• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.19-25
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• 1999

Background & Objectives : In cerebral palsy, spastic paraplegia is one of the most crippling motor manifestations. Reducing the spasticity may improve gait and decrease the incidence of lower-extremity deformities. The spasticity may result from abnormally increased afferent signals via dorsal roots onto interneurons and anterior horn and spreading of reflex activation to other muscle groups. To assess the influence of dorsal rhizotomy to spasticity, the authors analyzed five cerebral palsy patients with spastic paraplegia. Methods : The operation entailed and L1-2 laminectomy, ultrasonographic localization of conus medullaris and identification of lumbosacral dorsal roots. The innervation patterns of each dorsal root were examined by electromyography (EMG) responses to electrical stimulation. Tetanic stimulation was applied to individual rootlets of each root after reflex threshold was determined. the reflex responses were graded and rootlets producing high grade response were selected and cut. Short-term postoperative evaluations were performed. Results : Intraoperative EMG monitoring was satisfactorily performed in all five cases. One month after the operations, all patients showed greatly reduced spasticity which was measured by the instrumental gait analysis. Bilateral knee and ankle jerks were normalized and tip-toe gait with scissoring disappeared in all patients. Conclusion : Intraoperative EMG monitoring seems useful for the selective dorsal rhizotomy to reduce spasticity.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.75-80
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• 2001

Purpose : We have evaluated the morbidity of donor site after transfer of free fibular osseous and osteocutaneous flap to defect site of bone and soft tissue due to chronic osteomyelitis of long tubular bone, open fracture with bony defect, bone or soft tissue tumor and congenital anomaly. Materials and methods : The 54 cases of 79 cases to be carried out from May, 1982 to May, 2001 which could be followed up were reviewed. There were forty nine in male and five in female. The mean age was 35(4 to 66)years old and mean follow up period is 21.3 month(12 to 72). We have retrospectively analyzed the various postoperative complications such as compartment syndrome, donor site infection, skin defect, hypesthesia, hammer toes, ankle instability and activity of daily living by help of questionnaire, telephone, physical examination, follow up x-ray study and chart. Results : In the total 54 cases the medication period for pain control after operation were classified into three groups under 2 weeks(49 cases), from 2 weeks to 6 weeks(3 cases) and over 6 weeks(2 cases). The postoperative morbidity were occurred in total 12 cases(compartment syndrome: 0, infection : 2, skin defect: 1, hypesthesia: 5, hammer toe: 2 ankle pain: 2 discomfort in activity of daily living: 0), and also the morbidity rates of donor site were 23.5% in osseous flap and 21.6% in osteocutaneous flap were occurred. There was no statistical significonce in morbidity between osseous and osteocutaneous free fibular flap transfer(P>0.05). Discussion : In general the morbidity of free fibular flap transfer was relatively high but it did not have any effect on daily activity of living. We think that the meticulous operation technique, detailed wound care and early range of motion exercise will reduce the morbidity of donor site of flap.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.56-63
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• 1999

We report two patients whose acute soft tissue and tendon defects in the hand were treated by the dorsalis pedis tendocutaneous delayed arterialized venous flap between 1994 and 1997. The surviving surface area was 100% in both patients. The flap size was $10{\times}10cm\;and\;6{\times}6cm$. At two weeks postoperatively, active flextion and passive extension commenced, and progressive resistance exercises were performed for an additional 5 weeks. Flaps showed a similar color match and skin texture compared with the normal skin of the hand. Advantages of the tendocutaneous delayed arterialized venous flap are developing a larger flap than can be obtained with pure venous flap or arterialized venous flap, increasing survival rate of the arterialized venous flap which permits using a composite flap, preservation of main artery of the donor site, taking thin non-bulky tissue and easy elevation without deep dissection. The disadvantages are the requirement of a two stage operation, donor site scarring and weak extension of the toe.

• Archives of Reconstructive Microsurgery
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• v.21 no.1
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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.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.207-213
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• 2015

Background Pincer nail deformity is a transverse overcurvature of the nail. This study aimed to define the anatomical characteristics of pincer nail deformity and to evaluate the surgical outcomes. Methods A retrospective review was conducted on 20 cases of pincer nail deformity of the great toe. Thirty subjects without pincer nail deformity or history of trauma of the feet were selected as the control group. Width and height indices were calculated, and interphalangeal angles and base widths of the distal phalanx were measured with radiography. We chose the surgical treatment methods considering perfusion-related factors such as age, diabetes mellitus, kidney disease, and peripheral vascular disease. The zigzag nail bed flap method (n=9) and the inverted T incision method (n=11) were used to repair deformities. The outcomes were evaluated 6 months after surgery. Results The interphalangeal angle was significantly greater in the preoperative patient group ($14.0^{\circ}{\pm}3.6^{\circ}$) than in the control group ($7.9^{\circ}{\pm}3.0^{\circ}$) (P<0.05). The postoperative width and height indices were very close to the measurements in the control group, and most patients were satisfied with the outcomes. Conclusions We believe that the width and height indices are useful for evaluating the deformity and outcomes of surgical treatments. We used two different surgical methods for the two patient groups with respect to the perfusion-related factors and found that the outcomes were all satisfactory. Consequently, we recommend taking into consideration the circulatory condition of the foot when deciding upon the surgical method for pincer nail deformity.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.239-244
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• 2010

Purpose: Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson's pseudoangiosarcoma, is a rare disease which is now considered as a reactive process of the endothelium rather than a benign neoplasm. It can occur in any blood vessels in the body but more common in the head and neck region as a solitary, often tender, bluish or reddish nodule. IPEH is characterized by the development of endothelial-lined papillary projections in a vascular lumen, usually associated with thrombotic material, the endothelial cells in the papillary structures showing only slight atypia and occasional mitotic Figures, the absence of tissue necrosis. Methods: 8 patients with IPEH were enrolled in the study from 2002 to 2007. All 8 lesions were surgically excised for histopathologic diagnosis. Results: 4 patients were female. The duration of the lesions ranged from 3 months to 15 years. The tumors were first noted between the ages of 20 and 72 years. 4 patients had lesions on the head; 2 on the toe; 1 on the back; and 1 on the finger, respectively. All lesions were solitary, ranged in size from 2 mm to 27 mm. There were no recurrences. Conclusion: The clinical appearance of IPEH is not specific, presented as a primary neoplasm, and the diagnosis can be established by microscopic examination. Complete surgical excision is the best choice of therapy for patients with IPEH, and is both diagnostic and curative. Awareness of this lesion will prevent incorrect diagnosis and overly aggressive treatment.

• Korean Journal of Applied Biomechanics
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• v.15 no.2
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• pp.1-10
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• 2005

G. B. LEE, A. S. GWON, The Research for Using methodof GRF (Ground Reaction Force) on Rotational Movement in Arabesque. Korean Journal of Sport Biomechanics, Vol. 15, No. 2, pp.1-10, 2005. As, in relation to all movements of a human being, the movements such as mutually walking, running, rotating, and jumping are attained endlessly through the ground amid the interaction with the ground, in terms of the harmonious movement of the upper limbs and the lower limbs, related to the basic movement in ballet, the type of a movement depends on the size and direction of the force that presses down the ground (Fz, Fx, Fy) amid the interaction with the ground. Therefore, aiming to correctly and efficiently perform a rotational movement in Arabesque, this study analyzed factors of the force manifestation through GRF (Ground Reaction Force), by dividing into preparing, stepping, standing, rotating, and finishing stages (events (1) ${\sim}$ (5)), targeting the subjects of 4 elite female students who majored in ballet. 1. At the No.5 position of the preparing stage, It is necessary that support the ground with left and right foot balance, 2. As the stepping stage is the phase ranging from the event (2), in which a plie movement of bending a knee is started, to the event (3) of stretching a knee, Rebunding motion is not good, and One have a position with ankle and knee flextion condition in order to stretch strengthly in event (3) position 3. At the event (1) position, It is necessary that exert the Fz reaction force at the event (3) position. Because large stretch force help to have a toe on position easily and show a active motion 4. In order to have a stand and rotation motion smoothly, One need a muscle strength training for ankle extension, knee extension, control horizental force

• Journal of Korean Society of Steel Construction
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• v.10 no.4 s.37
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• pp.709-720
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• 1998

In order to study the distribution of welding residual stress through the plate thickness. experiment and analysis of fillet welding details were carried out. Especially, a residual stress in the weld root part of T-joint fillet weld whose measurement was difficult up to now was measured. By using the heat input and the number of the weld layers as parameters, the distribution of the 3-dimensional residual stress was investigated. As a result, we can say that with increasing the heat input, the residual stress in the weld toe and weld root barely changes. But, the area of the tensile residual stress became wide. Then, comparing a single pass with multi-pass weld method, it was found that the residual stress decreased more in multi-pass than in single pass. Moreover, it was found the thing that the area of tensile residual stress by multi-pass is lower than that by single-pass in the near weld part.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.158-169
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• 2015

Purpose: Frostbite can affect still soldiers. Initial clinical manifestations are similar for superficial and deep frostbite, so early treatment is identical. It is under-estimated by physicians. We try to identify the challenges of managing these complex tissue injuries. Methods: A retrospective analysis of 84 patients hospitalized at AFCH from 2009 to 2015 was conducted. We investigated differences of epidemiological characteristics, identification of soft tissue injury, treatment and complications between superficial (SF: 43; 51.2%) and deep (DF: 41; 48.8%) frostbite. Results: The major (94.0%) developed frostbite in dry circumstances (89.3%). Wet circumstances (66.7%) were more susceptible to DF rather than dry (46.7%). The 38 (45.2%) arrived to specialist within 7days. Most prone sites were feet, followed by hands. Toes had more deep injuries. DF presented more increased levels of ALT, CPK, CKMB, CRP. The bone scan of W+S+ was 48.3%, 87.1% and W+S- was 20.7%, 12.9%, respectively. The treatment resulted in improved or normalized perfusion scan with matching clinical improvement. It was a good tool to assess treatment response. Eighteen normal and 8 stenotic type of PCR resulted in normal with matching clinical improvement. One continuous obstructive waveform led to minor amputation. Twelve underwent both PCR and MRA. Among 6 normal PCR, 5 showed normal and one stenosis in MRA. All 5 stenosis and one obstruction showed the same findings in MRA. It was a good tool to evaluate vascular compromise. They were treated with rapid rewarming (11.6%, 22.0%), hydrotherapy (16.3%, 29.3%), respectively. Six (14.6%) underwent STSG, 2 (4.9%) had digital amputation in DF. Berasil, Ibuprofen, Trental were commonly administered. PGE1 was administered selectively for 6.8, 10.8 days, respectively. Raynaud's syndrome (16.3%), CRPS (4.7%), LOM (14.6%) and toe deformity (4.9%) were specific sequelae. Conclusion: We should recommend intensive foot care education, early rewarming and evacuation to specialized units. The bone scanning and PCR should allow for a more aggressive and active approach to the management of tissue viability.

• Journal of Veterinary Clinics
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• v.16 no.1
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• pp.86-94
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• 1999

To invstigate the available dosage and effects of xylazine as preanesthetics on the propofol anesthesia in the dog, the experimental animals were randomly divided into 3 groups (xylazine 0.55 mg/kg (group 1), 1 mg/kg (group 2) and 2 mg/kg (group 3) were premedicated) and, monitored analgesic and anesthetic effect, body temperature, respiratory rate (breaths/minute), heart rate (beats/minutes). Also, hematological and serum chemical changes were monitored. In all experimental groups, the animals were recumbent just after propofol injection and time difference was not detected. Except vomitting after xylazine injection and insignificant ataxia during recovery, no significant side effects were observed. In group 2, loss of toe-web needle prick response time was slightly longer than group 1 but the response in group 2 and group 3 were similar, In group 2 and 3, the duration of anesthesia was longer than group 1 (2 folds) but there was no difference between group 2 and 3. Recovery time was prolonged in proportion to administration dosage of xylazine. In all experimental groups, the body temperature of animals was decresed gradually according to experimental time but no significant changes were monitored. The heart rate and respiratory rate were significantly (p<0.01, p<0.05) decreased after propofol injection Hematologically, no significant changes were monitored in total leukocye numbers, total erythrocye numbers, MCV, MCH, MCHC, serum GOT and GPT values Significant changes in all groups were not observed except significant increase in BUN, total-protein and abumin values of group 3. On the basis of these result, premedication of xylazine can be helpful in decresing some side effects and the dosage of propofol. 1 mg/kg of xylazine as preanesthetics on the propofol anesthesia in the dog is considered to be available.