• Title/Summary/Keyword: soft recovery

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Spinal Cord Ependymoma Associated with Neurofibromatosis 1 : Case Report and Review of the Literature

  • Cheng, Hongwei;Shan, Ming;Feng, Chunguo;Wang, Xiaojie
    • Journal of Korean Neurosurgical Society
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    • v.55 no.1
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    • pp.43-47
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    • 2014
  • Patients with neurofibromatosis 1 (NF1) are predisposed to develop central nervous system tumors, due to the loss of neurofibromin, an inactivator of proto-oncogene Ras. However, to our knowledge, only three cases of ependymomas with NF1 have been reported in the literature. The authors present a case of NF1 patient with a spinal cord ependymoma. She was referred for about half a year history of increasing numbness that progressed from her fingers to her entire body above the bellybutton. Magnetic resonance imaging revealed a relative-demarcated, heterogeneously enhanced mass lesion accompanied by perifocal edema in C5-7 level, a left-sided T11 spinous process heterogeneously enhanced mass in soft tissue, intervertebral disk hernia in L2-5 level, and widespread punctum enhancing lesion in her scalp and in T11-L5 level. The patient underwent C5-7 laminectomies and total excision of the tumor under operative microscope, and intraoperative ultrasonography and physiological monitoring were used during the surgery. Histopathologically, her tumor was found to be a ependymoma without malignant features (grade II in the World Health Organization classification). Therefore, no adjuvant therapy was applied. Following the operation, the patient showed an uneventful clinical recovery with no evidence of tumor recurrence after one year of follow-up.

COMBINATION THERAPY USING GLOSSOPEXY AND RADIOFREQUENCY THERAPY IN PIERRE ROBIN SEQUENCE

  • Oh, Yu-Jin;Rotaru, Horatiu;Park, Young-Wook;Kwon, Kwang-Jun;Kim, Seong-Gon;Kim, Min-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.242-245
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    • 2010
  • Pierre Robin sequence (PRS) describes the clinical triad of micro- and/or retrognathia, glossoptosis and cleft soft palate. Glossopexy has been demonstrated to be an effective treatment in selected cases of obstruction caused by glossoptosis (generally 6 to 10 months of glossopexy period). If radiofrequency therapy (RF) can reduce tongue volume in PRS, it will be helpful in early releasing of the glossopexy. Two-dayold patient showed a PRS triad. Intermittent cyanosis, respiratory difficulty and feeding problems were also observed. The respiration was not improved and prolonged intubation increased the possibility of respiratory complications like pneumonia. The surgical intervention- glossopexy and RF was done 20 days after birth. We applied RF combined with conventional glossopexy and could get successful results while reducing the overall treatment time to 6 weeks. The follow-up until 12 months after birth was uneventful. Considering that early recovery is highly beneficial to PRS patients by reducing risks associated with glossopexy and low energy RF application is very simple and low risk to patient, our combination therapy should be considered for the treatment of airway problem related to PRS.

An Analytical Study for Determining Optimum Section and Trench Range on Soft Counter Weight Fill (연약지반상 압성토의 최적단면 및 측구위치 결정을 위한 해석적 연구)

  • Park, Jongcheol;Chang, Yongchai;Baek, Incheol;Jung, Donghwan
    • Journal of the Korean Geosynthetics Society
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    • v.14 no.1
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    • pp.51-58
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    • 2015
  • The counter weight filling is a technology to accumulate soils on the side of berm with a proper width and height for improving the stability of the embankment. This study aims to assess a feasibility of the counter weight filling in the construction of pavement roads for recovery of shear failure during the construction. An effective counter weight filling section was suggested using the numerical analysis. The results showed that the effective counter weight filling section is two-fold (x2) higher than the ratio of width in counter weight filling : embankment height and one third (1/3) to the ratio of height in counter weight filling : embankment height. Also a range of effective trench crossing the counter weight filling required when a trench crossing counter weight filling is installed was suggested by supplying a proper distance between the counter weight filling section and cross-sectional trench.

The Result of Closed Reduction and Percutaneous Screw Fixation for Intra-articular Calcaneal Fracture of Joint Depression Type (관절 함몰형 종골 골절에 대한 비관혈적 정복 및 경피적 내고정의 수술적 치료 결과)

  • Kim, Kyang-Yul;Park, Young-Il;Yim, Moon-Sup;Yoon, Sung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.168-173
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    • 2008
  • Purpose: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular joint depression type fracture of calcaneus. Materials and Methods: Thirteen cases with intra-articular joint depression type fracture of calcaneus, from September 2004 to March 2006, were reviewed. There were 9 males and 4 females with 52.5 years old mean age (range: $31{\sim}74$ years old). The average follow-up period was 18 months (range: $8{\sim}32$ months). Steinmann pins and Freers were used for closed reduction. After closed reduction, Acutrak screws and K-wires were inserted. The patients were evaluated with Creighton-Nebraska health foundation assessment sheet for calcaneal fracture, the extent of recovery of Bohler angle, fragment size, and state of subtalar joint. Results: Clinical results according to Creighton-Nebraska health foundation assessment sheet for calcaneal fracture were excellent in 6 cases (46%), good in 4 cases (30%), fair in 2 cases (15%), and poor in 1 case (7%). Average preoperative Bohler angle was $7.6^{\circ}$ (range: $2^{\circ}{\sim}13^{\circ}$). Average postoperative Bohler angle was $24.4^{\circ}$ (range: $4^{\circ}{\sim}33^{\circ}$). There were no soft tissue complications. There were one mild subtalar arthritis and one moderate subtalar arthritis. Conclusion: We think that closed reduction and percutaneous Acutrak screw fixation with or without K-wire is a good option for joint depression type fracture of calcaneus.

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The Effects of Cervical Manipulation on Blood Flow Velocity of Cranial Artery and Pain Level in Cervicogenic Headache Patients

  • Kang, Da-Haeng;Park, Seung-Kyu;Kang, Jeong-Il;An, Chang-Sik;Kim, Yong-Nam;Yoon, Hee-Jong;Koo, Ja-Pung;Chang, Duncan;Lee, Joon-Hee
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.2
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    • pp.99-106
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    • 2010
  • The purpose of this study was to identify the effects of manipulation on the velocity of cerebral blood flow and level of pain in cervicogeinc headache patients. The velocity of cerebral blood flow of 30 cervicogeinc headache patients(male=15, female=15, age=$24.00{\pm}3.60$) and 33 normal subjects(male=15, female=18, age=$23.27{\pm}3.00$) was compared. The 30 cervicogeinc headache patients were divided into suboccipitalis relaxation group, cervical manipulation group, and placebo group, and each were given different interventions. The velocity of cerebral blood flow and pain level was measured before intervention, and 1, 2, 3 weeks after intervention. The velocity of cerebral blood flow was measured with the Transcranial Doppler(TCD), and pain level was measured with visual analog scale(VAS). Blood flow velocity of middle cerebral artery in cervicogeinc headache patients was slower than those in healthy subjects. Physical therapy intervention did not have significant effect on velocity of cerebral blood flow, but slowly decreased at intervention for pain level increased. The suboccipitalis relaxation group and cervical manipulation group showed significant effect in decreasing pain level compared to the placebo group(p<.05). Directly applied manipulation therapy in the neck area not only has effect on joint of cervical and soft tissue but also on blood vessels and nerves which pass the neck area, and because of those results of manual therapy seems to help recovery.

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Effects of Annealing on Electromagnetic Wave Absorption Characteristics in FeSiCr Flakes/Polymer Composite Sheets (FeSiCr 박편/폴리머 복합 시트의 전자파 흡수 특성에 미치는 합금 어닐링 효과)

  • Kim, Ju-Beom;Noh, Tae-Hwan
    • Journal of the Korean Magnetics Society
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    • v.23 no.3
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    • pp.83-88
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    • 2013
  • The soft magnetic Fe-Si-Cr flakes with the thickness of about 1 ${\mu}m$ were annealed at 500 and $700^{\circ}C$ for 1 h, and the composite sheets for electromagnetic wave noise absorber available for quasi-microwave band were fabricated by using these annealed flakes and polymer. Further the power loss characteristics of the composite sheets was investigated to clarify the annealing effect on electromagnetic wave absorption properties. The power loss decreased in the frequency range of several GHz when the annealed flakes were used as compared to the sheet using the as-milled FeSiCr alloy flakes. Moreover the sheets using annealed flakes exhibited lower value of real and imaginary part of complex permeability. These inferior electromagnetic wave absorption properties of the composite sheets using annealed alloy flakes were considered to be obtained by the enhanced eddy current effect upon annealing-induced recovery of microstructure and resulted low complex permeability.

Characteristic Evaluation of Impact Absorption Materials for the Development of Fall Impact Protective Pants (낙상 보호 팬츠개발을 위한 충격흡수 소재특성 평가)

  • Park, Jung Hyun;Lee, Jin Suk;Lee, Jeong Ran
    • Journal of the Korean Society of Clothing and Textiles
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    • v.40 no.3
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    • pp.495-505
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    • 2016
  • This study explores and selects an appropriate material that considers light and soft physical properties as well as activity for impact absorption pads that can be used to develop practical impact protective clothes worn during daily life by the elderly to reduce the impact of falls. Physical properties, impact absorption performance, and compression characteristics were evaluated on 5 types of foam, 2 types of 3D spacer fabric, and 3 types of polymer gel to select a material appropriate for the pad to be inserted into impact protective clothes. The evaluation of the physical properties showed that 3D spacer fabrics had lower density compared to other materials and polymer gels had the highest density. The elongation percentage was higher in foams than 3D spacer fabrics and EPDM foam had the highest elongation percentage. The impact absorption performance of honeycomb polymer gel was better than foams and 3D spacer fabrics. As a result of looking into compression energy and compression characteristics of materials, 'CR foam A' was found to absorb the largest amount of compression energy, 24.1%, among foams and polymer gels. A high energy absorption rate of 50.0% (or above) was indicated by 3D spacer fabrics; however, foams and polymer gels showed a progressive deformation of energy compression / recovery curve with 3D spacer fabrics that showed drastic deformation. Based on characteristics of materials, 'CR foam C' and EPDM with relatively high absorption performance can be used as protective pad materials among foams. Among polymer gels, 2 open-type polymer gels that have relatively low impact protective performance but a relatively lighter weight on human body (compared to closed-type) are considered appropriate protective pad materials.

Role of Muscle Free Flap in the Salvage of Complicated Scalp Wounds and Infected Prosthetic Dura

  • Han, Dae Hee;Park, Myong Chul;Park, Dong Ha;Song, Hyunsuk;Lee, Il Jae
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.735-741
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    • 2013
  • Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.

Schwannoma of the Orbit

  • Kim, Kwang Seog;Jung, Jin Woo;Yoon, Kyung Chul;Kwon, Yu Jin;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.16 no.2
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    • pp.67-72
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    • 2015
  • Background: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. Methods: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. Results: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. Conclusion: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.

Clinical Experience of Finger Tip Amputation of Small Finger in 12-Months-Old: Use of the Technique of Artery-Only Anastomosis (단일동맥연결을 통한 유아 새끼 손가락끝 재접합 경험)

  • Kim, Sun-Joo;Choi, Hwan-Jun;Lee, Young-Man;Kim, Yong-Bae
    • Archives of Reconstructive Microsurgery
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    • v.18 no.1
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    • pp.27-30
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    • 2009
  • Purpose: Recently, replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. However the replantation of fingertip in adults is a well-established procedure, but the replantation in infant or child is still uncommon. Therefore we present one case of replantation of the fingertip of the small finger in 12-months-old patient. Methods: We experienced a 12-months-old male amputation of small finger. It had been amputated completely at the level of Zone I by Yamano classification. Replantation was performed using the arteryonly technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration. Venous drainage was provided by an external bleeding method with partial nail excision and repaired margin for approximately 7 days. Results: We were performed replantation in infant with only-arterial anastomosis successfully, result in good recovery of aesthetic and functional outcome. Conclusion: In conclusion, although fingertip injury was difficult to replantation in infant and child, we must try it. Because of its functional and cosmetic advantage.

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