• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.594-598
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• 2004

Signet ring cell carcinoma of lung is an unique variant of mucin producing adenocarcinoma which is characterized by abundant intracellular mucin accumulation. Only a few cases of primary signet ring cell carcinoma of lung have been reported in the world wide literature. And we have, recently experienced one case of primary signet ring cell carcinoma of lung. A 55 years old man was evaluated for paralysis of lower extremities and was found to have lung cancer in the left upper and lower lobe with pleural, multiple spinal, bone and liver metastases. Signet ring tumor cells were revealed by cytologic examination of pleural fluids. And there were no evidence of signet ring cell carcinoma of other organs. Primary signet ring cell carcinoma of lung seems to have an aggressive behavior and therapeutic modalities could be different from those for signet ring cell carcinomas from other organs. Therefore it is important to separate primary signet ring cell adenocarcinoma of lung from metastatic tumors.

• Korean Journal of Applied Biomechanics
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• v.26 no.1
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• pp.11-20
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• 2016

Objective: This study aimed to compare biomechanical data between elite and beginner cyclists during cycle pedaling by performing a comparative analysis and to provide quantitative data for both pedaling performance enhancement and injury prevention. Methods: The subjects of this study included 5 elite cyclists (age: $18{\pm}0years$, body mass: $64.8{\pm}9.52kg$, height: $173.0{\pm}4.80cm$) and 5 amateur cyclists (age: $20{\pm}0years$, mass: $66.6{\pm}2.36kg$, height: $175.6{\pm}1.95cm$). The subjects pedaled on a stationary bicycle mounted on rollers of the same gear (front: 50 T and rear: 17 T = 2.94) and cadence of 90. The saddle height was adjusted to fit the body of each subject, and all the subjects wore shoes with cleats. In order to obtain kinematic data, 4 cameras (GR-HD1KR, JVC, Japan) were installed and set at 60 frames/sec. An electromyography (EMG) system (Telemyo 2400T, Noraxon, USA) was used to measure muscle activation. Eight sets of data from both the left and right lower extremities were obtained from 4 muscles (vastus medialis oblique [VMO], vastus lateralis oblique [VLO], and semitendinosus [Semitend], and lateral gastrocnemius [Gastro]) bilaterally by using a sampling frequency of 1,500 Hz. Five sets of events ($0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, and $360^{\circ}$) and 4 phases (P1, P2, P3, and P4) were set up for the data analysis. Imaging data were analyzed for kinematic factors by using the Kwon3D XP computer software (Visol, Korea). MyoResearch XP Master Edition (Noraxon) was used for filtering and processing EMG signals. Results: The angular velocity at $360^{\circ}$ from the feet was higher in the amateur cyclists, but accelerations at $90^{\circ}$ and $180^{\circ}$ were higher in the elite cyclists. The amateur cyclists had greater joint angles at $270^{\circ}$ from the ankle and wider knee joint distance at $0^{\circ}$, $180^{\circ}$, and $360^{\circ}$ than the elite cyclists. The EMG measurements showed significant differences between P2 and P4 from both the right VLO and Semitend. Conclusion: This study showed that lower body movements appeared to be different according to the level of cycle pedaling experience. This finding may be used to improve pedaling performance and prevent injuries among cyclists.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.192-198
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• 1988

Sixty patients, of ASA physical status class I for elective operations in the lower abdomen, perineum, or lower extremities, were studied in a comparative prospective trial to evaluate the efficacy of epidural morphine and ketamine for postoperative analgesia. They were divided into two groups: an epidural morphine sulfate group (EMS group; 30 patients), and an epidural ketamine hydrochloride group (EKH group; 30 patients). Indwelling epidural catheters were placed in the patients' lumber areas (L3-4) and then all patients were anesthetized with thiopental, nitrous oxide, and halothane. After the patients had fully recovered from the anesthesia, the analgesic agents were administered epidurally via the catheter when the patients complained of pain in the postoperative period. The groups were given either 0.1 mg/kg of morphine sulfate or 0.5 mg/kg of ketamine hydrochloride administered in a volume of 10 ml of normal saline. Patients were observed for the onset and duration of postoperative analgesia and for other effects. Total doses were $5.7{\pm}0.6\;mg$ of morphine sulfate in the EMS group and $27.9{\pm}3.3\;mg$ of ketamine hydrochloride in the EKH group. The onset of analgesia was detectable within 35 min.($23.5{\pm}6.3$ min) in 86.7% (26 cases) of the EMS group and within 10 min. ($7.8{\pm}3.7$ min.) in 76.7% (23 cases) of the EKH group. Mean duration of postoperative analgesia was $22.3{\pm}2.1\;hr$. in the EMS group. In the EKH group, the duration of analgesia was shorter and variable, the range of duration was from 2 hr. to 24 hr., Cardiopulmonary changes were statistically insignificant ih both groups. Side effects such as nausea, vomiting, urinary retention, pruritus, dizziness, and headache were observed in EMS group. In the EKH group, there was no discomfort except dizziness (3 cases) and headache (1 case). Epidural ketamine was a safe technique for postoperative analgesia, but because of the variability and relative shortness in the duration of analgesia the use of this technique will require further clinical trials.

• Research in Community and Public Health Nursing
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• v.6 no.2
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• pp.319-334
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• 1995

To investigate the risk factors of low back pain, an epidemiological study was carried out among male workers aged 20-55 employed in an automobile industry in Korea during the time period from February 1993 to October 1995. Workers participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionnaires. General characteristics, medical history, work related factors, fatigue, and MMPI were compared between two groups. To clarify the relationship between job related low back pain and radiologic features of lumbar spine, radiographic study was carried out. The resultant data were processed for $x^2-test$, t-test, and stepwise logistic regression to confirm the adjusted odds ratios. The results were as follows: 1. History of back disease, lifting and carrying work, excessive physical fatigue, and weakend back strength of individual workers were directly associated with low back pain. Odd ratios of these 4 risk factors of low back pain were 5.07, 3.34, 1.49, and 1.22 respectively. 2. The frequency of low back pain history was significantly higher in LBP group. 3. Back muscle strength of lumbar spine of LBP group were significantly lower than control group. 4. The workers in LBP group revealed high fatigue symptoms. 5. In MMPI test LBP group showed higher scales in hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania. 6. LBP group were more frequently involved in lifting and carrying, working in awkward position, bending, twisting and using lower extremities. 7. LBP group were exposed more to vibration during working. 8. In the Analysis of radiographs of lumbar spine, Jacob's line not crossing fourth lumhar disc space, transitional vertebrae and lumbar displacement more than 4.4mm in standing lateral view were more frequently observed in LBP group than control group. Through these results, it is concluded that identification of previous history of back problem, change of work or working environment for workers with previous back problem and measures to relieve both physical and psychological fatigue of the workers are required for optimal management of work-related back problems among workers. In the present study, several results were different from the previous reports: Jacob's line not corssing fourth lumbar disc space, lumbarization, and vertebral slipping (spondylolisthesis) more than 4.4mm are related to backache. Meticulous studies are required to elucidate the difference.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.605-610
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• 2009

Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.455-458
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• 2007

A 40 year-old male patient admitted for dyspnea and edema of the lower extremities. A pulsatile abdominal mass with a bruit was palpable in the right lower quadrant. Four months previously, he had underwent left partial lam-inectomy ($L4{\sim}5$) and discectomy at the L4 level due to disc protrusion, Computed tomography showed an ilio-iliac AV fistula with pseudoaneurysm at the L5 level. Because massive bleeding occurred when the aneurysm was entered, we closed the aneurysm and performed resection and suture of the aorta and both iliac arteries very near the aneurysm. After exclusion of the arterial side, we performed reduction angioplasty at the aneurysm and aorto-biiliac reconstruction with an artifcial graft. Twenty-four months after operation, he is doing well and hasn't had any complications on the follow-up.

• Journal of radiological science and technology
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• v.44 no.6
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• pp.607-613
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• 2021

Long-bone examination is mainly used for inspection of the lower extremities. Recently, a long length detector (FXRD-1751S, VIEWORKS, Korea) with three digital detectors attached has been developed. High energy X-rays are used because pelvic areas require high image quality. In this case, X-rays are transmitted a lot in thin areas such as an ankle, and it is not suitable for diagnosing an image. Therefore, this study use copper filters made with 3D printers to increase image quality in the Long-bone inspection. A copper filter was manufactured in consideration of the overall thickness of the lower part. The experiment was conducted in anterior-posterior (AP) and lateral (LAT) positions, depending on the presence or absence of the filter. 5x5 pixels of region of interest (ROI) were selected from the pelvis, knee, and ankle areas. X-rays were irradiated under the conditions of 70 kVp and 40 mAs for AP, 80 kVp, and 63 mAs for lat when without filters, 90 kVp and 80 mAs for AP, 90 kVp and 100 mAs for lat when with filters. signal to noise ratio(SNR) ratio and contrast to noise (CNR) values were measured 1106.38, 14.34 before applying the filter and 1189.32, 70.43 after the filter. For the knee area, 650.44, 97.61 before applying the filter, and 1013.17, 444.24 after applying the filter. For the ankle area, 206.65, 23.68 before applying the filter and 993.50, 136.11 after applying the filter. In the Long-bone examination, SNR and CNR were greatly measured when the filter was applied, confirmed the availability of using the copper additional filter.

• Journal of Physiology & Pathology in Korean Medicine
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• v.35 no.6
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• pp.242-248
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• 2021

This study aims to compare nail-fold capillary blood velocity (CBV) according to the presence or absence of cold hypersensitivity in the hands (CHH) using nail-fold capillaroscopy under cold stress conditions. Eleven participants were taken from the cohort study for observing long-term health status of the faculty of Semyung university. Seven of the participants displayed CHH while four showed signs of non-CHH. CBV between 0 and 60 seconds (S1) and between 240 and 300 seconds (S2) was measured under cold stress for 5 minutes, respectively, and the average value was used to compare non-CHH group and CHH group. Body mass index, Nogung (PC8) temperature and temperature difference between Nogung (PC8) and Hyeopbaek (LU4) were significantly lower in CHH group compared to non-CHH group. The S2-S1 CBV difference was negatively correlated with PC8 temperature and PC8-LU4 temperature, and positively correlated with cold pattern score and cold hypersensitivity visual analog scale. The CHH group had a lower CBV overall than non-CHH group, and the S2-S1 CBV difference was significantly higher in the CHH group than in non-CHH group. This study suggests that CBV measured by nail-fold capillarosopy might be a useful indicator of cold hypersensitivity properties.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.343-347
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• 2020

May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.253-260
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• 2020

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm² and the mean size of the donor sites was 51.9 cm². The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.