• Archives of Plastic Surgery
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• 제33권4호
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• pp.510-513
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• 2006

Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

• 대한관절경학회지
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• 제10권2호
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• pp.173-177
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• 2006

목적: 외상성 재발성 견관절 탈구환자에서 Bankart 병변에 대해 봉합나사를 이용한 관절경적 봉합술의 유용성을 알아보고자 한다. 대상 및 방법: 외상성 재발성 견관절 탈구로 인한 전방 불안정성 환자에 대해 봉합나사를 이용한 관절경적 Bankart병변 봉합술을 시행한 환자중에 24개월 이상 추시가 가능하였던 90례를 대상으로 Rowe와 Zarins의 평가방법을 이용하여 결과를 판정하였다. 결과: 관절경하에서 확인된 동반병변으로 Hill-Sachs병변이 46례에서, SLAP병변과 회전근개 파열병변은 각각 12례, 7례에서 관찰되었다. Rowe와 Zarin의 평가방법에 따라 평가하여 82례(91.1%)에서 양호 이상의 결과를 얻었으며, 합병증으로 재탈구가 3례에서 발생하였다. 결론: 외상성 재발성 견관절 탈구로 인한 전방불안정성 환자에서 Bankart병변에 대해 봉합나사를 이용한 관절경적 봉합술은 우수한 임상 결과와 낮은 재발율을 보이고, 합병증을 낮출 수 있는 효과적인 술식 중에 하나라고 사료된다.

• 한방재활의학과학회지
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• 제28권1호
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• pp.185-193
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• 2018

The purpose of this study is to report the improved case of superior labrum from anterior to posterior tear patient treated with Shinbaro pharmacopuncture and motion style acupuncture treatment. We used Shinbaro pharmacopucture, motion style acupuncture treatment and other korean medicine treatment for this patient. This case is measured and assessed by visual analogue scale (VAS), shoulder range of motion (ROM) and shoulder physical examination (Neer test, O'Brien test). After treatment, VAS decreased and the patient showed improvement of range of motion. Also physical examination of shoulder was improved. Shinbaro pharmacopuncture and motion style acupuncture treatment are thought to be helpful to relieve pain and recover function on shoulder joints, although further study is needed.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.155-162
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• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• 대한정형외과스포츠의학회지
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• 제1권2호
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• pp.149-153
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• 2002

목적: Bankart병변이있는 외상성재발성견관절탈구환자에서봉합나사를이용한관절경적봉합술의유용성을알아보았다. 대상및방법: 견관절의외상성전방불안정성환자에대해봉합나사를이용한관절경적Bankart병변봉합술을시행한환자중12개월이상추시가가능하였던54례를대상으로Rowe와Zarins의평가방법을이용하여결과를판정하였다.결과: 관절경하에서확인된동반병변으로Hill-S achs병변이28례에서, SLAP병변과상완골골두의연골연화증은각각6례에서관찰되었다. Rowe와Zains의평가방법에따라평가하여50례( 92.6$\%$ )에서양호이상의결과를얻었으며, 재탈구는2례에서발생하였다.결론: 외상성재발성견관절탈구로인한전방불안정성환자에서Bankar병변에대해봉합나사를이용한관절경적봉합술은우수한임상결과와낮은재발율을보이고, 합병증이낮은효과적인술식중의하나라고사료된다.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.271-277
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• 2009

목적: 그동안 견관절과 견봉하 관절에 대한 연구는 전세계적으로 매우 많은 연구가 이루어져 왔고 많은 의사들의 관심분야로 각광받아왔다. 그러나 그에 비해서 견갑골과 그 주위근육들은 상대적으로 관심의 대상이 되어오지 못한 것이 사실이다. 이에 저자들은 견갑골의 운동장애에 대하여 기술해 보고자 하는 것이 목적이다. 대상 및 방법: 기본적으로 견관절의 움직임은 언제나 견갑골의 운동을 동반하게 되어있고, 견관절의 운동에 이상이 발생하면 이는 직접적으로 견관절 움직임에도 영향을 미칠 수 밖에 없다는 것은 이미 널리 알려진 사실이다. 결과 및 결론: 특히 운동선수에 있어서는 견갑골의 움직임과 견고한 고정이 매우 중요한 역할을 차지하게 된다. 이에 저자들은 견갑골의 움직임과 중요성에 대해서 조명해보고자 한다.

• 한국운동역학회지
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• 제14권3호
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• pp.203-218
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• 2004

The purpose of this study was to analyze the comparisons of the kinematical variables when performing Yoko Ukemi(side breakfall) by three Stage in Judo. The subjects were four male judokas who were trainees Y. I. University Squad members and the Yoko Ukemi were filmed by two S-VHS 16mm video cameras(60fields/sec.). The selected times were subject to KWON 3D analysis program and kinematical analysis to compare variables of three Yoko Ukemi. Temporal variables(total time-required : TK, TR by each phase), the body part touched order on the mat and COG variables were computed through video analysis while performing right Yoko Ukemi by three stage. From the data analysis and discussion, the following conclusions were drawn : 1. Temporal variables : total time-required(TR) when performing Yoko Ukemi(side breakfall) by each stage, the first stage(full squat posture: FP : 1.11sec.) showed the shortest time, the next was 3rd(Shizenhontai, straight natural posture: NP : 1.41sec.), and 2nd(Jigohontai, straight defensive posture, DP : 1.42sec.), respectively- 2. TR when performing Yoko Ukemi(side breakfall) by each stage, and phase : the first phase(take of phase, average 0.68sec.) showed the longest time, next was the third phase(ukemi phase, 0.39sec.), and the second phase(air phase, 0.23sec.), respectively. 3. When performing yore Ukemi the body part touched order and TR on the mat : hip(0.94sec.) showed the shortest time, the next was elbow hand(0.97sec.), back(0.98sec.), and shoulder(1.04sec.) order. The hip part touched on the mat the first, but slap the mat in order to alleviate the shock try hand palm and forearm before receiving impact (difference 0.03sec,) 4. Vertical COG variables in each event by each stage : e1(ready position, average 78.33cm) moved the highest, the next was e2(jumping position, 70.14cm), e3(transition position, average 64.00cm), e4(landing position, average 35.99cm), and e5(ukemi position, average 18.32cm) order, gradual decrease respectively. And the difference of COG were showed in initial by each stage, because position fo Yoko Ukemi was difference by each stage in preparation position, but in accordance with executing of Ukemi phase that difference of COG was by decreasing, almost equal displacement in e4(landing) and e5(Ukemi)position finally.

• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.87-94
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• 2000

Purpose : The purpose of this study was to evaluate the activity of the biceps brachii muscle in the vulnerable abduction and external rotation position of the shoulder in patients with anterior instability. Materials and Methods: This experimental study include a prospective analysis of the electromyographic(EMG) data on a group of patients with traumatic unilateral anterior instability of the shoulder. The EMG data of unstable shoulders was compared with those of opposite shoulders as control. The optimal sample size for the case-control study was calculated using an nQuery Advisor program(nQuery Adviser 3.0, Statisticl solutions Ltd., Ireland). The EMG analyses were conducted in 76 shoulders in 38 patients who had a traumatic anterior instability in one shoulder. The EMG records were obtained at different position of shoulder, which included 0° , 45° , 90° and 120° of shoulder abduction. In each angle of shoulder abduction, the arms were placed in an external rotation as tolerated by the anterior apprehension. The paired-sample T test was used to compare the difference of the root mean square(RMS) voltages between the stable and unstable shoulders in each degree of arm position. Results : The RMS voltage of the biceps muscle was significantly greater in the unstable shoulder than opposite stable shoulder in all position of the arm(p<0.001). The RMS voltage of the biceps was maximal at 90° and 120° of external rotation in the unstable shoulder(p<0.05). The RMS voltage of the supraspinatus muscle revealed no differences in any of the test conditions(p=0.904, 0.506, 0.119 and 0.781 in 0° , 45° , 90° and 120° , respectively) Conclusion: In the vulnerable abduction and external rotation position, the biceps muscle plays an active compensatory role in the unstable shoulder while not in the stable shoulder.

• 대한소아치과학회지
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• 제32권1호
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• pp.144-151
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• 2005

현재 시판중인 대부분의 음료가 산성을 띤다는 사실은 이미 잘 알려져 있으며 이러한 산성의 음료 음용의 증가는 우려할 만한 수준으로 치아 침식증을 촉진할 것으로 생각된다. 따라서 본 연구는 어린이들이 비교적 일상적으로 쉽게 접하는 탄산음료 중 가장 보편화된 한 종을 택하여 치아와의 노출과 노출빈도에 따른 법랑질의 침식정도를 조사 분석할 목적으로 시행되었다. 탈락 시기의 건전한 유치를 발거하여 두 개의 군, 즉 magnetic stirrer에 의해 진동(agitation)을 받은 군과 그렇지 않은 군으로 나뉘었고 나뉜 군들은 또 각각 콜라에의 노출빈도에 따라 3개의 군으로 나뉘었다. 각각의 군들은 신선한 콜라에 5분씩 노출되었으며 노출 전과 후에 증류수에 의해 세척되었고 시편의 노출이 이루어지지 않는 시간에는 생리 식염수에 보관한 후, 인공적으로 침식을 유발시켰을 때 나타나는 양상을 표면미세경도측정법으로 분석하여 다음과 같은 결론을 얻었다. 1. 본 실험에 사용된 콜라의 산도는 평균 pH 2.5로서 치아 침식증을 유발하기에 충분한 수준이었다. 2. 콜라에 의한 침식유발 후의 법랑질 표면경도는 대조군에 비해 모든 시료에서 감소되었다(p<0.05). 침식유발 시간이 경과함에 따라 법랑질 표면경도는 모든 실험군에서 초기에는 급격히 낮아지다가 이후에는 그 정도가 덜해지는 양상을 보였다. 3. 법랑질을 콜라에 노출시킨 빈도가 증가함에 따라 법랑질 표면경도는 감소되었다. 4. 콜라에 진동(agitation)을 가하여 탄산가스를 증가시킨 결과 법랑질의 표면경도는 진동을 가하지 않은 군에 비해 감소되었다(p<0.05).

• 대한방사선치료학회지
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• 제19권1호
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• pp.27-33
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• 2007

목 적: 본원에서는 AVM (artery vein malformation)이나 뇌종양을 치료를 위하여 뇌정위방사선수술(SRS: stereotactic radiosurgery)을 시행한다. 치료위치의 확인과 선량을 검증하기위하여 본 연구에서는 Gafchromic EBT film (Gafchromic EBT QD+, International Specialty Products, USA)을 이용 두부팬톰 내의 선량분포를 계산치와 측정치를 비교하였다. 대상 및 방법: 본 실험에서는 기존의 인체모형팬톰의 두부의 2.5 cm 두께 한 슬라이스를 5장의 0.5 cm 아크릴로 대체하여 필름을 0.5 cm 간격으로 삽입할 수 있게 하였다. 4장의 필름과 5장의 아크릴판은 팬톰 단면모양을 따라 잘랐다. 이 두부팬톰에 실제 환자치료와 같은 절차로 SRS head ring과 localizer를 장착 후 0.5 cm 간격의 CT 영상을 얻어 치료계획을 수립하였다. 6 MV의 광자선을 2 cm 크기의 SRS cone을 장착하여 5개의 arc beam으로 300 cGy의 선량을 전달하였다. 필름 교정을 위해서 각각의 필름에 0, 50, 100, 200, 300, 400, 500, 600, 700, 800, 900 cGy의 선량을 조사하여 교정곡선을 얻었다. 3시간 후 팬톰내의 필름을 스캔하고 흑화도에 따른 선량으로 교정하였다. 뇌정위방사선수술의 평가를 위해 Gafchromic EBT 필름을 이용 두부팬톰 내 치료 위치를 확인하고 선량을 측정하여 계산 값과 비교하였다. 결 과: Gafchromic $EBT^{(R)}$ 필름의 선량교정 곡선은 900 cGy까지 선형을 잘 유지하였다. 모든 단면에 걸쳐 Gafchromic $EBT^{(R)}$ 필름을 이용한 두부팬톰 내 필름으로 측정한 선량과 치료계획장치(XKnife, Radionics, USA)로 계산된 선량의 차이는 5% 이내 였다. 결 론: 본 실험에서 2차원적 선량분석만이 가능한 GafChromic EBT 필름을 적층시켜 모든 슬라이스의 선량을 확인할 수 있었으며, Gafchromic $EBT^{(R)}$ 필름을 이용한 정위방사선수술에서 정도관리의 방법으로 가능할 것으로 사료된다.