• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.252-255
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• 2018

A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.18-25
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• 2011

Purpose: In the process of replantation of the amputated fingertips, the primary concern was given to survival of the amputees, while the functional aspect of digits after the surgery has been easily neglected. Although an internal fixation with a K-wire is often a part of replantation of the amputated fingertips, little consideration had been given to the study of relationship between distal interphalangeal joint fixation and post operative range of motion. A comparative study in relation to post operative range of motion was done on two different groups, one group with K-wire insertion and the other group without a K-wire insertion at the distal interphalangeal joint. Materials and Methods: The study was done on the cases of a single digit amputation conducted at our institute (the age in the range of 10 to 60) in about four-year of time span from March of 2005 to March of 2009. The cases with a thumb replantation, osteomyelitis or articular surface injury have been excluded from this study. The cases of both head and shaft fracture, except the insertion site of tendon, of distal phalanx of internal fixation with a single K-wire were reviewed for this study. A group of 24 cases without distal interphalangeal joint fixation in comparison to a group of 22 cases with distal interphalangeal joint fixation was reviewed to assess the postoperative range of motion at distal interphalangeal joint on the 6th week after the surgery. And, on the 30th month after the surgery, a group of 10 cases without distal interphalangeal joint fixation in comparison to a group of 10 cases with joint fixation was reviewed. A K-wire was removed in about 5 weeks after the fracture was reunited under the radiographic image, immediately followed by a physical therapy. Result: The active range of motion for a group without interphalangeal joint fixation was measured $49.0^{\circ}$ on average, while $28.6^{\circ}$ was measured for a group with interphalengeal fixation on the 6th week after the surgery. On the 30th month after the surgery, the active range of motion was measured $52.0^{\circ}$ and $55.0^{\circ}$ on average for a group without and with interphalangeal fixation respectively. Conclusion: In the process of replantation of the amputated fingertips, short-term(on the 6th week) improvement of postoperative active motion of range can be expected in the cases without distal interphalangeal fixation in comparison to the cases of interphalangeal joint fixation with a K-wire. However, there seems to be no difference on motion of range in a long-term (on the 30th month) follow up period.

• 대한골관절종양학회지
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• 제13권1호
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• pp.55-59
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• 2007

활액막 연골종은 관절의 활액막에서 결체조직의 화생에 의해 연골 조직이 형성되는 질환이며 드물게 건초, 활액낭에 발생하는 경우도 있다. 정확한 발생 기전은 아직 밝혀지지 않았으나 외상, 감염 등이 원인으로 제시되고 있으며 관절 연골을 구성하던 연골의 일부가 떨어져 나와 활액막내로 흡수되어 연골성 화생을 일으킨다는 가설이 유력하다. 주로 슬관절에 발생하며 그 외 견관절, 주관절, 고관절 등에서 발생하는 것으로 알려져 있다. 65세 남자가 약 6개월 간의 우측 주관절 동통, 주관절 구축 및 우측 제1수지와 완관절의 신전 장애 및 감각 저하를 주소로 내원 하였다. 단순 방사선 검사상 주관절의 관절 간격이 좁아져 있었고 관절면의 가장 자리에 골극이 형성되어 있었으며 연골하골은 경화소견이 관찰되었다. 자기 공명 영상 검사상 요골두 직하방 전외측에 약 $16{\times}12$ mm 크기의 원형의 종양이 관찰되었으며, T1 강조 영상에서 균질의 저신호 강도, T2 강조 영상에서 고신호 강도와 저신호 강도가 혼재되어 있었다. 종양 절제술을 시행하였으며 수술소견상 종양에 의해 요골신경이 압박되어있는 소견이 관찰되었다. 절제한 종양은 조직소견상 활액막 연골종으로 진단되었다.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.105-108
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• 2011

Purpose: An extensive knowledge of the arterial anatomy of the upper extremity and its variations is indispensable to the hand surgeon. We report a patient with anomalous radial artery, superficial course of two radial arteries, encountered during the excision of volar wrist ganglion. Methods: The patient was a 53-year-old man who had a painful mass on the left volar wrist for 1 year. Under general anesthesia, a curved incision was made around the mass. With the skin flaps retracted, the dome of the cyst was identified. Particular care was taken to identify and protect the radial artery, which was intimately attached to the wall of the ganglion. Two radial arteries completely encircled the ganglion. The pedicle was traced to the volar joint capsule, radiocarpal ligament. The joint was open and the capsular attachments were excised. Results: The patient made an uneventful recovery. There were two arterial pulsations at the volar side of the wrist joint. Compressing this site revealed that the major arterial contributor to blood supply in the hand was the ulnar artery. At angioCT, an anomaly of the radial artery was found with a duplication. The pathway of this aberrant artery was superficial to the original radial artery. It changed its course subcutaneously at the level of the tendon of the brachioradialis muscle, and crossing the wrist lateral to the original radial artery and ending in the deep palmar arch. Conclusion: Authors experienced a case of bifurcating radial artery encountered during the excision of ganglion on the volar of the wrist. Because these duplicated radial arteries make strong contributions to the thumb and index finger as well as to the deep palmar arch, when they are present there may be probably less blood supply to the hand from the ulnar artery. If the radial artery is palpated superficially on the brachioradialis muscle, it is important to remember the kind of anomaly.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.21-28
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• 2010

Purpose: To report the clinical results of the use of arterialized venous free flaps in reconstruction in soft tissue defects of the finger and to extend indications for the use of such flaps based on the clinical experiences of the authors. Materials and Methods: Eighteen patients who underwent arterialized venous free flaps for finger reconstruction, between May 2007 and July 2009 were reviewed retrospectively. The mean flap size was 4.7${\times}3.2$ cm. The donor site was the ipsilateral volar aspect of the distal forearm in all cases. There were 8 cases of venous skin flaps, 5 cases of neurocutaneous flaps, 4 cases of tendocutaneous flaps, 1 case of innervated tendocutaneous flap. The vascuality of recipient beds was good except in 4 cases (partial devascuality in 2, more than 50% avascuality (bone cement) in 2). Results: All flaps were survived. The mean number of included veins was 2.27 per flap. Mean static two-point discrimination was 10.5 mm in neurocutaneous flaps. In 3 of 5 cases where tendocutaneous flaps were used, active ROM at the PIP joint was 60 degrees, 30 degrees at the DIP joint and 40 degrees at the IP joint of thumb. There were no specific complications except partial necrosis in 3 cases. Conclusions: An arterialized venous free flap is a useful procedure for single-stage reconstruction in soft tissue or combined defect of the finger; we consider that this technique could be applied to fingers despite avascular recipient beds if the periphery of recipient bed vascularity is good.

• 한국지반공학회:학술대회논문집
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• 한국지반공학회 2002년도 가을 학술발표회 논문집
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• pp.303-310
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• 2002

Overbreak occurred inevitably in a tunnel excavation, Is the main factor for increasing cost and time in tunnel projects. Furthermore the damage to the remained rock mass related to the overbreak can give rise to a serious safety problem in tunnels. As a rule of thumb, causes for the overbreak are inaccuracy in drilling, the wrong design of blasting and selection of explosives, and heterogeneity in rock mass. Specially, the geological features of the rock mass around periphery of an excavation are very important factors, so a lot of researches have been conducted to describe these phenomena. But the quantitative geological classification of the rock mass for the overbreak and the method for decreasing the amount of the overbreak have not been established. Besides, the technical improvement of the charge method is requested as explosives for the smooth blasting have not functioned efficiently. In this study, the working face around periphery of an excavation has been continuously sectionalized to 5∼6 parts, and the new Blastability Index for the overbreak based on 6 factors of RMD(Rock Mass Description), UCS(Uniaxial Compressive Strength) JPS(Joint Plane Spacing), JPO(Joint Plane Orientation), JPA(Joint Plane Aperture) and FM(Filling Material) is proposed to classify sections of the working face. On the basis of this classification, the distance between contour holes and the charging density are determined to minimize the overbreak. For controlling the charging density and improving the function of explosives, the New Deck Charge(N.D.C) method utilizing the deck charge method and detonation transmission in hole has been developed.

• 제어로봇시스템학회논문지
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• 제18권5호
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• pp.487-495
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• 2012

In this paper, a Smart Home Service Robot, McBot II, which performs mess-cleanup function etc. in house, is designed much more optimally than other service robots. It is newly developed in much more practical system than McBot I which we had developed two years ago. One characteristic attribute of mobile platforms equipped with a set of dependent wheels is their omni- directionality and the ability to realize complex translational and rotational trajectories for agile navigation in door. An accurate coordination of steering angle and spinning rate of each wheel is necessary for a consistent motion. This paper develops trajectory controller of 3-wheels omni-directional mobile robot using fuzzy azimuth estimator. A specialized anthropomorphic robot manipulator which can be attached to the housemaid robot McBot II, is developed in this paper. This built-in type manipulator consists of both arms with 4 DOF (Degree of Freedom) each and both hands with 3 DOF each. The robotic arm is optimally designed to satisfy both the minimum mechanical size and the maximum workspace. Minimum mass and length are required for the built-in cooperated-arms system. But that makes the workspace so small. This paper proposes optimal design method to overcome the problem by using neck joint to move the arms horizontally forward/backward and waist joint to move them vertically up/down. The robotic hand, which has two fingers and a thumb, is also optimally designed in task-based concept. Finally, the good performance of the developed McBot II is confirmed through live tests of the mess-cleanup task.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.5219-5226
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• 2011

본 논문에서는 홈서비스 로봇인 맥봇 II(McBot II)의 빌트인(Built-in) 로봇 팔과 핸드를 설계한다. 이 빌트인 타입의 로봇 머니퓰레이터는 각각 3 DOF(Degree-of-Freedoms)의 로봇팔과 3 DOF의 로봇핸드로 구성되어 진다. 제한된 공간에서 인간과 함께 생활하는 홈서비스 로봇에 탑재되는 머니퓰레이터는 최소의 로봇 크기와 최대의 작업 공간이라는 상반된 설계 스펙이 요구되어 진다. 즉, 최소의 질량과 팔 길이에도 불구하고 효율적 작업을 위한 공간 확보가 필요한 것이다. 본 논문에서는 이와 같은 상반된 문제를 해결하기 위하여 수직 방향으로 움직이는 로봇 허리 구조와 수평방향의 전후방으로 이동할 수 있는 어깨 관절을 이용한 태스크 기반의 설계 방법을 제안한다. 또한, 양손 협업시스템인 로봇 핸드도 4절 링크 핑거를 이용한 작업 기반 설계를 시도한다. 끝으로 본 논문에서는 구현된 빌트인 머니퓰레이터의 실제 동작 실험을 통하여 그 성능을 확인한다.

• Clinical and Experimental Pediatrics
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• 제57권6호
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• pp.292-296
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• 2014

The deletion of the distal long arm of chromosome 1 is associated with a characteristic facial appearance and a pattern of associated malformations. Characteristic manifestations include a round face with prominent 'cupid's bow' and downturned corners of the mouth, thin vermilion borders of lips, a long upper lip with a smooth philtrum, a short and broad nose, epicanthal folds, apparently low-set ears, micrognathia, microcephaly, abnormal hands and feet, variable cardiac or genital anomalies, moderate to severe mental retardation, and growth retardation. Using fluorescent in situ hybridization (FISH) analysis to map precisely the deletion, we present a case of chromosome 1q44 deletion with craniofacial characteristics, multiple congenital anomalies, and growth and psychomotor retardation. In comparison with other reported cases of 1q43-44 deletion, the subject does not show hydrocephalus, seizure, syn- or polydactyly of hands, and a urogenital anomaly. However, an arachnoid cyst, pinpoint dimple on the midline of the forehead, a right-sided supernumerary nipple and auricular pit, polydactyly of the right foot, adducted thumb, and flexion restriction of the proximal interphalangeal joint with a simian line in both hands were observed additionally.