• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.56-61
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• 2000

Recommendable reconstructive surgery in the patient with thumb amputation through base of the first metacarpal bone is pollicization. Some patients who do not agree with harvest sound finger as a new thumb, we can consider other options as toe transplantation or osteoplastic thumb reconstruction for creating thumb. Toe transplantation to the thumb is effective procedure in the amputation of distal to metacarpal shaft, it is rarely indicated in the cases of proximal to base of the first metacarpal bone. We performed three cases of modified osteoplastic thumb reconstruction with free vascularized rib that combined with scapular free flap or radial forearm flap. The length of transplanted rib ranged from 7~11cm, the donor vessels are posterior intercostal artery and vein which anastomosed to radial artery. The grafted rib wrapped with additional free flap for creating new thumb. Result of that procedure was not much encouraging, aesthetic appearance and mobility of thumb were not so satisfactory but reconstructed thumb gave improvement of the hand function without sacrificing toe or other digit. That gave reasonable stability for powerful side pinch and three pod pinch and opposable thumb with normal carpo-metacarpal joint motion that can give much function to the thumb absent hand. In spite of those disadvantages, thumb reconstruction with rib transfer can be useful for patients who do not want to lose another part of the body for creating thumb in basal amputation of the thumb metacarpal.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.117-122
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• 2006

The function of the thumb is critical to overall hand function. The thumb enables motions such as pinch, grip, fine manipulation and allows to circumduction and opposition. It's loss is a serious problem not only from cosmetic point of view but also functional. Therefore, we should make every effort on thumb reconstruction. Many methods of thumb reconstruction from simple osteoplasty to complex microsurgical reconstruction have been reported. We should understand merits and demerits of each method and choose proper method on case by case. When both hands are injured and there is no option but to amputate one hand and the thumb of another hand is lost, spare part flap from the thumb of the amputated hand to another hand can solve cosmetic problem, functional problem and donor morbidity. We report a case of amputated thumb which has been reconstructed with amputated ring finger of the contralateral hand using spare part flap concept.

• 한국전문물리치료학회지
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• 제5권2호
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• pp.39-46
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• 1998

Thumb adduction is an abnormal pattern typically noted in children with spastic cerebral palsy. This abnormal pattern can limit hand function, specifically in the type and quality of prehension pattern used and in the coordination of release. This ABAB single-subject research was designed to examine the effects of short thumb opponens splint on hand function in cerebral palsy. The subject was a 4 years and 8 months old boy with right upper extremity spasticity. The child was fitted with a short thumb opponens splint, which was worn for 8 hours per day during the daytime. Two different measures were used: (a) prehension component scores; (b) Bruininks-Oseretsky test of motor proficiency. Data was collected three times a week for 10 weeks. Visual analysis of data indicate that after the application of a short thumb opponens splint, improvements were noted in the prehension pattern and fine motor functional task. The results of this study suggest that short thumb opponens splint may prove efficaciousness in the treatment of the child with cerebral palsy.

• 한국정보과학회논문지:소프트웨어및응용
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• 제32권3호
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• pp.227-235
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• 2005

임베디드 시스템에서는 메모리와 에너지의 소비가 중요한 관심사 중 하나이다. 메모리와 에너지의 소비를 줄이기 위해 32비트의 ARM 프로세서는 16비트 Thumb 명령어 세트를 지원한다. 주어진 응용프로그램에 대해 Thumb 코드는 일반적으로 ARM 코드보다 코드 사이즈가 작지만, 실행속도는 느리다. 코드 사이즈가 작으면서도 실행속도가 느리지 않은 코드를 생성하기 위한 방법으로 Krishnaswarmy는 응용프로그램에 대한 프로파일 정보를 이용하여 모듈 수준에서 ARM과 Thumb 명령어 세트를 선택하는 알고리즘을 고안했다. 이 알고리즘은 작은 성능 손실로도 상당한 코드 사이즈 감소 효과를 갖지만, 명령어 세트가 모듈 수준에서 선택되기 때문에 Thumb 코드로 컴파일 하면 코드 사이즈를 줄일 수 있는 함수들도 ARM 코드로 컴파일 되어, 추가적인 코드 사이즈 감소의 기회를 잃게 되는 문제점을 갖고 있다. 본 논문에서는 ARM과 Thumb 코드가 혼합된 코드 사이즈의 감소를 이끌어내기 위해 함수 수준에서 프로파일(Profile) 정보를 이용한 명령어 세트 선택 알고리즘을 제안했다. 우리는 성능에서의 페널티는 없이 2.7％의 코드 사이즈를 추가로 줄일 수 있었다.

• 디지털융복합연구
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• 제16권7호
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• pp.511-516
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• 2018

외상성 뇌손상 환자에게 일반적인 형태의 짧은 엄지보조기(thumb splint)와 헬스장갑을 수정하여 만든 장갑형 보조기를 적용하여 손기능과 기능적 과제 수행에서의 효과를 알아보고자 하였다. 대상자는 외상성 뇌손상 1인을 대상으로 하였고 개별실험연구 방법 중 동시중재교차 연구설계를 적용하였다. 짧은 엄지보조기와 맞춤 제작한 장갑형 보조기를 이용한 중재의 결과는 보조기를 적용하지 않은 손과 비교하였을 때 즉각적인 손기능의 향상이 있었으며 두 가지 보조기 중에서는 장갑형 보조기를 사용하였을 때 기능적 과제에서 더 유용하였다. 외상성 뇌손상 환자가 가지는 손기능 장애의 작업치료중재로써의 보조기가 효과적임을 확인할 수 있었고 개인별 특성에 맞춘 보조기 적용의 필요성을 확인할 수 있었다. 앞으로 유사한 대상자들에 대한 다양한 상태에서의 보조기 적용에 대한 연구가 필요하다.

• 대한한의학방제학회지
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• 제29권2호
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• pp.93-103
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• 2021

Objectives : This study was conducted to evaluate the Intraocular pressure (IOP) and retina neuroprotective effect of Acer palmatum thumb. extract in glaucoma of DBA2/J mice vivo model. Methods : The amount of change in intraocular pressure(IOP) was measured every two weeks for 30 weeks in the DBA2/J glaucoma animal model. The increased IOP were regrouping into drug treatment groups. EW and EE (1, 2 mg/㎖)extract was eye drop administered twice per day for 8 weeks. After administration of the extract, IOP was measured every 1 week at a fixed time for 8 weeks, and protein expression levels and serological changes related to retinal function were investigated. Results : The DBA2/J mice were IOP increased as time dependent, resulting in damage to the retinal function protein related in glaucoma animal model. However, administration of extracts from Leaves of Acer palmatum thumb. prevented an increase IOP, increased for Brn3α, PKCα, and OPN1SW. Additionally, the experssion of Aterocyte maker, GFAP was decreased in DBA2/J mice. Conclusions : These results demonstrate that both IOP and age can be considered in studies using DBA2/J mice and suggest that the extracts from Leaves of Acer palmatum thumb. regulating of IOP and expression of proteins related to retinal function.

• Archives of Reconstructive Microsurgery
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• 제3권1호
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• pp.81-89
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• 1994

Firstly the wrap-around free flap from the great toe was transferred successfully by Morrison and O'Brien in 1980 for reconstruction in chronic case of amputated thumb distal to the MP joint. Since then, significant bone peg resorption and grafted bone fracture have been reported in most of cases after operation. We have performed thumb reconstructions within 2 weeks after injury in 11 cases which included acute crushing injuries or failed replantation of thumb at Guro Hospital from September, 1983 to October, 1993. The results obtained from this study are as follows: 1. There were 8 males and 3 females and the mean age was 28.8 years old ranged from 3 years old to 50 years old. 2. The most common injury mechanism was machinary injury in 10 of 11 cases. 3. We have performed thumb reconstructions by using wrap-around free flap from the great toe without bone graft in 6 cases and with bone graft in 5 cases within 2 weeks after injury. 4. During 6 years and 1 month mean follow-up period, there were bone resorptions in 3, grafted bone fracture in 1, infections in 2 and soft tissue necrosis in 3 cases. 5. We obtained satisfactable results in respect of function and cosmesis and urged to use this flap for reconstruction in acute thumb injury.

• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.56-60
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• 2012

Purpose: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. Methods: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. Results: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. Conclusion: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.232-235
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• 2013

Objective : Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. Methods : Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. Results : The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). Conclusion : Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.86-92
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• 2001

Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; Pinch Power was average 1.2 Pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.