• Journal of Chest Surgery
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• v.9 no.2
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• pp.251-264
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• 1976

Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.46-55
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• 1996

The purpose of this study is to investigate if there is a higher rate of free flap failure in cases of vein grafts compared to non-vein graft, and to analyze the clinical usefulness and necessity in elective free flap surgery. We have used 24 vein grafts in 208 free flaps from May, 1986 until August, 1995. Vein grafts were from 2cm to 50cm in length between the recipient and donor vessels. Reconstructed sites were 10 lower extremities, 8 head and neck, 4 hand, and 2 trunk. Vein grafts were used 14 for arterial, 6 venous, 4 in both arterial and venous anastomoses. We intentionally used long vein grafts longer than 5cm for improved blood flow in cases of peripheral vascular disease, radionecrotic wounds, lower leg trauma. Short vein grafts of about 3cm in length were used to overcome the shortage of vascular length in cases of unexpected vessel anomaly, short donor vessel, and difficult access to recipient vessels after radical neck dissection. All veins were carefully handled with ligation of very small branches and were transferred to the recipient site without irrigation. 8 flaps were failed out of a total of 208 free flaps, however there was no failure among the 24 cases that needed vein grafts between the donor and recipient vessels. Success rates between non-vein grafts free flaps and vein graft free flaps were 95.6%(8/184) and 100%(0/24). Even though the vein grafts increase the operation time and the number of anastomoses, they do not result in any increased failure rate of free flap surgery(4.4% versus 0%). In addition to the reducing tension between recipient and donor vessels, the surgeon can select better recipient vessels with excellent blood flow so that vein grfats in microsurgery can provide a high success rate of free flaps.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.55-62
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• 2019

PURPOSE: This study examined the muscle activity while stepping over obstacles with various heights and widths to provide basic data for training and preventing falls. METHODS: Fifteen normal young adults (seven males and eight females) were recruited. The participants walked on a 5m walkway with six obstacles. The heights of obstacles were 0%, 10%, and 40% of the subject's leg length, and the width of the obstacles was 7cm and 14cm. The participants traversed the course twice per obstacle. The muscle activities of the soleus, tibialis anterior (TA), vastus medialis (VM), and vastus lateralis (VL) were measured using surface electromyography. A Mann-Whitney test and Kruskal-Wallis test were used to examine the differences between obstacles. RESULTS: The muscle activities of the VL and the soleus of the stance leg and lead leg after crossing over the obstacles increased with increasing width, and there were significant differences in muscle activities between obstacle width (p<.05) except for the muscle activity of TA of the stance leg after crossing over the obstacles. A significant difference in muscle activities was observed according to the height of the obstacles with 14 cm (p<.05) except for the muscle activity of the VL, soleus of the leading leg, and TA of the stance leg CONCLUSION: The role of the VL and Soleus increased with increasing obstacle width, and the overall muscle activities of the lower extremities increased with increasing obstacle height. These results can be used to suggest a program to prevent falls.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.104-109
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• 2001

We describe the accidental injection of local anesthetics containing steroid into the subdural space during an attempted lumbar epidural injection for intractable radiculopathy in a patient with failed back surgery syndrome. A 24-year-old man complained of severe radiating pain to left lower extremity and showed a walking disturbance and severe lumbar scoliosis. The MRI finding was a left paramedian recurred disc herniation on L4-5 in a laminectomy state. Several therapeutic modalities such as epidural steroid injection, transforaminal injection, L2 root block, medication, and exercise therapy, etc failed. Initially, during epidural block at L4-5 under fluoroscopic guidance, a railroad track appearance appeared on epidurogram suggesting the presence of a subdural space. A second epidural block was tried at L5-S1. Following confirmation of epidural space upon epidurogram, 6 ml of 0.5% lidocaine including triamcinolone 40 mg was injected. The patient showed signs of the subdural injection including an unexpectedly high sensory block (T2) and a motor weakness of both lower extremities. Following this event, the severe radiculopathy and lumbar scoliosis were improved. Therefore, we conclude that subdural injection of steroid could be helpful in intractable radiculopathy, especially in the failed back surgery syndrome. However, it must be used cautiously with careful patient selection.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.273-276
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• 2006

Although cavernous angioma itself is not rare, the epidural spinal localization is uncommon and makes preoperative differential diagnosis difficult. An extraordinary case of a thoracic epidural cavernous angioma in very young age, causing sudden paraplegia is presented. Only 79 cases have been reported in the literatures and among them, this kid was the youngest. A 23-month-old boy was referred to us with a 2-day history of sudden both lower limb weakness. Two days before admission, he got up at morning and was unable to stand and even to move the legs. MRI revealed an epidural mass surrounding spinal cord associated with cord compression at the level of the C5 through T3. Through posterior approach with exposure of C6 to T3 level, the hematomatous mass was removed subtotally due to intraoperative bleeding and its ventral location. After the first operation, the weakness of bilateral lower extremities was improved so as to move gainst the gravity. But the next day, the limb weakness was aggravated as same as preoperative status due to mass effect of new hematoma. The second operation was performed to remove the hematoma and to control the bleeding focus. Several weeks later, the limb weakness was improved and he was able to walk. The literatures about spinal cavernous angioma are reviewed.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.1
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• pp.391-396
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• 2012

The purpose of this study is to identify which width of the base of support(BOS) is safer and more effective in lifting by comparing muscle activations and body sways when lifting objects under the width variation of the BOS. A total of fifteen healthy adults participated in this study. For the width variation of the BOS, the participants changed the width between their feet into three different types(10cm, 32cm, 45cm) and lifted a 10kg four times in each type after going up on a force plate. In order to measure body sways according to the width variation of the BOS, a motion analysis system was used. In addition, in order to measure the muscle activations of lower extremities, including the erector spinae, gluteus maximus, rectus femoris, and tibialis anterior, an electromyogram(EMG) analysis was employed. In addition, the Borg's scale was drawn by quantifying the subjective discomfort levels felt from each width of the BOS. In conclusion, no statistically significant differences according to the width variation of the BOS were observed(p=.295, .308)(p>.05). However, a statistically significant difference was exhibited between the Borg's scale, which indicates the discomfort levels from lifting performances, and the width variation of the BOS (p=$.000^*$).

• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.159-163
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• 2015

Purpose: This study aimed to determine the interaction among the neck, trunk, and lower extremities on the non-paretic side in head rotation along with non-paretic-side weight shifting of stroke patients. To compare stroke patients' ability to control posture through muscle activity variation related to pertubation during head rotation along with the non-paretic limb. Methods: We tested 15 hemiplegic patients and 15 normal individuals. Each group's muscle activity was measured by electromyography in neutral head position and head rotation position. We compared each group's resu lt based on measured values in patients' non-paretic neck muscles, trunk muscles, and lower limbs muscles activation. Results: The study showed that muscle activity increased in the sternocleidomastoid muscle (102.26%, 53.00%), splenius capitis muscle (97.93%, 54.93%), erector spinae muscle (241.00%, 127.60%), external oblique abdominal muscle (256.66%, 152.00%), and internal oblique abdominal muscle (252.80%, 152.6%), peroneus longus muscle (117.53%, 137.13%) and gastrocnemius muscle (119.06%, 137.20%), while the results for the sternocleidomastoid muscle, splenius capitis muscle, erector spinae muscle, external oblique abdominal muscle, internal oblique abdominal muscle, peroneus longus muscle, and gastrocnemius muscle showed a statistically significant difference (p<0.05). Conclusion: It is hard for stroke patients to engage in normal movement control under suggested conditions because of the insufficient movement against gravity on the stroke patient's non-paretic side and impaired cooperative patterns. To solve these problems, patients need their bodies to improve through effective movement, resulting in advanced control of their effective and functional activity.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.16-19
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• 2006

Synovial sarcoma is rare soft tissue tumor mesenchymal origin. Osseous involvement of synovial sarcoma is rare. A 24-year-old man presented with pain and swelling of the lower extremity. MRI of the lower extremity demonstrated a large mass encircling tibia with osseous involvement. Surgical excision of the mass was done and the mass was diagnosed as biphasic synovial sarcoma with bone marrow involvement. We also discuss the other imaging findings of synovial sarcoma on MRI.

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.317-326
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• 2012

Purpose: The purpose of this study was to identify the effects of an exercise program on muscle strength, Activities of Daily Living (ADL), health perception, and depression among post-stroke elders. Methods: Nonequivalent control group design with pretest and posttest was used. A total of 23 post-stroke elders who met inclusion criteria were recruited. Muscle strength in upper and lower extremities, ADL, health perception, and self-rated symptoms of depression were measured. The exercise program consisted of deep breathing, range of motion, and muscle strengthening exercises using Thera-band, 30~40 min/day, three days a week, for 12 weeks. Results: Muscle strength of right shoulder (U=11.50, p=.001), right leg (U=13.50, p=.002), and health perception (U=24.00, p=.010) in the experimental group was significantly higher compared to the control group at 12 weeks of post-intervention. Depression scores were significantly lower in the experimental group compared to the control group at 6 weeks (U=28.00, p=.021), at 12 weeks (U=22.00, p=.006) of an exercise program. Conclusion: By applying this program, post-stroke elders showed increases in muscle strength and a decrease in depression as well as improvement of health perception. Further study is needed to verify the effects of the exercise program on cardiovascular physiologic variables through long-term follow-up.

• Korean Journal of Applied Biomechanics
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• v.25 no.3
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• pp.249-256
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• 2015

Objective : The purposes of this study was to perform a kinematical analysis on age and walkway types in elderly women subjects. Method : Forty subjects participated in the experiment (A1 group - age: $67.30{\pm}1.49yrs$, height: $153.81{\pm}4.47cm$, weight: $61.80{\pm}5.24kg$, A2 group - age: $71.70{\pm}1.10yrs$, height: $152.01{\pm}2.84cm$, weight: $59.69{\pm}7.34kg$, A3 group - age: $76.80{\pm}0.98yrs$, height: $150.16{\pm}6.08cm$, weight: $57.27{\pm}6.42kg$, A4 group - age: $81.80{\pm}0.60yrs$, height: $152.18{\pm}4.77cm$, weight: $55.80{\pm}7.78kg$). The study method adopted was the 3D analysis with six cameras. Ground type were classifed as gait pattern on flat, ascent and descent ramp. For the statistical analysis, the SPSS 21.0 was used to perform Repeated measured Two-way ANOVA. Results : In velocity of CM, there was faster movement on flat ground. When it came to the velocity of right toe, there was no significance in early mid-swing of right foot, but A4 was the slowest in late mid-swing of right foot on flat ground. In joint angle in left foot strike, the left hip joint and knee joint were more flexed in descent ramp, In addition left and right ankle joints were more plantarflexed in descent ramp, and left ankle joint was more plantarflexed in the over 75 yrs age groups. Conclusion : The higher age group were more flexed in lower body joints during descent ramp.