• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.891-900
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• 2022

Purpose: The purpose of this paper is to report the improvement of a patient with amyotrophic lateral sclerosis after long-term combined Korean medical treatment. Methods: A patient diagnosed with amyotrophic lateral sclerosis was treated with herbal medicine, acupuncture, pharmacopuncture, moxibustion, and rehabilitation for four separate hospital stays. To evaluate their respiratory discomfort and limb weakness, we used Manual Muscle Testing, the Pulmonary Function Test, and the Korean Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised. Results: The weakness of the muscles of the lower extremities and respiratory function was improved. Conclusion: We consider that combined Korean medicine treatments might be an effective treatment for muscle weakness and respiratory discomfort of amyotrophic lateral sclerosis. To verify the effectiveness of these treatments, further research is required.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.41-52
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• 2023

Background: Bulgarian split squat (BSS) is beneficial to improve dynamic balance ability and muscle activity of lower extremities, however its effects have not been fully investigated. Therefore, this study aimed to compare changes in dynamic balance ability and muscle properties according to various modifications of BSS exercises. Methods: Thirty healthy male volunteers participated in this study, and they were randomly divided into three different groups. The subjects performed the BSS exercise either on a stable surface with the eyes opened (n=10) or eyes closed (n=10), and on an unstable support plane with eyes opened (n=10) conditions, respectively. Dynamic balance ability was measured via Biodex balance system under the eyes-opened and closed conditions. Additionally, muscle properties of the rectus femoris (RF), vastus medialis (VM) and vastus lateralis (VL) were evaluated. Results: Dynamic balance ability did not show the significant differences among the groups that performed the BSS exercises. However, in the Unstable group, there were significant differences in the overall stability index and anterior posterior stability index under the eyes-closed condition between pre-exercise and post-exercise. In comparison of muscle properties according to the groups, RF muscle showed a significant difference in amount of change of elasticity (p=.038). Additionally, there were significant changes in post measurements of VM muscle tone (p=.016), stiffness (p=.012) and elasticity (p=.002). VL muscle, however had no significant differences in muscle properties. Conclusion: These results indicate that BSS exercises could induce the alteration of RF and VM muscle properties, in particular VM muscle which is susceptible to weakness. Thus, BSS could be applied in various ways as an effective rehabilitation exercise.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.192-196
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• 2019

Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.293-301
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• 2019

Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.211-218
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• 2019

Herniation of the intervertebral disc is a medical disease manifesting as a bulging out of the nucleus pulposus or annulus fibrosis beyond the normal position. Most lumbar disc herniation cases have a favorable natural course. On the other hand, surgical intervention is reserved for patients with severe neurological symptoms or signs, progressive neurological symptoms, cauda equina syndrome, and those who are non-responsive to conservative treatment. Numerous surgical methods have been introduced, ranging from conventional open, microscope assisted, tubular retractor assisted, and endoscopic surgery. Among them, microscopic discectomy is currently the standard method. Biportal endoscopic spinal surgery (BESS) has several merits over other surgical techniques, including separate and free handling of endoscopy and surgical instruments, wide view of the surgical field with small skin incisions, absence of the procedure of removing fog from the endoscope, and lower infection rate by continuous saline irrigation. In addition, existing arthroscopic instruments for the extremities and conventional spinal instruments can be used for this technique and surgery for recurred disc herniation is applicable because delicate surgical procedures are performed under a brightness of 2,700 to 6,700 lux and a magnification of 28 to 35 times. Therefore, due to such advantages, BESS is a novel technique for the surgical treatment of lumbar disc herniation.

• 한국노년학
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• v.29 no.4
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• pp.1261-1275
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• 2009

Age related decrease of muscle strength, balance, and gait abilities bring about physical inactivity in the elderly. Virtual reality (VR) training has been used successfully to rehabilitate functional balance and mobility in elderly subjects. This study was aimed at determining the effect of VR-based exercise programs by using a video game on the muscle strength, balance, and gait abilities in the elderly. 48 old people were randomly divided into two groups; VR-group (men: 11, women: 14, age: 68.42yrs) and control group (men: 10, women: 13, age: 67.58yrs). VR-group performed an exercise program twice a week for 8 weeks and control group had no intervention. The VR-based exercise program was composed of warm up(10 mins), VR-program(40 mins), and cool down(10mins). It was performed by playstation eyetoy play that provided visual and auditory feedback as well as movements of the upper and lower extremities. Muscle strengths of the knee and ankle were measured using manual muscle tester. Static balance was estimated using computerized posturography. Dynamic balance was measured by Timed up and go test (TUG), Functional reach test (FRT). 10m walk test and 6-min walk test were used to assess gait abilities. After the completion of the VR-exercise program, muscle strength, balance, and gait abilities were improved significantly (p<0.05). In conclusion, the VR-based exercise program showed improvement on the muscle strength, balance, and gait ability in the elderly. This exercise program is both effective and interesting for this age group.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.240-246
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• 2024

Epithelioid angiosarcoma is a rare variant of angiosarcoma characterized by an epithelioid morphology that mimics carcinoma. Therefore, multicentric epithelioid angiosarcoma is easily misdiagnosed as bone metastasis from carcinoma and has an aggressive clinical course. Here, we present a rare case of a 61-year-old male with multicentric epithelioid angiosarcoma of the bone. Plain radiography, CT, and MRI revealed multiple osteolytic lesions in both femurs; some lesions showed soft tissue extension with cortical bone destruction. Interestingly, PET-CT revealed that the lesions were only distributed along the bones of the lower extremities, including the pelvic bones, femurs, and tibiae. Despite histological analysis initially suggesting metastatic carcinoma, after additional immunohistological staining, including that for vascular markers (CD31 and ERG), the final diagnosis was epithelioid angiosarcoma. A better understanding of the clinicoradiological features of this disease may help eliminate diagnostic confusion and provide better management.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.603-612
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• 2020

This study has a purpose to look into the effect of the relationship between the Tube current (mA) and SOD(Source to Object Distance), which is a parameter of lower limb angiography examination, and the dilution rate of the contrast medium concentration (300, 320, 350) on the image. To that end, using 3 mm vessel model water phantom, a vessel model custom made in the size of peripheral vessel diameter, this study measured relationships between change of parameters, such as tube current (mA), SOD and varying concentrations (300, 320, 350) of contrast medium dilution into SNR and CNR values while analyzing the coefficients of variance(cv<10). The software used to measure SNR and CNR values was Image J 1.50i from NIH (National Institutes of Health, USA). MPV (mean pixel value) and SD (standard deviation) were used after verifying numerically the image signal for region of interest (ROI) and background on phantom from the DICOM (digital imaging and communications in medicine) 3.0 file transmitted to PACS. As to contrast medium dilution by the change of tube current, when 146 mA and 102 mA were compared, For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As to contrast medium dilution by concentration for SOD change, when SOD's (32.5 cm and 22.5 cm) were compared,For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As to contrast medium dilution by concentration for SOD change, when SOD's (32.5 cm and 12.5 cm) were compared,For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As a result, set a low tube current value in other tests or procedures including peripheral angiography of the lower extremities in the intervention, and make the table as close as possible to the image receiver, and adjust the contrast agent concentration (300) to CM: N/S dilution (30%: 70%). ) Is suggested as the most efficient way to obtain images with an appropriate concentration while simultaneously reducing the burden on the kidney and the burden on exposure.

• Journal of Korea Entertainment Industry Association
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• v.15 no.7
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• pp.225-233
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• 2021

This study quantitatively compares and analyzes lower extremity muscle activity and motor neurons by performing blood flow-restricting aerobic training in the lower extremities, which is closely related to aerobic capacity for health, in normal people, and provides basic data to suggest the effectiveness of an effective blood-restricting exercise program. would like to provide A group of 10 people who applied aerobic exercise on a treadmill by restricting blood flow to 140 mmHg of pressure was set as Experimental Group I. And 11 people who applied only aerobic exercise on a treadmill were randomly assigned as a control group. The intervention program was implemented on a treadmill for 4 weeks, 3 times a week, once a day, for 30 minutes once. In addition, muscle activity and motor neurons were measured and analyzed using surface electromyography before intervention. As a result of the study, the muscle activity of the rectus femoris, biceps femoris, tibialis anterior and gastrocnemius was significantly increased (p<.001) in the pre-and-poster comparison within the group of experimental group I (p<.001). In the pre-and-poster comparison of the control group, the muscle activity of the rectus femoris, biceps femoris, tibialis anterior and gastrocnemius was significantly increased (p<.001). In comparison of changes between groups, there was a significant difference in the activity of the rectus femoris muscle (p<.05). Combining aerobic exercise in parallel with lower extremity blood flow restriction can be developed into an injury prevention exercise program that can restore functional activity in rehabilitation training for elite athletes and elderly people with weak joints. In addition, based on these results in future research, it is considered that it is necessary to expand the scope of non-normal subjects and conduct various studies according to the pressure intensity.