• Archives of Plastic Surgery
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• v.33 no.4
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• pp.474-479
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• 2006

Purpose: To report of a series of successful reconstruction of soft tissue defect on distal leg with extensor digitorum brevis myo-cutaneous flap. Methods: Between April 2002 to December 2004, 7 patients with soft tissue defect on distal leg were operated with Extensor Digiotorum Brevis myocutaneous flap. 6 of these patients had osteomyelitis. Results: Extensor Digiotorum Brevis myocutaneous flap were used in 6 patients and reverse flow flap was used in one patient. Average follow up was 19 months. All flap were survived 100% without any complication and osteomyelitis were controled in all cases. Aesthetic and functional out come were excellent on both recipient and donor sites. Conclusion: The advantages of this flap are effectively control of local wound infection, constant and reliable anatomical structures, adequately thin flap. Technical easiness for raising flap and wide arch of rotation. Extensor Digitorum Brevis myo-cutaneous flap is one of ideal option for the reconstruction of distal leg and foot defects.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.2
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• pp.223-231
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• 2014

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.108-111
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• 2010

Purpose: In reconstructing a defect on the dorsum of the hand, there are many cases of extensor tendons exposed or even missing. The repaired or reconstructed tendons need relevant gliding environment for good functional recovery. The anterolateral thigh flap offers a vascular fascial component with large amounts that can be used for covering exposed tendons and we report a unique case of single-stage hand dorsum and gliding surface reconstruction. Methods: A 35-year-old man had severe post-traumatic scarring in his left dorsal hand and coverage of the flap with split-thickness skin graft has been done before. After scarred skin excision and extensor tendon graft for missed part, a free anterolateral thigh adipofascial flap was used to resurface the hand dorsum and to reconstruct a two-layer gliding surface of the extensor tendons. The extensor tendons were wrapped in the fascial component with the fat layer inside. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. Good overall functional recovery and tendon excursion were observed. He was also satisfied with postoperative appearance. Conclusion: A free anterolateral thigh adipofascial flap was used successfully for reconstruction of a two-layer tendon gliding surface to treat a patient with severe scarring in the dorsal hand.

• Journal of Nutrition and Health
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• v.35 no.10
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• pp.1031-1037
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• 2002

The purpose of present study was to evaluate the effect of endurance exercise training on skeletal muscle free amino acid concentrations, and differences in free amino acid concentration between soleus muscle which consists of mostly slow twitch oxidative fiber and extensor digitorum longus muscle which consists of fast twitch oxidative glycolytic fiber. Sixteen male SD rats (4 weeks old) were randomly devided into two groups, and fed a purified AIN-93M diet with or without aerobic exercise training according to the protocol (running on the treadmill at 25 m/min for 60 min, 5 days a week) for 6 weeks. Exercise-training for 6 weeks significanly reduced the commulative body weight gain (p＜0.05) and food efficiency ratio (p＜0.01) of rats. The result showing mitochondrial citrate synthase activity of soleus muscle was significantly higher in exercise-trained rats compared to the value for control animals (p＜0.01) indicates aerobic exercise-training was successfully accomplished in the trained group. No difference was found in the muscle aminogram pattern between soleus muscle and extensor digitorum longus muscle of control animals. However, free amino acid concentrations of soleus muscle were from 1.2 to 3.9 times of those found in extensor digitorum longus muscle of control rats, depending on an individual amino acid. Intermediate level of endurance exercise training for 6 weeks did not influence concentrations of most of free amino acid in soleus muscle of rats collected at an overnight fasted and rested state. In contrast, isolucine and leucine concentrations in extensor digitorum longus muscle of exercise-trained rats were significantly lower than those for control animals. These results indicate that aerobic energy metabolism had not been efficiently conducted, and thereby the utilization of BCAA for energy substrate was enhanced in fast twitch oxidative glycolytic fibers of extensor digitorum longus muscle of rats followed exercise-training protocol for 6 weeks.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.1-5
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• 2008

Purpose: We studied the diagnostic value of dynamic US in the extensor tendon dislocation at the metacarpophalangeal joint. Materials and Methods: From January 2007 to October, we studied 6 cases that had been diagnosed and followed over 5 months (2-10) in average. US examination using a 10-MHz linear transducer were performed in three cases. The causes of dislocations were traumatic in 5 cases and congenital in one case. Results: In only 3 cases which could not be diagnosed clinically, we performed US. In dynamic US, all three cases showed the extensor tendon dislocation evidently. Operative findings were sagittal band rupture in 4 cases, capsular loosening in one case and sagittal band thinning in one case. Sagittal band repair was performed in 4 cases and capsular augmentation in one case. In case of congenital dislocation showing 4 digital extensor tendon dislocations in right hand, we operated only the second extensor by sagittal band repair with augmentation by looping. At last follow-up, no case showed recurrence or limitation of motion. Conclusion: In case of extensor tendon dislocation without apparent clinical finding, US with dynamic study has so great value that it can detect the dislocation in real time, which is superior to MRI.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.304-310
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• 2015

Purpose: The purpose of this study was to examine the change in the kinematics and kinetics of the knee joint depending on high-heeled shoes during sit-to-stand (SitTS) task. Methods: Nineteen healthy females participated in this study. The subjects performed the SitTS task wearing high-heeled shoes and barefoot. The experiment was repeated three times for each task with foot conditions. The kinematics and kinetics of the knee joint were measured and analyzed using a 3D motion analysis system. Results: The result of this study showed kinematic and kinetics differences in knee joints during the SitTS task based on high-heeled shoes. Significant differences in knee flexion angle were observed during SitTS. The knee extensor force showed statistically significant differences during SitTS tasks. At the initial of SitTS, the knee flexor and extensor moment showed significant differences. The knee extensor moment showed statistically significant differences at the terminal of SitTS. At the maximum of SitTS, the knee extensor moment showed statistically significant differences. Conclusion: Therefore, wearing high-heeled shoes during SitTS movements in daily life is considered to influence knee joint kinematics and kinetics due to the HH, suggesting the possibility of increased risk of patellofemoral pain, and knee osteoarthritis caused by changes in loading of the knee joint.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.675-683
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• 2010

Purpose : The purpose of this study was to evaluate the effect of Whole body vibration exercise(WBVE) in patient with chronic stroke. Methods : Thirty patients were divided into two groups by randomly experimental group(14 subject) and control group(16 subject) in a single blinded, randomised study. experimental group was conducted for the 6-weeks WBVE program and had a structured exercise program for 16 minutes, 5 days per week and control group was conducted for the shame exercise program. Outcome variables included the knee extensor strength, Berg balance scale, Timed up and go test at 0 and 6 weeks. Results : The experimental group tended to improve more than the control group in balance(Berg balance scale) and walking ability(Timed up and go test). There were no trends in differences in change scores by the knee extensor strength. Conclusion : WBVE program may be helpful to improve knee extensor strengthening, dynamic balance and walking ability for patients with chronic patients.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.479-483
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• 2018

Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient's quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring $9{\times}6cm$ and $7{\times}5cm$, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a $24{\times}8cm$ anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.

• Journal of Mechanical Science and Technology
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• v.18 no.4
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• pp.582-591
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• 2004

The purpose of this study was to determine the effects of elbow joint angle on mechanical properties, as represented by ultimate load, failure strain and elastic modulus, of bone-tendon specimens of common extensor tendon of the humeral epicondyle. Eight pairs of specimens were equally divided into two groups of 8 each, which selected arbitrarily from left or right side of each pair, positioned at 45$^{\circ}$ and 90$^{\circ}$ of elbow flexion and subjected to tension to failure in the physiological direction of the common extensor tendon. For comparison of the differences in the failure and elastic modulus between tendon and the bone-junction, data for both were evaluated individually. Significant reduction in ultimate load of bone-tendon specimens was shown to occur at 45$^{\circ}$. The values obtained from the bone-tendon junctions with regard to the failure strain were significant higher than those from tendon in both loading directions, but the largest failure strain at the bone-tendon junction was found at 45$^{\circ}$. The elastic modulus was found to decrease significantly at the bone-tendon junction when the loading direction switched from 90$^{\circ}$ to 45$^{\circ}$. Histological observation, after mechanical tensile tests, in both loading directions showed that failure occurred at the interface between tendon and uncalcified fibrocartilage in the thinnest fibrocartilage zone of the bone-tendon junction. We concluded that differences in measured mechanical properties are a consequence of varying the loading direction of the tendon across the bone-tendon specimen.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.484-492
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• 2006

Purpose: The purpose of this study was to investigate the effects of a rehabilitation nursing program(RNP) for persons with disabilities. Method: a quasi-experimental pretest and post test study was used to examine the changes of patient's muscle strength, flexibility, self efficacy and health related quality of life at the completion of an 8-week education and physical exercise with a Thera-Band and Exercise Ball course. The subjects consisted of 40 adults who were disabled. Twenty-two experimental and 18 control subjects completed pre and post-test measures. Outcome variables were flexibility, hand grip, elbow flexor and extensor, knee flexor and extensor, self efficacy and quality of life. Independent t-test and ANCOVA were used to examine group differences by using SPSS 12.0 Result: Mean comparisons of the change scores revealed that the experimental group increased significantly in knee extremity flexor(p=0.035), extensor(p=0.039), flexibility(p=0.008), self efficacy(p=0.000), and quality of life(p=0.000). No significant group differences were found in each patient's hand grip, elbow flexor and extensor. Conclusion: RNP can improve lower extremity flexibility, muscle strength, self efficacy and health related quality of life in people with disabilities. The intervention to tailor exercise and education to the unique needs of the disability was suggested for further study.