• Title/Summary/Keyword: Lower-limb

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Clinical Analysis of Arterial Occlusive Disease in the Lower Extremity (하지 혈행장애의 임상적 고찰)

  • 서정욱;조은희
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.889-896
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    • 1996
  • Aggressive revascularization of the ischemic lower extremities in atherosclerotic occlusive diseases or acute embolic arterial occusion due to cardiac valvular disease by thromboembolectomy or an arterial by- pass operation has been advocated by some authors. To evaluate clinical pattern and operative outcome of the ischemic lower extremity, surgical experience in 101 patients who were admitted to Dong-A Univer- sity Hospital between March 1990 and August 1995 was analyzed. The patients were 92 males and 9 females ranging fro 25 to 87 years of age. The underlying causes of arterial occlusive disease were atherosclerotic obliterances in 54 case, Buerger's disease in 20 cases, thromboembolism in 24 cases, vascular trauma in 3 cases and pseudoaneurysm in 3 cases. - The major arterial occlusive sites of atherosclerotic obliterance were femoral artery in 30 cases, iliac artery in 23 cases, popliteal artery in 10 cases, distal aorta in 6 cases and the major arterial occlusive sites of Buerger's disease were posterior tibial artery in 14 cases, anterior tibial artery in 8 cases, popliteal artery in 5 cases. The operative procedures of arterial occlusive disease were bypass graft operation in 61 cases, thromboembolectomy in 21 cases, sympathectomy in 20 cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 61 cases which Included femoro-popliteal bypass in 21 cases, femoro-femoral bypass in 15 cases, axillo-bifemoral bypass in 7 cases, aorto-bifemoral with inverted Y-gr ft In 3 cases, femoro-profundafemoral bypass in 3 cases, popliteo-tibial bypass in 2 cases, aorto-iliad bypass in 1 case Over all postoperative patency rates were 83.6 oyo at 1 year, 75.5% at 3 years and limb salvage rate was 86.8 oyo . Six patients died in the hospital following vascular surgery for ischemic lower extremities, although the causes of death were not directly related to the vascular reconstructive operative proccedures. The leading causes of death were in the order of multiple organ failure, acute renal failure, and sepsis.

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Cognitive Dysfunction in non-hypoxemic COPD Patients (저산소증을 동반하지 않는 만성폐쇄성폐질환 환자에서의 인지기능장애)

  • Kim, Woo Jin;Han, Seon-Sook;Park, Myoung-Ok;Lee, Seung-Joon;Kim, Seong Jae;Lee, Jung Hie
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.382-388
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    • 2007
  • Background: The cognitive function is impaired in patients with hypoxemic chronic obstructive pulmonary disease (COPD). However, there are conflicting results regarding the cognitive function in patients with non-hypoxemic COPD. COPD patients also have sleep disorders. This study examined the cognitive function in non-hypoxemic COPD patients, and nocturnal sleep was assessed in COPD patients with a cognitive dysfunction. Methods: Twenty-eight COPD patients (mean age, 70.7 years) with an oxygen saturation > 90%, and 33 healthy control subjects (mean age, 69.5 years) who had visited for a routine check-up were selected. The neurocognitive tests were performed using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Neuropsychological Battery. Results: The scores of the word list recall test (p=0.03) and the word list recognition test (p=0.006) in the COPD group were significantly lower than those in the control group. Nine patients showed a significantly impaired cognitive function. Seven of these underwent polysomnography, which revealed apnea-hypopnea indices ${\geq}$ five per hour in five patients. The median oxygen desaturation index and median limb movement index were 3.6/h and 38.6/h, respectively. Conclusion: These results suggest that the verbal memory function is impaired in non-hypoxemic COPD patients. Six out of seven COPD patients with an impaired cognitive function had sleep disorders of sleep apnea and/or periodic limb movements during sleep.

Segmental Resection and Rotationplasty of Malignant and Aggressive Bone Tumors Around Knee (슬관절 주위 악성 및 침윤성 골종양의 분절 절제술 후 회전 성형술)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kim, Hyoung-Sik;Kim, Sung-Hun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.51-58
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    • 2001
  • Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

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Igneous Activity and Geological Structure of the Ogcheon Metamorphic Zone in the Kyemyeongsan area, Chungju, Korea (충주 계명산지역 옥천변성대의 화성활동과 지질구조)

  • 강지훈;류충렬
    • The Journal of the Petrological Society of Korea
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    • v.6 no.3
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    • pp.151-165
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    • 1997
  • The Kyemyeongsan area of Chungju in the NE part of the Ogcheon metamorphic zone, Koera, consists mainly of the Ogcheon Supergroup(Taehyangsan Quartzite, Hyangsanri Dolomite and Kyemyeogsan Formation) and the MeSozoic Chungju granite. The Kyemyeongsan Formation is composed mainly of metamorphic rocks of various grades derived from conglomeratic, basic, acidic, pelitic and psammitic rocks. The basic and acidic rocks show alternated or interfingered appearence, indicating that they were derived form bimodal type of magmatism in rift environment. Conglomeratic rocks overlie acidic volcanic rocks in geneal, but are underlain by both acidic plutonic and volcanic rocks. This indicaties that the acidic magmatism before the formation of conglomeratic rocks was different from that during or after the formation of conglomeratic rocks in its occurrence mode. The geological structure of the Ogcheon metamorphic zone in the Kyemyeongsan area, Chungju was formed at least by three phases of deormation. The first phase deformation(D1) formed a regional-scale sheath-type fold(F1) closed into the east. Its axial phane(S1) strikes NNW to NW and dips WSW to SW. The stetching lineation(L1), related to the sheath-type fold, plunges westward. The second phase deformation (D2) formed asymmetric fold(F2) of ESE-to SE-vergence with NNE to NE striking axial plane(S2) and $20~45^{\circ}/210~230^{\circ}$ plunging axis(L2). The F2 fold reoriented the original westward plunging L1 into northwestward plunging L1 in its lower limb(overturned limb). The third phase of deformation(D3) was recognized as chevron-type fold(F3) with $45^{\circ}/265$^{\circ}$ plunging axis. The F3 fold was formed by the compression of N-S direction, resulting in the reorientation of the original $20-45^{\circ}/210~230^{\circ}$ plunging L2 into mainly $35~45^{\circ}/260~280^{\circ}$ and subsidiarily $30~45^{\circ}/135~165^{\circ}$ plunging L2. After this deformation, open fold with NS striking and steeply E or W dipping axial plane is formed by the compression of E-W direction.

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The essay of Bijeung by chinese doctors in 20th century - Study of - (20세기(世紀) 중의사(中醫師)들의 비증(痺證)에 대(對)한 논술(論述) 연구(硏究) - 《비증전집(痺證專輯)》 에 대(對)한 연구(硏究) I -)

  • Kim, Myung Wook;Oh, Min Suk
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.547-594
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    • 2000
  • I. Introduction The essence of Oriental medicine consists of ancient books, experienced doctors and succeeded skills of common society. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. $\ll$DangDaeMyeongIImJeungJeongHwa(當代名醫臨證精華)$\gg$ written by SaWoogWang(史宇廣) and DanSeoGeon(單書健) has many medical experience of famous doctors. So it has important historical value. Bi(痺) means blocking. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. So I studied ${\ll}BiJeungJuJip{\gg}$. II. Final Decision Following decisions of Chinese doctors of 20th century are as follows ; 1. JuYangChun(朱良春) emphasized on IkSinJangDok(益腎壯督) to treat BiJeong. And he devided WanBi(頑痺) as PungHanSeup(風寒濕), DamEo(痰瘀), YeolDok(熱毒), SinHeo(腎虛). He used insects for medicine. 2. ChoSuDoek(焦樹德) introduced past prescription. He used ChiBiTang(治痺湯) to treat HaengBi(行痺), TongBi(痛痺), ChakBi(着痺). He insisted that Han(寒; coldness) and Seup(濕; dampness) be Eum(陰) and Pung(風; wind) can change his character to be Eum. After all BiJeung is usually EumJeung. So he used GaeJi(桂枝) and BuJa(附子). By the way he used ChungYeolSanBiTang(淸熱散痺湯) for YeolBi, BoSinGeoHanChiWangTang SaBok(王士福) emphasized on the importance of medicine. He introduced many treatments like CheongYeol(情熱) for YeolBi and YiO(二烏) for HanBi. And he divided BiJeung period for three steps. At 1st step, we must use GeoSa(祛邪), at 2nd step, we must use BuJeong(扶正) and at 3rd step, we must use BoHyeol(補血), he insisted. And he introduced many herbs to treat BiJeung. 4. JeongGwangJeok(丁光迪) said that GaeJi(桂枝), MaHwang(麻黃), OYak(烏蘖) and BuJa(附子) are very important for TongRak(通絡). And pain usually results from Han(寒), so he liked to use hot-character herbs. 5. MaGi(馬志) insisted that BiJeung usually result from ChilJeong(七情). And he liked to use insects for treatment of BiJeung. 6. WeolSeokMu(越錫武) introduced 8 kinds of treatments and divided BiJeung period. Also he divided BeJeung for PungBi(風痺), HanBi(寒痺) and SeupBi(濕痺). 7. SeoGeaHam(徐季含) observed many patients and concluded that 86.7% of BiJeung is HeuJeung(虛症). 8. YuJiMyeong(劉志明) said that YeolBi is important and CheongYeol is also important. So he emphasized on DangGyuiJeomTongTang(當歸拈痛湯) and SeonBiTang(宣痺湯). 9. WangLiChu(汪履秋) studied cause of WanBi. Internal cause is GiHyeolHeo(氣血虛) and GanSinHeo(肝腎虛) and external cause is SaGi(邪氣) he insisted. 10. WangSaSang(王士相) said that YeolBi can be SeupYeolBi or EumHeuYeolBi(陰虛熱痺) and HanSeupBi(寒濕痺) is rare. He use WooBangJaSan(牛蒡子散) and BangPungHwan(防風丸) for SeupYeolBi, DangGyuiSaYeokTang(當歸四逆湯) for HanSeupBi. 11. JinTaekGang(陳澤江) treated YeolBi with BaekHoGaGyeJiTang(自虎加桂枝湯) and SaMyoSan(四妙散). If they don't have effect, he tried to cure BiJeung step by step. And he used e term of GeunBi(筋痺) and BangGiMogwaEIInTang(防己木瓜薏苡仁湯) was good for GeunBi. 12. MaSeoJeong(麻瑞亭) said that PungSeupYeokJeul(風濕歷節) is BiJeung and it is related to GanBinSin(肝脾腎; liver, Spleen, Kindey). And he emphasized on balance WiGi(衛氣) and YoungHeul(營血). 13. SaJeJu(史濟桂) said that GeunGolBi(筋骨痺) is similar to arthritis and sometimes called ChakBi. And SinBi(腎痺) is terminal stage of ChakBi, he said. He also used insects for treatment. 14. JeongJeNam(丁濟南) tried to cure SLE and used GyeJi, CheonCho(川椒), SinGeunCho(伸筋草), SunRyeongBi(仙靈脾), HyconSam(玄蔘) and GamCho(甘草). 15. JinGYungHwa(陳景和) emphasized on diagnosis of tongue. If the color of tongue is blue, it usually has EoHyeol(瘀血), for example. And he also used insects. 16. JuSongI(朱松毅) tried to devide YeolBi with OnByeong(溫病), Wi(衛), Gi(氣) and Hyeol(血). 17. RuDaBong(蔞多峰) said that JyeongHeo(正虛), OiSa(外邪) and EoHyeol are closely related. And he explained BiJeung by deviding the body into the part, for example head, neck, shoulder, waist, upper limb and lower limb. 18. YuMuBo(劉茂甫) defined PungHanSyubBi as chronic stage and YeolBi as acute stage.

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Clinical Study of The Motricity Index and Symptoms and signs in Acute Ischemic Stroke Patients on East-West Collaborative Treatment : A Pilot Study (한·양방 병행치료를 시행한 급성기 뇌경색 환자의 운동 기능과 임상 증상 및 증후의 호전도에 관한 연구 : 예비연구)

  • Kim, Min-kyung;Shim, So-ra;Kim, Soo-kyung;Kim, Na-hee;Cho, Seung-yeon;Park, Joo-young;Park, Seong-uk;Jung, Woo-sang;Moon, Sang-kwan;Park, Jung-mi;Cho, Ki-ho;Kim, Young-suk;Bae, Hyung-sup;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.12 no.1
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    • pp.41-49
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    • 2011
  • Objective : Stroke is the most common disabling neurological disease of adult life. And some part of the clinical symptoms and signs are correlated to the post stroke complication. This study was to analyze the therapeutic effect of the East-West collaborative treatment, especially on the motor power and the clinical symptoms and signs improvement of ischemic stroke patients. Method : For 2 weeks as possible, we observed the patients with acute ischemic stroke receiving East-West collaborative treatment. We assessed the patients using Motricity Index (MI) and the changes of clinical symptoms and signs three times at seven-day intervals. At the end of the study, we compared the results. Result : Motricity Index of patients changed from 71.55 to 76.03 (upper limb) and 73.05 to 79.42 (lower limb), respectively. Some items of clinical symptoms and signs showed the statistically significant result. Especially, the urination and defecation symptoms improved obviously. Conclusion : The East-West collaborative treatment has an effect on motor power and clinical symptoms and signs improvement of acute ischemic stroke patients.

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Study of Deformity by the Involvement of the Femoral Head of the Proximal Femur in Polyostotic Fibrous Dysplasia (다발성 섬유성 이형성증에서 근위 대퇴골두 침범 여부에 따른 변형 정도)

  • Na, Bo Ram;Jung, Sung Taek;Cho, Yong Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.519-527
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    • 2019
  • Purpose: To evaluate the treatment result in polyostotic fibrous dysplasia classified according to the involvement of the femoral head. Materials and Methods: Twenty-three patients from March 1987 to March 2014 were reviewed retrospectively. Patients with no involvement of the physeal scar in the femoral head were classified as Type I, and those with involvement of the physeal scar were classified as Type II. A plain radiograph was used to measure the femoral neck shaft angle, articulo-trochanteric distance (ATD), and anterior bowing through the lateral view. A teleoroentgenogram of the lower limb was used to measure the leg length discrepancy and lower extremity mechanical axis. The pre- and postoperative femoral neck-shaft angle and ATD were compared to assess the degree of correction of the deformity. Results: Among a total of 46 cases (23 patients), 28 cases (23 patients) had lesions in the proximal femur. Type I were 16/28 cases (15/23 patients) and Type II were 12/28 cases (9/23 patients). The preoperative proximal femoral neck-shaft angle was 116.8° in Type I and 95.3° in Type II. The ATD was 12.08 mm in Type I and -5.54 mm in Type II. The deformity correction showed significant improvement immediately after surgery, the deformity correction was lost in Type II (neck shaft angle Type I: 133.8°-130.8°, Type II: 128.6°-116.9°, and ATD Type I: 17.66-15.72 mm, Type II: 7.44-4.16 mm). The extent of anterior bowing was 12.74° in Type I and 20.19° in Type II. The mean differences of 12 mm between the 9 patients who showed a leg length discrepancy and the lower extremity mechanical axis showed 4 cases of lateral deviation and 7 cases of medial deviation. Conclusion: In polyostotic fibrous dysplasia, when the femur head is involved, the femur neck shaft angle, ATD, and anterior bowing of the femur had more deformity, and the postoperative correction of deformity was lost, suggesting that the involvement of the femoral head was an important factor in the prognosis of the disease.

A Survey on the Current Status of Safety and Health and of Safety Management Levels among Korean Native Cattle Farms (한우 농가의 농작업 안전보건 실태 및 안전관리 수준 조사)

  • Kim, Insoo;Lee, Kyung-Suk;Kim, Hyo-Cher;Chae, Hye-Seon;Kim, Kyungsu;Choi, Dong-Phil
    • Journal of Environmental Health Sciences
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    • v.43 no.1
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    • pp.42-54
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    • 2017
  • Objectives: The present study was conducted to investigate farm work environments among farmers and examine the level of management of safety and health, and to subsequently produce study result to serve as foundational data for the development of guidelines on safety and health as part of the improvement of farming work environments among farmers raising Korean native cattle. Methods: The present study conducted a survey on farm work environments and the management of safety and health with 407 farmers engaged in Korean native cattle farming in selected regions in eight provinces. It also visited 10 farmers to verify the current status of farm work. Results: The survey results showed that 16.4% of the respondents experienced safety-related accidents due to farm work. The locations of the accidents were inside the cattle shed (71.4%) and facilities outside the cattle shed (19.6%). The types of accident showed collision with animals (35.7%), collision or contact with obstacles (27.1%), and musculoskeletal accidents due to heavy object handling (12.9%). The causes of the accidents were cattle (38.3%), cultivators and tractors (25.4%), facility tools in cattle sheds (9.0%), and slippery floors (6.0%). The damaged areas were hand (21.0%), spine (19.8%), lower limb (18.5%), and foot (17.3%). A self-diagnostic survey on respiratory diseases showed that 11.5% of the respondents experienced respiratory-related symptoms. The survey on safety and health during farm work showed that wearing personal protective equipment and response to emergency situations, which were needed to prevent safety-related accidents, were relatively low compared to the level of recognition of the need and awareness of safety issues. Furthermore, the field survey identified the current status of safety and health issues such as prevention management of collision accidents with cattle, how to handle heavy objects, and wearing of personal protective equipment. Conclusions: The present study identified safety-related accidents and problems in the management of safety and health among Korean native cattle farmers. In order to address the problem, it is necessary to not only provide guidelines on safety and health management which are appropriate to the characteristics of Korean native cattle farming work, but also to study the development of personal protective equipment.

A Study on Digital Infrared Thermographic Imagic Characters of women suffering from Postpartum disease (DITI를 이용한 산후풍 환자의 체표 온도 특성 연구)

  • Park, Kyoung-Sun;Lee, Yoon-Jae;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.6 no.1
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    • pp.49-55
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    • 2008
  • Purpose: During Postpartum period many women complain multiple pain, cold hypersensitivity, hot flush, sweating and so on. We call the postpartum disease as San Hu Pung. We studied characters of DITI Characters of women suffering from Postpartum disease. Methods: We studied 55 patients visiting OOhospital from February 2006 to November 2007. The subjects were categorized in two groups, symptom group(37) and no symptom group(18). We measured the temperatures of abdomen(CV17, CV12, CV4), upper and lower limb(PC8, LU4, LR3, ST32) and back(GB21, BL18, BL53). We studied the difference of DITI between two groups by Student T-test using SPSS for windows (version 12.0). Results: The general characteristics such as age, days of postpartum, primiparity, cesarean section, partum season, breast-feeding of two groups were not different statistically. Temperatures of abdomen(CV17, CV12, CV4) and back(GB21, BL18, BL53) of two groups were not different statistically. Temperatures of Lt. PC8 and both LR3 of symptom group were statistically higher than no symptom group. The difference between Lt. PC8 and LU4, both LR3 and ST32 of symptom group were statistically higher than no symptom group. Conclusion: The results suggest that women suffering from Postpartum disease shows high temperature on hand and foot. It seems that postpartum disease patients tend to have blood deficiency. DITI can be useful to diagnose San Hu Pung. The more studies to diagnose San Hu Pung would be needed.

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Anterior Knee Pain Syndrome & Shin Splint (전방 슬관절 동통 증후군 및 경부목)

  • Kim, Yeung-Jin;Chun, Churl-Hong;Lee, Ji-Wan;Choo, Ji-Woong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.7-15
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    • 2010
  • Anterior knee pain syndrome would best be defined as a painful condition that arises in or around the patellofemoral joint and is insidious in onset and bilateral, with an enigmatic entity with multiple causes. Although its etiology is uncertain, the cause is often considered to be abnormal lower limb biomechanics, pathology of extensor mechanism, disorder of patellofemoral joint, malalignment or lateral tracking of the patella, soft tissue tightness, muscle weakness. The measurement of patellar alignment has come to be accepted as an integral part of the examination of anterior knee pain syndrome. Various measurement techniques exist, both clinical and radiological, and these have been frequently used in the diagnosis and treatment of the condition.?Treatment depends on the underlying cause of anterior knee pain and should be directed to the cause rather than to the results. Most often, this involves non-surgical measures, such as anti-inflammatory medications, quadriceps exercises, and hamstring stretching. Shin splint, or medial tibial stress syndrome refers a syndrome of pain running along the inner distal 2/3 of tibia shaft. Shin splint is a common problem for athletes whose sport involves a repeated, jarring impact to the leg. A major factor determining the efficacy of the treatment is that correct diagnosis be made of the problem. The varied etiology has led to the development of several theories as to the cause, treatment, rehabilitation and prevention of shin splint. The management is rest, ice massages, pain relief by medication, and muscle strengthening exercise. Proper rehabilitation and preventative measures can ensure that there is no further recurrence.

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