Hong, Min Ki;Lee, Dong Chul;Choi, Min Suk;Koh, Sung Hoon;Kim, Jin Soo;Roh, Si Young;Lee, Kyung Jin
Archives of Plastic Surgery
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v.47
no.6
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pp.590-596
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2020
Background The introduction of the partial second toe pulp free flap has enabled superior aesthetic and functional results for fingertip reconstruction in adults. Children undergoing fingertip amputation for various reasons have limited options for reconstruction. Conventional treatment could shorten the finger, leading to poor cosmesis and function. We report 18 years of our experiences with fingertip reconstruction using partial second toe pulp free flaps in patients in early childhood. Methods Medical charts of children who had undergone fingertip reconstruction using partial second toe pulp free flaps from 2001 to 2018 were retrospectively reviewed. The surgical procedures were identical to those for adults, except for the usage of 11-0 nylon sutures. Patients' demographic data, vessel size, flap dimensions, length of the distal phalanx, and functional outcomes over the course of long-term follow-up were documented. The statistical analysis was performed with the Student t-test, the Mann-Whitney U test, and Pearson correlation analysis. Results Eighteen toe pulp flaps in 17 patients (mean age, 3.0 years) were identified. All the flaps survived without any major complications. In long-term follow-up, the flap-covered distal phalanges showed growth in line with regular development. There was no donor-site morbidity, and all children adapted to daily life without any problems. In two-point discrimination tests, the fingertip sensation recovered to almost the same level as that in the contralateral finger. Conclusions Partial second toe pulp free flaps are an excellent option for fingertip reconstruction in young children, as well as in adults.
This study was peformed to investigate the morbidity of nutritional secondary hyperparathyroidism(NSH) caused by imbalance of Ca and p, and related athletic disease in Cheju pony racehorse. The seventeen horses with clinical signs among 33 NSH affected, administered CaCO$_3$(34 g) and Vita-rinka1(120 g) respectively for 40 days. The results were asd follows; Morbidity of NSR was 33 among 47 horses, and it was caused by the deficiency of Ca in 32 horses. In a case, level of Ca was norm질 although P was high. There was no case of Ca deficiency with P excess. Among 33 NSH affected horses, 13 were subclinical and 20 were clinical types with severe lameness in 6 and transient lameness in 14. Although there was no difference in bone density between transient lameness and normal horses on radiography, among six horses wlth severe lameness two showed hyperplasia at periosteum, one had low density of phalanges and metacarpal bones, and thin cortex. and there with fracture at carpus, nivicular bone and proximal sesamoids. The levels of FECa and FEP were recovered after CaCO$_3$ administration in 2 horses among ten, and after Vita-rinkal in all of seven. The clinical signs were disappeared in slx horses among ten CaCO$_3$ treated, and in five among seven Vita-rinkal treated. There were no differences on radiography in bone density and thickness of cortex on 14 horses with transient lameness. Three horses with severe signs were recovered to normal bone density and thickness of cortex, and there was no significant difference between two groups. In summary, the morbidity of NSH in Cheju pony racehorses was relatively high because of deficiency of Ca. Constant admistration of Ca supplements is desirable to treat and prevent athletic disease development in Cheju racehorses.
Kim, Jae Woo;Choi, Hwan Jun;Kim, Mi Sun;Kim, Jun Hyuk
Archives of Plastic Surgery
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v.34
no.3
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pp.409-412
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2007
Purpose: Percutaneous Kirschner wire fixation is common method for hand fracture. It is simple but has risk of ascending infection through the pin and bony injury by multiple drilling. Ascending infection through pin tract is mostly superficial and can be treated with antibiotics and aseptic dressing. This is a case review of subacute osteomyelitis on phalangeal bones after Kirschner wire fixation with literature review. Methods: A 40-years-old man with distal phalangeal fracture on right second finger is presented. He went to a local clinic and had percutaneous Kirschner wire fixation under local anesthesia. He was transferred to our hospital for ulcerative wound on DIP joint at 4 weeks after operation. Radiography showed osteolytic change around medulla of middle and distal phalanges, leading to diagnosis of a subacute osteomyelitis. We treated it with amputation at the level of shaft of middle phalanx. Results: The postoperative course was uneventful. We thought several possible reasons for osteomyelitis in our case. First, it could resulted from ascending infection through the wire. Second, it could be resulted from a bony burn by repeated drilling. And bony necrosis could be a consequence of arterial insufficiency caused by 2 pin insertion. Conclusion: We suggest that a precise pinning based on accurate anatomical understanding is required for a percutaneous Kirschner wire fixation. The frequency of drilling should be minimized. Careful observation and patient education for pin site care are essential.
Noh, Seung Man;Kim, Jin Soo;Lee, Dong Chul;Roh, Si Young;Yang, Jae Won
Archives of Plastic Surgery
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v.35
no.4
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pp.450-454
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2008
Purpose: From May 2000 to January 2008, We experienced the 10 cases of the thenar free flap for the coverage of the large volar soft tissue defect in the finger. Methods: The pedicles of the flap were the superficial palmar artery of radial artery and subcutaneous vein, and we anastomosed them to the digital artery and subcutaneous vein of the finger. Results: The average size of the flaps was $12cm^2$ and it was large enough to cover the entire color soft tissue defect of a phalanx or the defect of the neighbored phalanges. All of donor wounds were closed primarily. Conclusion: The color and skin texture of the flap was matched with the volar skin of the finger functionally and cosmetically and the debulking of the flap was not necessary. Other advantages were constant anatomic pedicle of the flap, minimal donor site morbidity, one operation field. We consider that the thenar free flap is another reliable and useful method for the reconstructing of the large volar defect of the finger especially at the situation of emergency.
To investigate the relationship between the pubertal spurt in body height and bone maturity of the hand-and-wrist in normal occlusion, the author X-rayed the hand-and-wrists of 1,141 students (male 614, female 527) and assessed their bone maturity. In this study, eleven skeletal stages were selected. The bones used to determine skeletal maturity were the ulnar sesamoid of the metacarpophalangeal joint of the first finger, the epiphyses of the proximal, middle, distal phalanges of the third finger, and middle phalanx of the fifth finger, and distal epiphysis of the radius. From the longitudinal data for height, an assessment was made of the change in growth velocity. The pubertal growth stage was divided into onset and peak height velocity phases. The results were as follows; 1. The onset of the pubertal growth was between the $PP_3=\;and\;MP_3=$ stage for boys, and between the $MP_3=\;and\;MP_5=$ stage for girls; the mean age of onset was 10.6 years for boys and 9.0 years for girls. 2. The peak height velocity was between the S and $MP_{3_{cap}}$ stage for boys, and between the $MP_{3_{cap}}$ and $MP_{5_{cap}}$ stage for girls; the mom age of peak height velocity was 12.5 years for boys and 10.9 years for girls. 3. As the stages of bone maturity progressed from $DP_{3u},\;to\;PP_{3u},\;MP_{3u}$, Ru, the peak height velocity had been reached, and the growth rate retarded, therefore the approach to full physical maturity was attained. 4. The evidence for the period of onset, peak height velocity and bone maturation suggested that girls were in advance of boys. During the latter part of pubertal growth, the rate of boys' bone maturation was faster than that of girls'.
The purpose of this study was to determine the adverse effects of methylmercuric chloride(MMC) against the fetal growth and the ossification rate of fetal pectoral and pelvic girdle, stermebrae, ribs and tail in pregnant Fischer 344 rats administered orally on day 7 of gestation. The resulted obtained are as follows. The weight and size of fetus were highly reduced by MMC. The reduction of fetal weight and size were 16. 2%~24.5%(p<0.01), and 34.1%~48.8%(p<0.01), and that of the litter’s weight were 67.0%(p<0.01) and 89.2%(p<0.01) by 20 and 30mg/kg MMC, respectively. Ossification centers were never formed in pectoral and pelvic phalanges and sternebrae, and was reduced as much as 70% in tail by 30mg/kg MMC. And also those were 82.4%~ 91.2%(p<0.01) in ischium, and 52.4~66.7%(p<0.01) in the others(ilium, fenur, tibia, fibula, metatarsals)of pelvic girdle by 30 mg/kg MMC. Ossification of sternebrae was terrible. 5th bone of sternebrae was not ossificated by 20 and 30 mg/kg MMC(p<0.01), and 2nd was also not ossificated by 30 mg/kg MMC(p<0.01).And reduction of ossification rate was 84.8~97.8%(p<0.01) in the others of sternebrae by 30 mg/kg MMC. And then, the reduction of ossification rate was 26.65~49.8%(p<0.01) in fetal ribs by 30 mg/kg MMC, and they were trend to increased as following from center to each edge. In conclusion, it was observed that fetal weight, size, and ossification of each bone were highly significantly reduced by the increased dosage of MMC.
Journal of Physiology & Pathology in Korean Medicine
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v.21
no.6
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pp.1663-1669
/
2007
Acute transverse myelitis(ATM) is defined as an acute intramedullary dysfunction of the spinal cord, ascendng or static involving both halves of the cord and appearing without any history of previous neurological diseases due to traumatic accident, tumor of all kind, encephalitis and of course excluding all possible viral, bacterial and fungal infection. It is mainly characterized by acute motor disorder of both limbs in respect to which spinal segments are affected as well as sensory disorder and dysuria & dyschezia. The exact cause is unknown, however it is recently suggested that immunological factors are highly involved. It has been reported by several reliable sources that it is often accompanied by immunological diseases such as systemic lupus erythematosus(SLE). As treatments non steroid anti-inflammatory drugs(NSAIDS) are primarily recommended as to steroids, limited doses are injected only with the proper prescription from the physician. Operative methods are not options as traumatic accidents and tumors are excluded as factors. To enhance muscle strength and prevent articular contracture physical therapy and passive exercise is imperative. The following patient whose chief complaints were mainly about hypoesthesia of Rt. lower limb and stiffness of phalanges of both fingers as well as to weakness of lower extermity. Therefore it has been diagnosed as arthalgia syndrome. In oriental medicine factors such as wind evil heat-evil, dampness-heat evil, cold evil cause the arthalgia syndrome. In this case the patient was diagnosed as dampness-heat evil and herbal medicine Chunglijagam-Tang and Dong-Qi acupuncture was applied to treat bladder disorder.
Objective: This study aimed to analyze the effects of computer game exposure on pathological musculoskeletal symptoms in adolescents. Method: This study included 10 male junior high school students who used computers less than 3 times a week for 1 hr per day. The subjects were asked to play computer games for 4 hr. Magnetic resonance imaging of the hand and wrist, from the distal radius and ulnar head to the distal phalanges, and radiography of the cervical vertebrae were performed before and after playing computer games. For each dependent variable, a paired t-test was performed to identify significant changes before and after a 4-hr active computer game (p<.05). Results: The horizontal diameters of the flexor tendons in the index and middle fingers were significantly reduced after playing computer games. The horizontal diameters of the flexor tendons of other fingers did not show any significant differences, but there was a tendency toward a decrease after playing computer games. There was no significant change in the cervical lordosis angle before and after playing computer games. However, the cervical lordosis angle was relatively decreased. Conclusion: The results of this study showed that computer game exposure had direct and indirect effects on morphological changes of flexor tendons. In addition, playing computer games for long periods of time can have a negative effect on normal functioning of the musculoskeletal system, with the possible development of abnormalities. However, computer game exposure in adolescents cannot be decisively identified as a factor causing pathological symptoms, based on the results of this study alone. Thus, longterm longitudinal studies on the overall musculoskeletal system are necessary.
Kim, Sung Hoon;Huh, Rhin Sou;Do, Jae Cheul;Lee, Young Ho;Park, Joon Hyoung
Current Research on Agriculture and Life Sciences
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v.4
/
pp.124-126
/
1986
A teratogenecity study was carried out on SD rats administered antiemetic drug (components: diphenhydramine hydrochloride, caffeine, promethazine hydrochloride) at dose levels of 5, and 10ml/kg/day for a period of 11 days from day 7 to 17 of gestation. All of the pregnant females in each group were sacrificed on 20th day of gestation and their fetuses were examined. The incidences of external and skeletal anomalies were not significantly increased in the fetuses of any treated groups, and delayed ossification and resorptions in the treated groups were increased compared to these of the control group and mean number of corpus lutea on the treated groups were decreased compared to that of the control group.
Kim, Jung-Hyun;Kim, Hyun-Jin;Lee, Seung-Gu;Song, Chang-Ho
PNF and Movement
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v.18
no.3
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pp.305-313
/
2020
Purpose: The aim of this study was to investigate the relationship between a functional evaluation model and the Fugl-Meyer assessment (FMA) scale in evaluating the upper extremities of stroke patients Methods: Thirty-eight stroke patients were evaluated using the FMA and performed reaching and grasping motions using a three-dimensional motion analysis (Qquas 1 series, Qualisys AB, Sweden). The participants sat on a chair with a backrest. The position of the cup was located at a distance of 80% to the front arm length. The markers were attached to the sternum, acromion, elbow lateral epicondyle, ulnar styloid process, three metacarpal heads, and the distal phalanges of the thumb and index finger. The variables of the correlation between the functional evaluation model and the FMA scale were analyzed. Multiple regression (stepwise) was used to investigate the effect of the kinematic variables. Results: A significant negative correlation was found between the movement time (p < 0.05), movement unit (p < 0.05), and trunk displacement values (p < 0.05) in the FMA total scores, while a positive correlation was found between the peak velocity (p < 0.05) and maximum grip aperture values (p < 0.05). As a result of the multiple regression analysis, the most significant factor was the movement unit, followed by the general movement assessment and trunk displacement. The explained FMA total score value was 62%. Conclusion: This study presents a new functional evaluation model for assessing the reaching and grasping ability of stroke patients. The factors of the proposed functional evaluation model showed significant correlations with the FMA scale scores and confirmed that the new functional evaluation model explained the FMA by 67%. This suggests a new functional evaluation model for reaching and grasping stroke patients.
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