 활용 근거 연구)

  • Jeong, Eunju
    • Journal of Music and Human Behavior
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    • v.10 no.1
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    • pp.1-23
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    • 2013
  • Upper extremity dysfunction is a common consequence following stroke. Spontaneous recovery during the first six months post-stroke is rigorous and considered as a significant indicator of potential long-term progress. Various approaches have been utilized to regain functional upper limb movement necessary for independent living; however, conventional therapy approaches have failed to prove consistency, especially for subacute stroke patients. There is, thus, a need for innovative therapeutic strategies that motivate stroke survivors to facilitate neural and functional recovery during the critical window immediately following stroke. The effect of music on physical enhancement has been frequently reported in the field of medicine as well as neurorehabilitation. The efficacy of rhythm on lower extremity deficits has been well established. Yet, the rationale for using instrumental music making enhancing subacute upper extremities rehabilitation is not clearly described to date. Based on the key mechanism of music as sensori-motor movement facilitator, this paper reviews previous empirical research that utilized music-based interventions for upper extremity rehabilitation for stroke patients, either in the form of receptive or expressive activity. This paper, further, focuses on the current research trends in subacute stroke upper limb rehabilitation and provides applicable rationale of using instrumental music playing.

A CASE OF AGGRESSIVE FIBROMATOSIS INVADED MANDIBULAR BODY ON THE PAROTID REGION (이하부에 발생한 침습성 섬유종증이 하악체에 침범한 증례 보고)

  • Kim, Young-Jo;Lee, Dong-Keun;Um, In-Woong;Min, Seung-Ki;Chung, Chang-Joo;Kim, Eun-Cheol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.186-195
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    • 1994
  • Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

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