• Journal of Korean Neurosurgical Society
• /
• v.41 no.3
• /
• pp.182-185
• /
• 2007

Acute stroke with isolated monoparesis manifesting as distal weakness of a single lower extremity has rarely been described. We report two patients with small cortical infarction who had distal weakness of a single lower extremity. In both cases, diffusion-weighted image [DWI] was used to detect small lesions in the contralateral cortex. These cases illustrate that small cortical infarction can cause isolated monoparesis limited to distal part of the leg and it may be misdiagnosed as spinal lesions, especially when lower back pain and transient sensory symptoms are accompanied. In case of the abrupt onset of weakness limited to one lower limb, the possibility of stroke should be considered and careful attention to identify cortical lesions using magnetic resonance imaging, especially DWI is required.

• Clinics in Shoulder and Elbow
• /
• v.9 no.2
• /
• pp.207-210
• /
• 2006

We presented a case of posteriorly displaced fracture of the distal clavicle in Child. The closed reduction was failed due to posteriorly displaced proximal fragment and interpositon of trapezius muscle and periosteum. We found that periosteal sleeve and coracoclaviclar ligament and acromioclavicular ligament was intact. The open reduction should be considered for the treatment of the irreducible posteriorly displaced fracture of the distal clavicle in child.

• Journal of the Korean Arthroscopy Society
• /
• v.15 no.1
• /
• pp.19-21
• /
• 2011

Clavicle Hook pate was commonly used in the injury around distal clavicle such as fractures, acromio-clavicular joint injury. We experienced a case of impingement syndrome following operation of distal clavicle fracture using Clavicle Hook plate. So we report this case with a reiview of current literatures.

• Journal of Korean Neurosurgical Society
• /
• v.59 no.4
• /
• pp.414-419
• /
• 2016

A 35 years old woman presented with an acute meningeal syndrome following an intra ventricular haemorrhage without subarachnoid haemorrhage. The angiography demonstrated a 6 mm partially thrombosed saccular aneurysm at the plexal point of the right anterior choroidal artery (AChoA). It was surgically approached inside the ventricle through a trans-temporal corticotomy. The aneurysm was excised after distal exclusion of the feeding artery under motor-evoked potentials monitoring. Of the 19 cases of distal AChoA aneurysm neurosurgical treatment, this is the only one performed under electrophysiology monitoring, a simple and safe method to detect and prevent motor tract ischemia. We discuss this rare case, along with a comprehensible review of the literature of the previous surgical cases of distal AChoA aneurysms.

• Journal of Korean Foot and Ankle Society
• /
• v.14 no.1
• /
• pp.105-107
• /
• 2010

The scanty literature on distal tibiofibular synostosis includes descriptions of relatively few specific complaints. Here we report a case of a 24-year-old young soldier who sustained a left ankle lateral malleolar fracture about 6 months ago and was initially treated by the open reduction and internal fixation with plate & screw. But 6 months later, he suffered from an vague ankle pain, each time the symptoms occurred right after an active ambulation, ankle dorsiflexion, especially when he had exercised aggressively. The radiographs revealed that there was a mature distal tibiofibular synostosis. We treated the patient with surgical excision of synostosis. Post-operative condition was satisfied to all concern and the result was found to be excellent during one-year follow-up.

• The Korean Journal of Physiology
• /
• v.27 no.1
• /
• pp.27-35
• /
• 1993

Effects of the endothelium on the contractile responses to norepinephrine (NE) were investigated in isolated helical strips of the proximal and distal coronaries artery of pigs. The helical strips were immersed in Tris-buffered Tyrode's solution equilibrated with 100% $O_2$ at $35^{\circ}C$ and its isometric tension was measured. NE relaxed the strips precontracted with acetylcholine from both the proximal and distal coronary artery. NE-induced relaxation, which might be induced mainly by $\beta$-adrenoceptor function was dominant in the distal coronary arteries. NE-induced relaxation was converted to a contraction after $\beta$-adrenoceptor blockade with propranolol $(3{\times}10^{-6}M)$. ${\alpha}$-adrenoceptor-mediated contraction by NE was greater in the proximal coronary artery than the distal coronary artery. Quantitatively, ${\alpha}_1$-adrenoceptor mediated contraction by NE was greater than ${\alpha}_2$-adrenoceptor mediated contraction by NE in both arteries. NE-induced relaxation was decreased by rubbing of endothelium in both arteries. ${\alpha}_1-and\;{\alpha}_2$-adrenoceptor mediated contraction by NE were potentiated by rubbing of endothelium in both arteries. Pretreatment with methylene blue, an inhibitor of soluble guanylate cyclase, increased ${\alpha}_1-\;and\;{\alpha}_2$-adrenoceptor mediated contraction by NE in both arteries with endothelium. From the above results, we suggest that the effect of activation of $\alpha$-adrenoceptors by NE may be modulated by endothelium in the proximal and distal coronary arteries of pigs. This effect may be mediated via endothelium derived relaxing factor.

• Archives of Plastic Surgery
• /
• v.43 no.6
• /
• pp.544-550
• /
• 2016

Background Although the use of temporary shunts in proximal extremity amputations has been reported, no study has described the use of temporary shunts in distal extremity amputations that require vein grafting. Moreover, the total volume of blood loss when temporary shunts are used has not been reported. The aim of this study was to investigate the applicability of a temporary shunt for distal extremity amputations requiring repair by vessel grafting with an ischemia time of >6 hours. This study also aimed to determine the total volume of blood loss when temporary shunts were used. Methods Patients who underwent distal major extremity replantation and/or revascularization with a vessel graft and who experienced ischemia for 6-8 hours between 2013 and 2014 were included in the study. A 6-Fr suction catheter was cut to 5 cm in length after the infusion of heparin, and secured with a 5-0 silk suture between the distal and the proximal ends of the artery. While bleeding continued, the bones were shortened and fixed. After the complete restoration of circulation, the arterial shunt created using the catheter was also repaired with a vein graft. Results Six patients were included in this study. The mean duration of ischemia was 7.25 hours. The mean duration of suction catheter use during limb revascularization was 7 minutes. The mean transfusion volume was 7.5 units. No losses of the extremity were observed. Conclusions This procedure should be considered in distal extremity amputations requiring repair by vessel grafting during critical ischemia.

• Clinics in Shoulder and Elbow
• /
• v.20 no.4
• /
• pp.230-235
• /
• 2017

Background: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. Methods: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. Results: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. Conclusions: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.

• Journal of Korean Foot and Ankle Society
• /
• v.8 no.2
• /
• pp.166-170
• /
• 2004

Purpose: To evaluate the results of MIPPO (minimal invasive percutaneous plate osteosynthesis) technique for distal tibial metaphyseal fractures. Materials and Methods: It is a retrospective study of 13 patients who were treated by MIPPO technique for distal tibial metaphyseal fractures from Jan. 2001 to Jan. 2003. The average age was 46.7 years and mean follow-up period was 13.3 months. According to AO classification, there were 8 cases of A1, 3 cases of A2, 1 case of B1 and 1 case of C2. One case of A1 was a Gustilo-Anderson type I open fracture and fibular fractures were combined in 12 cases. We applied anatomical reduction and internal fixation for the fibular fractures and internal fixation on the medial side of the tibia by MIPPO technique for distal tibial metaphyseal fractures. Clinical results were evaluated using radiographic results, Neer score, the starting time of postoperative exercise and clinical complications. Results: According to the Neer score, all cases showed satisfactory results. Active ankle ROM was started at average 2.4 weeks ($2{\sim}4$ weeks) and full weight bearing ambulation at average 5.2 weeks ($4{\sim}8$ weeks) postoperatively. Union of fractures was obtained by average 14.4 weeks ($8{\sim}18$ weeks) postoperatively. Two cases showed $5^{\circ}$ limitation of motion without functional deficits and other cases showed satisfactory ROM results. One case had $6^{\circ}$ valgus deformity without functional deficits. There were not any other complications like soft tissue problems and delayed-or non-union. Conclusion: MIPPO technique for the treatment of distal tibial metaphyseal fractures is a feasible technique with a good clinical outcomes.

• Journal of Korean Foot and Ankle Society
• /
• v.13 no.2
• /
• pp.169-174
• /
• 2009

Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.