• The Korean Journal of Pain
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• v.22 no.2
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• pp.158-162
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• 2009

Background: The loss of resistance (LOR) method is most commonly used to identify the epidural space. This method is thought to rely on the penetration of the ligamentum flavum. Unfortunately the exact morphology of the ligamentum flavum is variable at different vertebral levels. Especially, it has been pointed out that the lower cervical ligamentum flavum may be discontinuous in the midline in up to 50% of patients. Thus, the LOR method may be inaccurate to confirm the cervical epidural space. The aim of this study is to determine which method is the safest and most exact for confirming the cervical epidural space. Methods: 100 adult, chronic renal failure patients who were undergoing an arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. During the cervical epidural puncture, we identified the cervical epidural space by subjectively feeling the resistance with using a finger just through the ligamentum flavum, and we also used the drip infusion method, the loss of resistance method using air, and the hanging drop method. By using 5 grades, we classified the extent of whether or not the techniques were effective. Results: Using the drip infusion method, we identify the epidural space in all the patients as ＋/＋＋ grade. The catheter insertion method was also successful in identifying those epidural spaces over a ${\pm}$ grade. The pseudo LOR was over ${\pm}$ grade in 47 patients. Conclusions: The combined LOR/hanging drop with drip infusion method is useful for confirming the cervical epidural space.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.2
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• pp.21-33
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• 2014

Objectives : This study was to report the improvement of the patient with multiple sclerosis treated by Korean Medical treatment. Methods : The patient diagnosed as multiple sclerosis treated by acupuncture, bee venom pharmacupuncture, chuna manual therapy, and herbal medicine. To evaluate the effects of korean medicine, we used manual muscle test(MMT), the standard for assessment of the effect of stroke treatment, functional system(FS), visual analog scale(VAS). Results : 1. The patient's pain and optic dysfunction were reduced by the above therapy. 2. There was no change in manual muscle test(MMT), but there was mild improvement in finger joints function in the standard for assessment of the effect of stroke treatment. 3. In functional system(FS) scale, there was enhancement in optic function within a range. And there was improvement in expanded disability statue scale(EDSS) from 4.0 to 3.0. 4. In visual analog scale(VAS), there was considerable improvement from 9 to 6. Conclusions : The korean medical treatment was reduced pain and optic dysfunction.

• Proceedings of the KSME Conference
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• 2003.11a
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• pp.1373-1377
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• 2003

Current prostheses for amputees are generally extrinsic wearing socket type that the coupling between body stump and appliance wraps the soft tissue and this structure causes several problems :applying direct weight to soft tissue such as skin and muscle, skin trouble of contacting area and pain. In this study, osseointegration implant is a method to directly connect prosthesis to the residual stump skeletal tissue of arm, finger and leg through surgical operation. Technology presented in this paper essentially solves the problems of pain and abnormal weight transfer system indicated above and recovers the functions of the amputated arm and leg. In this paper, implant shape was designed for the first step for the development of osseointegration implant and then we studied the possibility to apply this osseointegration implant to human body by performing implant insertion operation to beagle tibia for the clinical animal test and normal beagle's gait analysis was executed in order to quantitatively verify the beagle's skeletal functions after the implant insertion.

• PNF and Movement
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• v.10 no.3
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• pp.19-23
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• 2012

Purpose : The purpose of the present study was to describe the prevalence and causes of occurrence on work-related musculoskeletal disorders(WMSDs) in physical therapist. Methods : Self-administered questionnaires were distributed by mail to 100 physical therapists in Daegu city. 85 of the questionnaires were returned and 80 of them except 5 unclearly answered ones were analyzed. Results : They felt the pain at shoulders(80%), lower back(74%), wrists(71%), neck(70%), elbow(48%), finger(40%). The major causes of the pain were "repeating the same job constantly(93%)," and "bending wrists too much and doing things that require excessive strength(90%)." It was significant different more Exercise therapist than modality therapist. Conclusion : We suggest that physical therapist for exercise therapy need the development and applies of various program for prevention of work-related musculoskeletal disorders.

• Clinical Pain
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• v.20 no.1
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• pp.15-19
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• 2021

There are many wrist and hand diseases in which ultrasound can help in the diagnosis and treatment. Because many small structures are located, identifying anatomical locations and pathways is especially important. In De Quervain's syndrome, it is necessary to find tendon lesions located in the first compartment of the wrist. If injection therapy is required, administer the regimen accurately within the tendon sheath through ultrasound. In carpal tunnel syndrome, there are several methods to diagnose a disease by measuring cross-sectional area of the median nerve. Ultrasound has the advantage of administering injection therapy without damaging the nerve. Intersection syndrome can be diagnosed by observing swelling and hypoechoic appearances at the point where the tendons of the first compartment cross over the second compartment of the wrist. Ultrasound-guided injection is also safe and efficient. If there is a trigger finger lesion, the most representative findings is to observe a nodular hypoechoic thickening of the involved A1 pulley. When injection therapy is performed, it is effective to administer medication between pulley and flexor tendons as much as possible to reduce pressure on the attached structures.

• Clinical Pain
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• v.18 no.2
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• pp.97-101
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• 2019

Tardy ulnar nerve palsy is ulnar neuropathy at or around elbow and commonly evaluated in the electromyography laboratory. However, ulnar neuropathy at the elbow due to neurofibroma is rare. Neurofibromas are tumors that arise within nerve fasciculi and anywhere along a nerve from dorsal root ganglion to the terminal nerve branch. We report one case of ulnar neuropathy at the elbow due to neurofibroma. Patient had paresthesia on the left 5th finger and there had been left hypothenar atrophy since 2 months ago. Tinel's sign was positive at left elbow. As a result of electromyography, there were suggestive of right ulnar neuropathy at or around elbow, referred to as tardy ulnar nerve palsy. Ultrasonography showed a diffuse tortuous thickening with multiple neurofibromas arising from individual fascicles of the ulnar nerve in cubital tunnel area. Surgery was then performed to release cubital tunnel of left elbow, then the patient's symptoms improved.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.37-45
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• 2010

Purpose: First introduced by Buncke and Rose in 1979, the neurovascular partial $2^{nd}$ toe pulp free tissue transfer has been attempted to reconstruct posttraumatic finger tip injuries. Although some surgeons prefer other reconstructive methods such as skin graft and local flap, we chose the partial $2^{nd}$ toe pulp flap owing to its many advantages. We report three successful surgical cases in which the patients had undergone this particular method of reconstruction. Methods: We retrospectively examined three cases of fingertip injury patients due to mechanical injury. Bone exposure was seen in all three cases, All had undergone partial toe pulp free flap for soft tissue defect coverage. Results: All flaps survived without any complications such as partial necrosis, hematoma or dehiscence. Although tingling sensation has returned in both cases, two-point discrimination has not returned yet. Currently no patient is complaining of any pain which gradually improved during their course of recuperation. All stitches were removed on postoperative 2 weeks. Patients are satisfied with the final surgical result and there are no signs of any edema or hematoma. Conclusion: The homodigital reconstruction of finger tip injury using the partial $2^{nd}$ toe pulp flap has numerous advantages compared to other reconstructive modalities such as its resistance to wear and tear and in that it provides a non-slip palmar digital surface. However it requires microsurgery which may not be preferred by surgeons. Advanced age of the patient can be a relative contraindication to this approach since atheromatous plaque from the donor toe can compromise flap circulation after surgery. We report three successful cases which patient age was considered appropriate. Further investigation with a larger number of cases and long term follow-up is deemed necessary.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.248-253
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• 2018

Purpose: The purpose of this study was to evaluate the clinical results of anatomic reduction of bony mallet finger using modified-intrafocal pinning technique. Methods: From March 2014 to October 2017, 18 patients with bony mallet finger were treated with modified-intrafocal pinning technique. Kirschner-wire was used to directly reduction the bony fragment, and extension block pinning and distal interphalangeal joint fixation were additionally performed to minimize the loss of reduction. Postoperative pain, range of motion, and radiological evaluation were performed. Duration of bone healing, functional recovery and complication rate were evaluated and Crawford's criteria was used to determine functional outcome after surgery. Results: Bone union was achieved in all cases after a postoperative mean of 6 weeks (5-7 weeks). An average of $2.8^{\circ}$ ($0^{\circ}-10^{\circ}$) extension loss occurred in all patients. All patients showed satisfactory joint congruency and reformation of the joint surface, the mean flexion angle of the distal interphalangeal joint at the final follow-up was $72.2^{\circ}$ ($70^{\circ}-75^{\circ}$). According to Crawford's classification, 12 patients (66.7%) were excellent and 6 patients (33.3%) were good. Conclusion: Modified-intrafocal pinning technique is a method of obtaining anatomical bone healing by directly reduction and fixation of the bony fragment. Combined with other conventional percutaneous pinning procedures, it is expected that good results can be obtained if applied to appropriate indications.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.557-563
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• 2004

A new vacuum assisted auto-lancing technique is proposed to minimize pain. Specially designed lancing device was introduced, which applied -100mmHg right after skin puncture on the forearm. Sampled blood volumes were measured in 58 normal females. Mean volume of 464 samples was approximately 2.6$\muL$ and the frequency of more than 0.5$\muL$ was 86%. Thus the success rate of blood sugar test should also be the same when using modern glucose meters capable of testing with only 0.3~0.5$\muL$ of capillary blood. When pain scores were quantitatively evaluated by the visual pain measure, only 23% pain of the traditional finger sampling was experienced, demonstrating that capillary blood sampling was performed on the forearm with almost no pain. The present technique reduced pain to a great degree, though resampling might be unavoidable due to 14% of test failure rate estimated for modern glucose meters. However, minimized pain makes the present technique of great convenience for diabetic patients who need blood sampling a few times a day.

• The Journal of the Korea Contents Association
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• v.15 no.7
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• pp.314-321
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• 2015

The purpose of this study is to investigate musculoskeletal symptoms and job stress of physical therapists in their 20s who are responsible for therapeutic exercise and to understand the correlation between the two. This study conducted a research on 144 subjects based on the measurement tools provided by national institution. The results are as follows. Many subjects were experiencing musculoskeletal symptoms and disorder in their hands/wrists/fingers, shoulders, and waist with high proportionate of subjects experiencing the symptoms and disorder in their right hand/wrist/finger. Among job stress, job environment, job requirement, and compensation had significantly positive correlation with physical burden(r=.297~.392, p=.000). In particular, shoulder pain intensity has significantly positive correlation with job requirement, duration of pain in hand, wrist, and fingers as well as workplace culture(r=.331~.478, p=.003~.009) which indicates that musculoskeletal symptoms are some what correlated with job stress. Based on this study, it is necessary to show more concern and make an effort to manage musculoskeletal symptoms and job stress.