• 제목/요약/키워드: lower extremities

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항암화학요법 유발 말초신경병증에 대한 한방치험 1례 (Case Report of Chemotherapy-Induced Peripheral Neuropathy Treated with Korean Medicine)

  • 신혜령;서욱철;안성후;원진희;송봉근
    • 대한한방내과학회지
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    • 제42권2호
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    • pp.104-113
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    • 2021
  • Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

하지 화상 환자의 재활치료를 위한 보행보조 로봇훈련의 선행연구 (The Pilot Study of Robot-Assisted Training for the Lower Extremity Rehabilitation of Burn Patients)

  • 조윤수;노민혜;주소영;서정훈
    • 대한화상학회지
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    • 제23권2호
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    • pp.31-36
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    • 2020
  • Purpose: Scar contracture influence the outcome of burn patients significantly. This study aims to investigate the feasibility of robot-assisted training for the lower extremity rehabilitation of burn patients. Methods: This pilot study was conducted on 7 burn patients for 8 weeks between January 2019 and November 2019. Two of 7 patients withdrew from this study because one had skin abrasion on the legs which thigh fastening devices were applied on and the other was not participate in the assessment at 4 weeks after training. Final 5 patients received gait training with SUBAR® and numeric rating scale (NRS), 6-minutes walking test, and range of motion in flexion and extension of knee and ankle joint were evaluated before training, 4 weeks and 12 weeks after training. Results: The subjects had a mean age of 51.8±98 years, mean total burn surface area of 30.8±13.7%, mean duration from injury to 1st assessment of 102.8±39.3 days. Anyone of 5 patients did not have musculoskeletal or cardiovascular side effects such as increased or decreased blood pressure or dizziness. The significant improvement in NRS, gait speed, and range of motion in knee extension and ankle plantarflexion after robotic training (all P<0.05). Conclusion: Robot-assisted training could be feasible for the rehabilitation of burn patients and it could improve muscle strength and range of motion in lower extremities, and gait function.

Clinical Efficacy of a Modified Surgical Procedure in the Treatment of Incompetent Great Saphenous Veins

  • Ki Pyo Hong
    • Journal of Chest Surgery
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    • 제56권6호
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    • pp.387-393
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    • 2023
  • Background: The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins. Methods: This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery. Results: The study included 179 limbs from 120 patients (47 men and 73 women). The mean patient age was 56.5 years (range, 20-78 years), and the distribution of preoperative Clinical-Etiology-Anatomy-Pathophysiology clinical classes was 8% C0-C1, 88% C2, and 4% C3-C6. The preoperative diameter of the saphenofemoral confluence averaged 6.9 mm (range, 2.7-15.8 mm). After a mean postoperative follow-up period of 24 months, evidence of neovascularization around the stump of the saphenofemoral junction (SFJ) was observed in 2 limbs (1.1%). Additionally, varicose vein recurrence was found in 1 limb (0.6%) and was associated with an incompetent thigh perforator. At postoperative follow-up, both VCSS and AVVQ scores were significantly lower than the preoperative scores. Conclusion: Modified surgical treatment of GSV incompetence, involving preservation of the SEV and stripping of a short segment up to the knee, demonstrated favorable clinical results in terms of postoperative complication rate, neovascularization rate around the SFJ stump, varicose vein recurrence rate, and improvement in lower extremity symptoms.

착지 동작 시 깔창 높이가 20대 남성의 하지 관절 각도와 근활성도에 미치는 영향 (The Effect of the Insole Height on Lower Limb Joint Angle and Muscle Activity at Landing when the Maximal Ground Reaction Force of Male in Their 20s)

  • 유경태
    • 융합정보논문지
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    • 제10권12호
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    • pp.132-139
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    • 2020
  • 본 연구의 목적은 착지 시 키 높이 깔창 높이에 따라 젊은 남성의 최대지면반발력시 하지관절각도와 근 활성도에 미치는 영향을 분석하는데 있다. 20대 남성을 대상으로 총 3주에 걸쳐 한 주당 0, 3, 5cm 의 폴리우레탄 소재의 깔창 중 무작위로 하나를 착용하여 40cm 높이의 플랫폼 위에서 Force plate로 착지 동작을 시행하였다. 착지 동작 중 최대 지면반발력 시 하지의 관절 각도와 넙다리곧은근, 넙다리두갈래근, 앞정강근, 장딴지근의 근활성도를 측정하였다. 깔창의 높이에 따른 하지관절 각도와 근활성도의 변화를 비교하기 위해 반복요인이 있는 분산분석(one-way ANOVA)을 실시하였다. 하지관절각도 분석 결과 깔창의 높이가 높아질수록 좌측 발목관절 각도에 영향을 주었으며, 근활성도 분석 결과 깔창의 높이가 높아질수록 우측 앞정강근과 양쪽 넙다리 두갈래근에 영향을 주었다. 하지 근육의 충분한 근력증가를 통하여 착지시 신체를 보호할 수 있을 것이라고 생각되며 깔창의 종류에 따라 영향을 미치는 근육과 하지관절의 각도도 다를 수 있으므로 그에 대한 연구가 필요할 것으로 사료된다.

사지에 발병한 카포시육종의 방사선치료를 위한 물볼루스 기구의 유용성 고찰 (Evaluation of a Water-based Bolus Device for Radiotherapy to the Extremities in Kaposi's Sarcoma Patients)

  • 안승권;김용배;이익재;송태수;손동민;장영재;조정희;김주호;김동욱;조재호;서창옥
    • Radiation Oncology Journal
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    • 제26권3호
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    • pp.189-194
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    • 2008
  • 목 적: 본 연구팀은 사지에 발병한 카포시육종의 방사선치료를 위하여, 물볼루스를 사용할 수 있는 기구를 고안하였고, 쌀볼루스 사용시와 비교하여 유용성을 평가하고자 하였다. 대상 및 방법: 환자가 앙와위 자세에서 하지를 삽입 할 수 있는 폴리스틸렌 상자를 만들고 비닐 재질의 진공비닐을 집어 넣어 물이 누수 되지 않도록 결합하였으며, 진공비닐안에 하지와 물 사이의 공기를 없애기 위해 진공 밸브와 진공 펌프를 연결하여 공기를 제거하였다. 본 연구에서 제작한 물기반 볼루스의 선량 균질도를 비교 평가하기 위해 진공비닐에 하지 팬텀을 삽입한 후 폴리스틸렌 상자에 직접 쌀을 채운 경우, 비닐봉지에 쌀을 담아서 넣은 경우, 그리고 물을 직접 채운 경우에 대해 전산화단층촬영을 시행하였다. 방사선치료계획시스템을 사용하여 공기층의 부피에 의한 밀도의 변화를 분석하였다. 또한 선형가속기를 사용하여 전산화단층 모의치료기와 동일한 셋업에서 하지 팬텀에 필름을 감고, 열형광선량계 6개를 조사야 안에 균등하게 붙여서, 대향이문 조사하여 선량의 균질도 및 선량 값을 측정하였다. 결 과: 각 세 종류 실험의 밀도 측정결과 물볼루스를 기준으로 쌀을 직접 넣은 경우는 14% 감소했으며, 쌀을 비닐 봉지에 나누어 넣은 경우는 18% 감소하였다. 필름의 분석 결과 물볼루스가 쌀볼루스보다 균질도가 $4{\sim}4.4%$ 정도 우수한 것으로 나타났다. 열형광선량계 측정 평균값 분석결과 물볼루스를 기준으로 쌀을 직접 넣은 경우는 3.4% 증가했으며, 쌀을 비닐봉지에 나누어 넣은 경우는 4.3% 증가하였다. 결 론: 자체 제작한 물볼루스 기구는 육안으로 치료 조사야를 확인할 수 있어 셋업의 정확성을 높였으며, 진공 밸브와 진공 펌프를 사용하여 공기층을 감소시켜 치료의 정확성을 높이는 동시에 목적 종양에 균질도가 높은 선량을 부여 할 수 있는 좋은 방안이라 할 수 있다.

흔들림이 있는 표면에서 여성 노인의 신발 굽 높이가 하지 근육 활성도에 미치는 영향 (Effect of heel Heights of shoe on Muscle Activation of Lower Extremity on the Rocking Surface in older Women)

  • 김경;조용호;차용준;송병섭
    • 대한의용생체공학회:의공학회지
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    • 제29권4호
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    • pp.316-322
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    • 2008
  • The purpose of this study was to investigate muscle activation of lower extremity such as rectus femoris, tibialis anterior and soleus according to 0cm(bare foot), 4cm and 7cm heel height of shoe on the rocking surface in older women. 20 older women who did not have any lower musculoskeletal and neurological disorders in the past were participated in this study. Each subject was standing for 15 seconds on the level 8 of Biodex Stability System (BSS) while wearing 4cm and 7cm heel height shoes including bare foot. Electromyography was used to measure muscle activation of lower extremity, and the muscle activation was expressed as a percentage of maximal voluntary isometric contraction (% MVIC). We measured % MVIC of three muscles during 5 seconds except for the first 5 seconds and last 5 seconds. SPSS 12.0 program was used for this study. Repeated one-way analysis of variance(ANOVA) was performed to compare the significant difference among the muscles of lower extremities according to heel heights of shoe on the rocking plate. % MVIC of each muscle such as rectus femoris, tibialis anterior and soleus regarding heel heights of shoe had statistically significant differences (p<0.05). The results of contrast test were as follows; 1) % MVIC of rectus femoris had significant differences between barefoot and 4cm, and barefoot and 7cm. 2) % MVIC of tibialis anterior had significant differences between barefoot and 4cm, barefoot and 7cm, and 4cm and 7cm. 3) % MVIC of soleus had significant differences between barefoot and 7cm, 4cm and 7cm. The results indicate that all commonly responsive muscle on the conditions of barefoot, 4cm, and 7cm shoe height on the rcoking surface is tibialis anterior muscle. We found out that the more heels of shoe high, the more muscle activation increases. High-heeled shoes above 7cm remarkably increase the muscle activation of lower extremity and may result in muscle fatigue. Thus, these shoes may summate risk factors of falls in older women. We can acknowledge that the heels above 4 cm affect each muscle activation in lower extremity on the rocking surface.

Overlapping Guillain-Barr$\acute{e}$ syndrome and Bickerstaff's brainstem encephalitis associated with Epstein Barr virus

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • 제57권10호
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    • pp.457-460
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    • 2014
  • A flaccid tetraparesis in Bickerstaff's brainstem encephalitis (BBE) is presumed to be a sign of overlapping Guillain-Barr$\acute{e}$ syndrome (GBS). In addition, BBE and Fisher syndrome, which are clinically similar and are both associated with the presence of the immunoglobulin G anti-GQ1b antibody, represent a specific autoimmune disease with a wide spectrum of symptoms that include ophthalmoplegia and ataxia. A 2-year-old boy presented with rapidly progressive ophthalmoplegia, ataxia, hyporeflexia, weakness of the lower extremities, and, subsequently, disturbance of consciousness. He experienced bronchitis with watery diarrhea and had laboratory evidence of recent infection with Epstein-Barr virus (EBV). He was diagnosed as having overlapping GBS and BBE associated with EBV and received treatment with a combination of immunoglobulin and methylprednisolone, as well as acyclovir, and had recovered completely after 3 months. In addition, he has not experienced any relapse over the past year. We suggest that combinations of symptoms and signs of central lesions (disturbance of consciousness) and peripheral lesions (ophthalmoplegia, facial weakness, limb weakness, and areflexia) are supportive of a diagnosis of overlapping GBS and BBE and can be helpful in achieving an early diagnosis, as well as for the administration of appropriate treatments.

좌심방 점액종 -1예 보고- (Left Artial Myxoma(One case report))

  • 김형묵
    • Journal of Chest Surgery
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    • 제13권3호
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    • pp.256-261
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    • 1980
  • Left atrial myxoma constitutes the most significant cardiac tumors, which occupies 30 to 50% of the total in most pathological series with the age range from 3 to 83 years, mostly between the age of 30 to 60 years. Over 90% of myxomas occur in the atria, with 3 to 4 times as many occurring in the left as in the right. They may cause severe and progressive disease mimicking mitral valvular disease with non-specific general symptoms. Recent attentions were focussed in the clinical features along with various diagnostic techniques including angiocardiography, echocardiography and cross-sectional sector scanning echocardiography, and definitive treatment with surgical removal under direct vision using cardiopulmonary bypass. There are several reports on the atrial myxomas removed from various cardiac chambers in Korea, and we report another typical case of left atrial myxoma of 6.8 x 3.8 x 1.7 cm3 attached to the upper margin of fossa ovalis with a short pedicle, also with calcification at it`s distal free end. 29 year old young mother complaining of mild fever, vaginal spotting, numbness of left upper and lower extremities, nocturnal attack of dyspnea and palpitation for 2 months was diagnosed as large left atrial myxoma with the aid of angiocardiography and echocardiography. Trans-right-atrial, transseptal surgical removal of the tumor was successfully performed under the cardiopulmonary bypass for 22 minutes on 24th of July 1980. Postoperative hospital course was uneventful and discharged from hospital on the 12th POD with complete recover from the previous symptoms and signs.

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Effects of Different Cool-down Exercise Methods on Muscle Strength and Endurance of the Lower Extremities

  • Bae, Chang-Hwan;Cho, Sung-Hyoun;HwangBo, Gak
    • International Journal of Contents
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    • 제8권2호
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    • pp.97-102
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    • 2012
  • The purpose of this study was to investigate the effects of various cool-down exercises on muscular strength and endurance. After receiving a treadmill training for main exercise, the subjects conducted isotonic and isometric cool-down exercises four times for three weeks. Isotonic exercise with leg press of 10kg was repeated by 20 times and isometric exercise was conducted at flexion of hip joint and knee joint with leg press of 10kg by maintaining it for 6 sec and resting for 2 sec by 20 times. Muscular strength after exercise was measured with 1 RM by times and muscular endurance with maximum repetition frequency using time to keep for loading the weight of 10 RM and 65% of maximum muscular strength. As a result of comparing and analyzing measured values, exercise recovery shape of isotonic and isometric cool-down group were more effective than rest recovery shape of the control group. The isometric cool-down group was more effective than isotonic cool-down group. In conclusion, isometric exercise was more effective than isotonic exercise or simple rest on muscular strength and endurance.

중환자실 환자를 위한 소매형 억제대의 개발 및 적용 (Development and Application of the Sleeve-type Restraints for Intensive Care Unit Patients)

  • 고현영;강지연
    • 성인간호학회지
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    • 제25권6호
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    • pp.665-678
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    • 2013
  • Purpose: The purpose of this study was to develop sleeve-type restraints and to compare the sleeve-type and conventional wrist restraints. Methods: Forty four pairs of intensive care unit (ICU) patients and their families participated in the experiment. The nurses applied sleeve-type restraints to the patients in the experimental group, and wrist restraints to the control group. The trained research assistant measured ROMs, skin temperature, edema, and skin lesions of both upper extremities (UEs) before, 24, 48, and 72 hours after the restraints applied. The emotional response of family was measured 72 hours after the restraints applied. Thirty one ICU nurses evaluated the efficiency of both types of restraints. Results: Compared to the control group, changes of ROMs, edema, and skin abrasions on both U/Es of the experimental group indicated a significant difference in physical side effects. The emotional response scores of the experimental group were significantly lower than those of the control group. The mean efficiency scores for the sleeve-type restraints were significantly higher than those for the wrist restraints. Conclusion: The results indicate that the sleeve-type restraints are better than wrist restraints with respect to physical side effects, emotional responses of family members, and application efficiency.