• The Journal of the Korean bone and joint tumor society
• /
• v.9 no.2
• /
• pp.131-138
• /
• 2003

Purpose: We analyzed our malignant peripheral nerve sheath tumor (MPNST) cases to find out their oncologic results following by each treatment modalities. Materials and Methods: Thirty four patients with MPNST were registered in Korea Cancer Center Hospital from Feb. 1986 to Nov. 1996. Seventeen cases were male and 17, female. Average age was 41 years (range 18 to 74). Location of the tumor was as follows; 17 in lower extremity, 11 upper extremity, 4 trunk, and 2 retroperitoneum. Following the AJC classification, stage IA were 2 cases, stage IIA 2, stage IIB 6, stage III 16 and stage IV 8. Twenty six patients took operations and adjuvant chemotherapy and/or radiation therapy, 3 operation only and 3 adjuvant chemotherapy or radiation therapy. Average follow up period was 33.5 months (5.6 to 146.1). Kaplan-Meiyer method was done for survival curve, and log rank test for comparison analysis. Results: Fourteen cases were continuous disease free, 2 no evidence of disease, 2 alive with disease and 14 dead of disease states at final follow up. Actual 5-year and 10-year survival rates were 53.5%, 35.7%. Local recurrence rate after operation was 24.1%. 5-year survival rates of stage I/II/III were 100/85.7/55.9% and 2-year survival rate of stage IV was 14.3% (p=0.04). In 21 cases operated with stage II-III, wide margin (15cases) had 76.0% 5-year survival rate, and marginal or intralesional marigin (6cases) had 40.0%. The actual 5-year survival rate of the group which were done 4 or more cycles chemotherapy (8cases) was 71.4% and the actual 3-year survival rate less than 4cycles chemotherapy (6cases) was 83.3% (p=0.96). In 19 cases operated with stage II-III and which had no radiotherapy, marginal or intralesional margin (5cases) had 3 cases of local recurrences (60.0%), though wide margin (14cases) had 4 cases recurrences (28.6%). There was no local recurrence in 8cases which had pre-or post-operative radiotherapy. Conclusions: Surgical margin is an important factor in local recurrence. Resection margin has a tendency to influence the survival despite insufficient statistical significance. Conventional chemotherapy has no defnite statistical sigficance in the effect on local control and survival. Preoperative and postoperative radiotherapy has some positive effect on local control.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.3 no.1
• /
• pp.87-91
• /
• 2004

Purpose: The purpose of this study is to investigate the incidence and patterns of fractures occurred in Inline skating accident. Materials and Method: We evaluated 20 patients, 20 cases(from september 2002 to August 2003) with fractures occurred during Inline skating. The incidence, sex, age, fracture site, associated injuries, causes of Inline skating injuries were analysed. The cases were male in 18(90$\%$), and female in 2(10$\%$). The most common distribution of age was in twenties and thirties. Result: The patients(12cases 60$\%$) with upper extremity fracture were more common than patients(8cases 40$\%$) with lower extremity fracture. Patients who had fracture in ankle were 35$\%$(7cases), forearm 20$\%$(4cases), wrist 20$\%$(4cases), elbow 15$\%$(3cases), thigh 5$\%$(1cases). According to the The Lauge-Hansen classification in ankle fractures there were four patients of supination-external rotation type, two patients of supination-abduction type, and 1 patient of pronation-external rotation type. In forearm and hand fractures, there were three distal radius fractures, one radio-ulnar shaft fracture, 2 scaphoid fractures, and two meta-carpal fractures. In elbow fractures, there were two supracondyle fractures, and one lateral condyle fracture. There were three epiphyseal plate injuries (Salt-Harris type II) in children, and all of them were treated by conservative method. Six fractures were intra-articular fractures. The most common associated injury was contusion(8cases 42.1$\%$). The number of patients who only rode Inline skating less than 3months(8cases 40$\%$) was the greatest. The number of non-contact injury(14cases, 70$\%$) in Inline skating was more than contact(6cases,30$\%$) injury. 11cases(55$\%$) had operative treatment, and 9cases(45$\%$) had conservative treatment, and there was not any complication. The more detailed study is required since the materials were only limited to fracture patients, and the follow up period was short. Conclusion: The most common age for fracture in Inline skating was in twenties, and thirties, and ankle was the most common fracture site.

• Journal of agricultural medicine and community health
• /
• v.26 no.1
• /
• pp.65-79
• /
• 2001

Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

• The Journal of Korean Academy of Sensory Integration
• /
• v.10 no.2
• /
• pp.11-22
• /
• 2012

Objective : This research investigated the intervention effects, protocol of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Methods : For the key words of a database search, "Cerebral Palsy", "Hemiplegia", "Constraint Induced Movement Therapy", "modified Constraint Induced Movement Therapy" were used. We examined papers published in journals from January 2001, when the modified Constraint Induced Movement Therapy was first suggested, to May 2011, using PubMed, Medline. Ovid. Results : A total of 10 papers were analyzed and results of modified Constraint Induced Movement Therapy were an effective therapeutic method to improve motor function, quality of movement and that they also increased the frequency of functional use of the affected hands of hemiplegic cerebral palsy. Conclusion : This paper conducted a systematic review of the research literature reporting on the effects of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Analysis of the fewer number of papers, there was limitation that we consider studies at all levels of evidence. However the restraint methods should be decided according to the characteristics of the individually and apply a variety of therapeutic activities, there is positive support for the use of modified constraint-induced movement therapy to improve the recovery of the paretic upper extremity with cerebral palsy.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.11
• /
• pp.5229-5237
• /
• 2012

Occupational therapist is required for patient-centered approaches to actively seek the perspectives of patients and their families in clinical settings. The purpose of this study was to investigate the current trends and to suggest future-oriented view of examination and assessment used by neurological occupational therapist in clinical settings. Sixty-six occupational therapists who work in persons with neurological disorders participated in this study. The survey was measured from Seoul and GyeongGi by means of E-mail about commonly used assessment tools and selecting considerations. The participants were 66 neurological occupational therapists. The number of patients by one day was from 10 to 14 persons, and the length of time for initial evaluation was 20-40 minutes per one patient, and reexamination periods was every 1 month or as functional changes were detected. The using tool was not limited only neurological tools, and choice consideration was the reliability and validity of clinical measures. The most frequently used tools for adults were: JHFT for motor function in upper extremity, MMSE-K for cognitive perceptual assessment, MBI for daily activity assessment, and COPM for occupational performance. The most frequently used tools for child were: MVPT for cognitive perceptual assessment and Wee-FIM for daily activity assessment. The results of this study suggest that it is necessary to integrate and associate patient-report, care-giver report, and results of performance-based assessment for estimating plan of care more quality.

• The Journal of Korean society of community based occupational therapy
• /
• v.4 no.1
• /
• pp.23-31
• /
• 2014

Objective : The objectives of this study were to compare the variables from Fitmeter accelerometer with them from CMS-70P(Zebris Medizintechnik Gmbh, Germany) and to suggest the availability the accelerometer in the field of occupational therapy. Methods : Twenty participants performed calling, drinking water, washing face and spooning and we measured Sum of Single Vector Magnitude(SSVM) and range of motion(ROM) on the wrist and elbow joints. Results :With respect to the wrist and elbow joints, SSVM and ROM differed significantly according to the task(calling, drinking water, washing face and spooning)(p<.001; p<.001; p<.001; p<.001). As for the wrist joint, SSVM and ROM did not show the significant correlation(p>.05) but as for the elbow joint, SSVM and ROM did show the significant correlation according to the task(p<.01; p<.001; p<.01; p<.05). With regard to the SVM-difference of wrist and elbow joints, calling and washing showed the significant difference (p<.001; p<.05) but drinking and spooning did not show the significant difference(p>.05; p>.05). Conclusion : We suggest that Fitmeter accelerometer would be use to record the kinematic variables during performance of ADL and it can compensate the function of CMS-70P as for the elbow joint than the wrist joint.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.3
• /
• pp.596-603
• /
• 1998

Lambert Eaton myasthenic syndrome(LEMS) is a paraneoplastic syndrome caused by defects in the secretion of acetylcholine from the presynaptic membrane of nerve terminals and is strongly associated with small cell lung carcinoma. The pathogenesis of LEMS is the destruction of voltage gated calcium channels by an autoimmune process resulting in clinical manifestations consisting of lower extremity weakness. decreased deep tendon reflexes and autonomic dysfunctions. The diagnosis can be confirmed by the characteristic clinical features and repetitive nerve stimulation. The neurological symptoms and signs of LEMS may manifest themselves months before the clinical manifestation of the underlying malignancy. Therefore early diagnosis and treatment of the primary malignancy may become possible through the diagnosis of this rare paraneoplastic syndrome. We report a case of a patient diagnosed with LEMS who upon further evaluation for an underlying malignancy was found to have a 0.2 cm sized nodular and infiltrative mass lesion at the bifurcation of the left apicoposterior segmental and anterior segmental bronchi by bronchoscopy. Although repeated bronchoscopic biopsies of the lesion was not able to disclose malignancy, under strong clinical suspicion left upper lobectomy was performed and subsequently the diagnosis of small cell carcinoma of the lung was confirmed. Muscle weakness began to improve starting from a week after the surgery, then reached a plateau 2 weeks later. Muscle weakness improved further after the trial of anticancer chemotherapy.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.9 no.1
• /
• pp.58-64
• /
• 2010

Purpose: Bicycle riding is an increasingly popular sports and leisure activity in Korea. The aim of this study was to identify injury patterns of admitted patients who were injured from bicycle riding. Materials and Methods: This study examined 71 patients from Jan. 2008 to May 2009. There were 54 male and 17 female patients. We investigated the injured body parts, mechanisms of injury, location of injury, types of bicycles, purpose of bicycle riding, any concomitant luggage or passenger on rear seat, injury seasons and the helmet use. We analyzed the data using Injury Severity Score(ISS). Results: There were 11 cases of ISS 1, 41 cases of ISS 4, 2 cases of ISS 5, 13 cases of ISS 9, one case of ISS 13, two cases of ISS 16 and one case of ISS 29 among the 71 patients. 36 patients(50.7%) underwent surgery for upper and lower extremity injuries, two patients for vertebral body fractures, 8 patients for facial bone injuries and one patient for abdominal organ injury. There were 10 head injuries among whom three patients received treatment in ICU(4.2%). Conclusion: Bicycle riding can cause severe injuries with subsequent admission and major surgeries. Several measures including constructing more bicycle road, public campaign and wearing protective gears should be instituted.

• Journal of Biomedical Engineering Research
• /
• v.38 no.2
• /
• pp.74-81
• /
• 2017

The purpose of this study was to investigate the EMG characteristics of driver's upper extremity and driving performance for manipulating brake and accelerator pedal by using left and right hand control devices during simulated driving. The people with disabilities in the lower limb have problems in operation of the motor vehicle because of functional loss for manipulating brake and accelerator pedal. Therefore, if hand control device is used for adaptive driving controls in people with lower limb impairments, the disabled people can improve their quality of life by driving a motor vehicle. Six subjects were participated in this study to evaluate driving performance and muscle activities for operating brake and accelerator pedal by using two different hand controls (steering column mounted hand control and floor mounted hand control) in driving simulator. We measured EMG activities of six muscles (posterior deltoid, middle deltoid, triceps, biceps, flexor carpi radialis, and extensor carpi radialis) during pushing and pulling movement with different hand controls for acceleration and braking. STISim Drive 3 software was used for the performance test of different hand control devices in straight lane course for time to reach target speed and brake reaction time. While pulling the hand control lever toward the driver, normalized EMG activities of middle deltoid, triceps and flexor carpi radialis in subjects with disabilities were significantly increased (p < 0.05) compared to the normal subjects. It was also found that muscle responses of posterior deltoid were significantly increased (p < 0.05) when using the right hand control than left hand control. While pushing the hand control lever forward away from the driver, normalized EMG activities of posterior deltoid, middle deltoid and extensor carpi radialis in subjects with disability were significantly increased (p < 0.05) compared to the normal subjects. It was shown that muscle responses of middle deltoid, biceps and extensor carpi radialis were significantly increased when using the right hand control than left hand control. Brake reaction time and time to reach target speed in subjects with disability was increased by 12% and 11.3% on average compared to normal subjects. The subjects with physical disabilities showed a tendency to relatively slow acceleration at the straight lane course.

• The Journal of Korean Academy of Sensory Integration
• /
• v.14 no.1
• /
• pp.41-49
• /
• 2016

Objective : The purpose of this study was to investigate how undressing skill training based on Neuro-developmental treatment (NDT) approach effected on the midline orientation and protective reaction of children with cerebral palsy (CP). Methods : Two participants of this study were 3 years 5 months old boy and 4 years 5 months old girl, living in B city. They were medically diagnosed as cerebral palsy. Research design used in this study is AB design for a single subject research. There was no intervention on the baseline A phases, and functional activity based NDT was used undressing skill training during the B phases. Midline orientation was tested by Stepping subtest in MAP. Protective reaction was measured by Protective reaction subtest in QUEST. Results : In comparison with the baseline (A), midline orientation was improved above 2 standard deviations at intervention phase (B). and protective reaction was improved above averages in both hands. Conclusion : The study showed undressing skill training based on NDT approach that were effective for midline orientation of children with CP. Undressing skill training was one of the major functional activities. Thus, large studies are required to ensure the training effects.