• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.111-117
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• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.66-73
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• 2008

Purpose: To report the clinical results of tibio-talo-calcaneal arthrodesis fixed with multiple cannulated screws for the cases of painful ankle and hindfoot arthropathy regardless of any deformity or instability. Materials and Methods: A retrospective analysis was performed upon 10 patients that underwent tibio-talo-calcaneal arthrodesis from October 1999 to May 2006. There were 4 males and 6 females, with an average age of 63 years (43-70). The etioloty of arthrodesis included 5 osteoarthritis, 2 Charcot joints, 1 rheumatoid arthritis, 1 Tbc arthritis and 1 residual poliomyelitis. Chief complaints were pain in 9 cases and instability in 1 case. Three patients had combined severe varus deformity. Tibio-talo-calcaneal arthrodesis using multiple cannulated screws was performed by transfibular approach for all cases and short leg cast was applied for 12 weeks postoperatively. Results: The average follow-up period was 16.5 months (12-26 months). VAS pain score was average 8.2 (7-10) and modified AOFAS score was average 25 (8-40, total 86) preoperatively. At final follow-up, VAS score was average 1.0 (0-3) and AOFAS score improved to average 66 (58-75). There were 4 complications: 2 nonunion, 1 tibia stress fracture and 1 malunion. Seven of 8 patients were satisfied with the results at final follow-up. Conclusion: Fixation with multiple cannulated screws for tibio-talo-calcaneal arthrodesis through transfibular approach is a recommendable surgical option.

• Atmosphere
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• v.21 no.4
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• pp.391-404
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• 2011

This study investigates the impact of cumulus parameterization scheme (CPS) with different horizontal grid sizes on the simulation of the local heavy rainfall case over the Korean Peninsula. The Weather Research and Forecasting (WRF)-based real-time forecast system of the Joint Center for High-impact Weather and Climate Research (JHWC) is used. Three CPSs are used for sensitivity experiments: the BMJ (Betts-Miller-Janjic), GD (Grell-Devenyi ensemble), and KF (Kain-Fritsch) CPSs. The heavy rainfall case selected in this study is characterized by low-level jet and low-level transport of warm and moist air. In 27-km simulations (DM1), simulated precipitation is overestimated in the experiment with BMJ scheme, and it is underestimated with GD scheme. The experiment with KF scheme shows well-developed precipitation cells in the southern and the central region of the Korean Peninsula, which are similar to the observations. All schemes show wet bias and cold bias in the lower troposphere. The simulated rainfall in 27-km horizontal resolution has influence on rainfall forecast in 9-km horizontal resolution, so the statements on 27-km horizontal resolution can be applied to 9-km horizontal resolution. In the sensitivity experiments of CPS for DM3 (3-km resolution), the experiment with BMJ scheme shows better heavy rainfall forecast than the other experiments. The experiments with CPS in 3-km horizontal resolution improve rainfall forecasts compared to the experiments without CPS, especially in rainfall distribution. The experiments with CPS show lower LCL(Lifted Condensation Level) than those without CPS at the maximum rainfall point, and weaker vertical velocity is simulated in the experiments with CPS compared to the experiments without CPS. It means that CPS suppresses convective instability and influences mainly convective rainfall. Consequently, heavy rainfall simulation with BMJ CPS is better than the other CPSs, and even in 3-km horizontal resolution, CPS should be applied to control convective instability. This conclusion can be generalized by conducting more experiments for a variety of cases over the Korean Peninsula.

• Journal of Korean Neurosurgical Society
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• v.55 no.5
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• pp.255-260
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• 2014

Objective : The purpose of this study was to compare the radiological and neurological outcomes between two atlantoaxial fusion method for atlantoaxial stabilization; C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) versus C1-2 transarticular screws (TAS). Methods : Forty-one patients in whom atlantoaxial instability was treated with atlantoaxial fixation by SRC group (27 patients, from March 2005 to May 2011) or TAS group (14 patients, from May 2000 to December 2005) were retrospectively reviewed. Numeric rating scale (NRS) for pain assessment, Oswestry disability index (ODI), and Frankel grade were also checked for neurological outcome. In radiologic outcome assessment, proper screw position and fusion rate were checked. Perioperative parameters such as blood loss during operation, operation time, and radiation exposure time were also reviewed. Results : The improvement of NRS and ODI were not different between both groups significantly. Good to excellent response in Frankel grade is shown similarly in both groups. Proper screw position and fusion rate were also observed similarly between two groups. Total bleeding amount during operation is lesser in SRC group than TAS group, but not significantly (p=0.06). Operation time and X-ray exposure time were shorter in SRC group than in TAS group (all p<0.001). Conclusion : Both TAS and SRC could be selected as safe and effective treatment options for C1-2 instability. But the perioperative result, which is technical demanding and X-ray exposure might be expected better in SRC group compared to TAS group.

• Journal of Korean Academy of Nursing
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• v.18 no.1
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• pp.34-43
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• 1988

The present study has been undertaken to assess the electrical activity of right tibialis anterior, right gastrocnemius, right rectus femoris, right biceps femoris and right paralumbarvertebral muscles quantitatively by EMC while standing erect on the height of 0cm, 3cm, 5cm and 7cm heels. The inclinations of the heels were 0, 6, 11, 17 degrees, respectively. Foully young women ranging from 18 to 24 of age were examined. Electrical activity of various muscles while standing erect on the height of various heels were compared with that of 0cm heel. The results obtained were as follows : 1. Electrical activity of the tibialis anterior increased significantly as the height of heels became higher ; which was thought to be due to the effort to counteract the instability standing with high heels. 2. There was a significant increase in electrical activity of the gastrocnemius as the height of heels increased. It might be due to compensatory activity against shifting of the center of gravity forward. 3. There was a significant increase .in electrical activity of the rectus femoris and biceps femoris at the height of 3cm, 5cm and 7cm heels ; which seemed to be due to the effort to stabilize the knee joint. 4. Electrical activity of the paralumbarvertebral muscles increased significantly at the height of 5cm and 7cm heels ; which was considered to be due to the effort to prevent forward imbalance. From These results, it may be concluded that electrical activities of various postural muscles increase significantly while standing erect on the height of 3cm, 5cm and 7cm heels to counteract an instability of their posture and compensate the forward shifting tendency of the center of gravity.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.203-209
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• 2008

Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months ($6{\sim}24$ months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months ($6{\sim}36$ months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Brostrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1997.05a
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• pp.164-166
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• 1997

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex(LOLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalis in image interpretation related to evaluation of the LOLC. MR Arthrogram of 56 shoulders in 41 asymptomatic young, active volunteers were prospectively reviewed to evaluate the labral shapes. capsular insertions and images which may mimic the lesions of glenohumoral instability. The anterior and posterior parts of the labra. respectively. varied in shape: triangular$(72\%,\; 36\%)$. round $(13\%,\; 35\%)$. cleaved$(8\%,\; 1\%)$. notched$(2\%,\; 0\%)$. flat$(5\%,\; 24\%)$ and absent$(0\%,\; 4\%)$. The anterior and posterior capsular insertions. respectively. varied in sites: Mosely and Oevergaard type I$(82\%,\;62\%)$, type II$(13\%,\; 3\%)$ and type III $(5\%,\; 2\%)$. A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum$(29\%)$ and middle glenohumoral ligament in proximity to anterior labrum $(5\%)$ simulated a labral tear. Joint fluid interposed in the central. superior portion of the sublabral sulci$(25\%)$ simulated a SLAP lesion. Synovial fold$(38\%)$ in axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral capsular - ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.

• Structural Engineering and Mechanics
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• v.61 no.4
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• pp.497-510
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• 2017

A framed structure may be composed of two sub-structures, which are linked by a hinged joint. One sub-structure is the primary system and the other is the secondary system. The primary system, which is subjected to the periodic external load, can give rise to an auto-parametric resonance of the second system. Considering the geometric-stiffness effect produced by the axially internal force, the element equation of motion is derived by the extended Hamilton's principle. The element equations are then assembled into the global non-homogeneous Mathieu-Hill equations. The Newmark's method is introduced to solve the time-history responses of the non-homogeneous Mathieu-Hill equations. The energy-growth exponent/coefficient (EGE/EGC) and a finite-time Lyapunov exponent (FLE) are proposed for determining the auto-parametric instability boundaries of the structural system. The auto-parametric instabilities are numerically analyzed for the two frames. The influence of relative stiffness between the primary and secondary systems on the auto-parametric instability boundaries is investigated. A phenomenon of the "auto-parametric internal resonance" (the auto-parametric resonance of the second system induced by a normal resonance of the primary system) is predicted through the two numerical examples. The risk of auto-parametric internal resonance is emphasized. An auto-parametric resonance experiment of a ${\Gamma}$-shaped frame is conducted for verifying the theoretical predictions and present calculation method.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.63-68
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• 2009

Purpose : The purpose of this study was to investigate the effect of tensor fasciae latae length on the rotation of pelvis during one leg stance. Methods : 41 healthy adults participated in this study. The movement of the pelvis and trunk was measured using 3-dimensional motion analyzer, during one leg stance. The movement of the pelvis and trunk was collected lateral shift, rotation, side bending, and flexion-extension. Tensor fasciae latae length of subjects was measured in sidelying positon with neutral position of hip joint and flexion $90^{\circ}$ of knee. Also, the range of motion of hip exteral and interal rotaion were measured in prone position wih lexion $90^{\circ}$ of knee. The subjects were separated 2 groups that more pelvic rotation group(n=15) and less pelvic rotation group(n=15) according to the degree of pelvic rotation. Results : The more pelvic rotation group was showed significantly higher in the ROM of hip external rotation than less pelvic rotation group(p<0.05). The difference of tensor fasciae latae length not showed significant difference between groups. During one leg stance, The movement of the shifting and flexion-extension of trunk and pelvis were not showed significant difference. But the side bending and the rotation of pelvis and trunk showed significant difference between groups. Conclusion : The difference of tensor fasciae latae length not showed significantly in more pelvic rotation group and less pelvic rotation group. But, this study suggests that the pelvis instability brings the instability of the trunk during one leg stance.

• Journal of the Korea Convergence Society
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• v.12 no.10
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• pp.305-310
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• 2021

Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joint with an inflammatory condition in the adjacent soft tissues. Due to the instability of the cervical spine, careful airway management is crucial to prevent potential cervical spinal cord injury following airway manipulation. We successfully secured the patient airway using a supraglottic airway device (I-gel) in a patient who had previously diagnosed with Grisel's syndrome. The operation was successfully completed, and the patient recovered without any neurological complications. I-gel can be a good option for airway management during general anesthesia in a patient diagnosed with Grisel's syndrome.