• The Journal of Internal Korean Medicine
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• v.44 no.6
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• pp.1279-1293
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• 2023

A 67-year-old female patient diagnosed with acute transverse myelitis visited our hospital in February 2023. Consultation papers indicated that she was diagnosed with acute transverse myelitis and that she complained of quadriparesis and numbness in both hands and feet. However, her spine magnetic resonance imaging (MRI) did not clearly indicate that she suffered from acute transverse myelitis. She was then sent to a high-level hospital and diagnosed with Guillain-Barre Syndrome through electromyography, cerebrospinal fluid test, and spine MRI. On March 2023, she visited our hospital again, still complaining about weakness in both hands and inability to walk. She was treated with Korean medicine, including acupuncture, electroacupuncture, pharmacopuncture, and herbal medicine such as Yanggyeoksanhwatang and Sipimijihwang-tanggami. After three months, she was discharged on cane walking. The manual muscle test (MMT) grade of her upper limbs increased from 3-/3-/3-/3- (shoulder/elbow/wrist/fingers) to 4/4/4/3+, and the MMT grade of her lower limbs increased from 2/2/2/2 (pelvis/knee/ankle/feet) to 4/4/4-/4-. Her numbness in both feet disappeared, and her numbness in both hands decreased from a numeric rating scale of 7 to 2. No adverse events were reported during treatment. This case implies the therapeutic potential of Korean medicine for Guillain-Barre Syndrome, especially for those who had delayed diagnosis and missed the opportunity to get plasma exchange.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.86-108
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• 2001

This study was performed to examine the annual experience rate of musculoskeletal symptom and its related factors in rural farmers. Six-hundred and sixty one rural farmers were investigated by questionnaire survey through interview from July 1 to July 31 in 2000. The results were as follows; The rural farmers who had experienced musculoskeletal symptom during recent 1 year was 82.7% in male, 92.1% in female. The annual experience rate of musculoskeletal symptom by part of the body in male were turned out as back; 42.3% leg and knee; 36.4%, shoulder; 21.4%, arm and hand; 12.7%, elbow; 7.7%, hip; 6.8% neck; 6.4%, ankle and foot; 6.4% in order. The annual experience rate of musculoskeletal symptom by part of the body in female were turned out as back; 59.4%, leg and knee; 48.5%, shoulder; 20.2%, arm and hand; 13.8%, hip; 10.7%, neck; 6.8%, ankle and foot; 6.3%, elbow; 5.0% in order. The annual experience rate of musculoskeletal symptom, back pain, and pain on leg and knee were significantly higher in female. In male, the experience rate of musculoskeletal symptom was different significantly according to educational level, family size, economic status, status of smoking, duration of farming, type of major agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, family size and economic status were the significant variables. It was higher in male with no or one family living together and low economic status. In female, the experience rate of musculoskeletal symptom was different significantly according to body mass index, perceived health status, type of agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, body mass index, perceived health status, and type of major agricultural affairs were the significant variables. It was higher as female farmer's body mass index was increasing and when female farmer's perceived health status was not healthier, and it was lower when female farmer did livestock farming as major agricultural affair. The experience rate of musculoskeletal symptom was higher in the busy season for farmers and treatment methods for musculoskeletal symptom were physical therapy, medication, herb medical treatment, etc. In conclusion, because most of farmers experience musculoskeletal symptom, continuous systematic study on musculoskeletal symptom of farmers and active effort to prevent and manage musculoskeletal symptom of farmers are necessary.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.447-463
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• 1994

Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.68-81
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• 2001

Herniated lumbar intervertebral disc(H.I.V.D) is the most common reason causing low back pain and leg radiating pain. Objective : The purpose of this report is to observe the effects of oriental medical conservative treatment in the different herniated type. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Taejon Cheonan O. M. hospital from Nov 1, 2000 to Apr 30, 2001. 30 patients had a diagnosis of herniated lumbar interver tebral disc by Lumbar-C.T and Lumbar-M.R.I. we treated 30 patients by oriental medical conservative treatment (Ex: acupuncture, herb-med, physical theraphy, bed-rest, etc.) Results : 1. The mean hospitalization of patients was 21.1 days. that in the bulging type was l4days, protruded type 21days, mixed type 27days, extruded type 30days. that shows the less herniation of lumbar intervertebral disc, the mean hospitalization was more short. 2. In the distribution of the clinical symptoms admitted at that time, low back pain, leg radiating pain were showed in the all types(29patients, 96.6%). and sensory disorder, muscle powerlessness were showed least in the bulg ing type(0%, 37.5%), but that were showed most in the extruded type(50%,75%). 3. In the result of treatment due to clinical syptoms, bulging type was more execellent than any other other types. 4. The less herniation of lumbar intervertebral disc, angle of straight leg raising test was higher. In the result of treatment due to angle of straight leg raising test, bulging type was more execellent than any other other types. 5. In the distribution of physical. test, positive case in the Peyton sign, Ankle Dorsiflexion were showed least in the bulging type(25%, 12.5%), but that were showed most in the extruded type(100%, 75%). 6. In the result of treatment due to physical.test, bulging type was more exec ellent than any other other types. 7. The efficacy of total treatment was 90%(when we set a standard things more than fair), that in the bulging type was 100%, protruded 92%, mixedtype 80%, extruded type 75%. Bulging type had a more remakable effectsthan any other types. Conclusions : The less herniation of lumbar intervertebral disc, clinical syptoms were slighter, physical. test were better, and efficacy of oriental medical conservative treatme nt was remakable high.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.1-16
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• 2004

The use of artificial nerve conduit containing viable Schwann cells is one of the most promising strategies to repair the peripheral nerve injury. To fabricate an effective nerve conduit whose microstructure and internal environment are more favorable in the nerve regeneration than existing ones, a new three-dimensional Schwann cell culture technique using $Matrigel^{(R)}$. and dorsal root ganglion (DRG) was developed. Nerve conduit of three-dimensionally arranged Schwann cells was fabricated using direct seeding of freshly harvested DRG into a $Matrigel^{(R)}$ filled silicone tube (I.D. 1.98 mm, 14 mm length) and in vitro rafting culture for 2 weeks. The nerve regeneration efficacy of three-dimensionally cultured Schwann cell conduit (3D conduit group, n=6) was assessed using SD rat sciatic nerve defect of 10 mm, and compared with that of silicone conduit filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method (2D conduit group, n=6). After 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were examined using image analyzer and electromicroscopic methods. The SFI and ankle stance angle (ASA) in the functional evaluation were $-60.1{\pm}13.9$, $37.9^{\circ}{\pm}5.4^{\circ}$ in 3D conduit group (n=5) and $-87.0{\pm}12.9$, $32.2^{\circ}{\pm}4.8^{\circ}$ in 2D conduit group (n=4), respectively. And the myelinated axon was $44.91%{\pm}0.13%$ in 3D conduit group and $13.05%{\pm}1.95%$ in 2D conduit group to the sham group. In the TEM study, 3D conduit group showed more abundant myelinated nerve fibers with well organized and thickened extracellular collagen than 2D conduit group, and gastrocnemius muscle and biceps femoris tendon in 3D conduit group were less atrophied and showed decreased fibrosis with less fatty infiltration than 2D conduit group. In conclusion, new three-dimensional Schwann cell culture technique was established, and nerve conduit fabricated using this technique showed much improved nerve regeneration capacity than the silicone tube filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method.

• Journal of Korean Academy of Nursing
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• v.23 no.1
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• pp.56-67
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• 1993

The purpose of this study was to compare the circumference and skinfold thickness of upper and lower limb and the leg strength of the casted limb with those of the normal limb after removal of a leg cast. The subjects for the study were orthopedic patients who had had long and short leg casts or splints due to tibial, fibulal, metatarsal, calcaneus fracture or ankle sprains. The subjects were divided into two groups, those who had the cast on for less than 40 days and those for over 41 days. Circumference and skinfold thickness of the upper and lower limb on the side on which the cast was ap-plied were compared with those of the contralateral side after removal of the cast. Circumference and skinfold thickness of the upper and lower limb, and leg strength for those in a cast for under 40 days were compared with those of over 41 days for both the side to which cast was applied and the contralateral side. Measurements were made after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and lower extremity strength was determined with flat foot pressing on an electronic digital health meter in the sitting position. The results can be summarized as follows : 1. The circumference of the upper and lower leg on the side on which the cast was applied, when measured after the cast was removed, were significantly less than those of the normal side, 93.88%, 93.11% each. 2. Skinfold thickness of the quadriceps and gastrocnemius on the side on which the cast was applied were significantly less than those of the normal side when measured after removal of the cast, 85.98%, 82.85% respectively. 3. Leg strength on the side where the cast was applied was significantly 1ss than that on the normal side, 60.20%. 4. There was no difference in the circumference of upper and lower limbs, skinfold thickness or leg strength on the side where the cast was applied between the group which had the cast applied for under 40 days and the group that had it applied for over 41 days. 5. The circumference of the upper arm and lower leg on the normal side for the group that had the cast applied for over 41 days was significantly greater than the group that had the cast application for under 40 days. T ere was no difference between the two groups in the circumference of the forearm and upper leg, skinfold thickness and leg strength in the normal side. From these results, it may be concluded that muscle atrophy was apparent in the casted limb compared to the normal limb, and the circumference of the upper arm and lower leg, and leg strength on the normal side increased after removal of the cast in the group which had the cast on for more than 41 days.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.36 no.5B
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• pp.502-510
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• 2011

In this research, a wireless movable systems is introduced that is applicable for real-world clinical examination in order to resolve the inconvenience of wired motion analysis system which uses markers by measuring more accurately the angle of the 3D motion. The system is composed of bluetooth data transmission and 6 DOF inertial measurement system that is composed of 3-axis acceleration and 3-axis gyroscope. The samples were collected from 10 feet of 5 young children who were confirmed as patients having flat feet and achilles tendonitis by podiatric expert in pediatrics, and the validity of the system was evaluated by comparison with the opinion by the expert using the EMG data and the data measured by the developed system. ROM of ankle was measured by the difference between the maximum and the minimum peaks of 3-axis values (pitch, roll and yaw) measured at lateral malleolus bone, and based on this measured value, the eversion rate became relatively higher as flat feet state become worse, which is equivalent to the opinion from the podiatric experts. It was shown that there is a relation between the certain muscle activities and the abnormal motion of foot caused by disease.

• Radiation Oncology Journal
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• v.30 no.3
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• pp.132-139
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• 2012

Purpose: The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. Materials and Methods: A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). Results: The mean age of patients in this study was $59.4{\pm}11.9$ years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss ${\geq}5%$ (OR, 2.299). Conclusion: SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5723-5729
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• 2013

The purpose of this study was to investigate the imbalance of muscle tone and frequent exposure to excessive gait training in patients with chronic spasticity due to stroke, the thickness of the plantar fascia to change and to evaluate. The subjects of this study was in 54 patients with chronic stroke from 18 patients Group I(MAS G0), 18 patients Group II(MAS G1), and 18 patients Group III(MAS G2) were selected. Measurement of clinical symptoms and physical examination, MAS(Modified Ashworth Scale), ultrasonographic, ROM(Range of Motion), VAS(Visual Analogue Scale), TUG(Timed Up and Go test) was measured. The study results were each group between the unaffected side and the affected side on plantar fascia thickness was statistically significantly thicker(p<.001). Each group between the unaffected side and the affected side on ankle dorsiflexion ROM was statistically significantly decrease(p<.001), VAS(p<.001), TUG(p<.001) statistically significantly increase(p<.001). In this study, the plantar fascia pathokinesiology ever presented by the contents of gait training in stroke patients is one of the information that you need to consider when presented.