• Title/Summary/Keyword: Joint Instability

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Rare Disease Entity of Dorsolateral Foot Pain: Lateral Branch of Deep Peroneal Nerve Entrapment Syndrome (외측 심부 비골신경 포착 증후군의 증례 보고)

  • Na, Yoonju;Yeo, Seung Mi;Park, Jin Ho;Hwang, Ji Hye
    • Clinical Pain
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    • v.20 no.2
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    • pp.122-126
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    • 2021
  • When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

Statistical Study of the Ferguson's Angle, Lumbar Gravity Line and Lumbar Lordotic Angle in HIVD Patients. (요추간판탈출증 환자의 요천각, 요추중력중심선 및 요추전만각의 통계적 관찰)

  • Koh, Dong-Hyun;Hong, Soon-Sung;Lee, Jin-Ho;Jung, Sung-Yub;Shin, Joon-Shik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.17-32
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    • 2007
  • Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

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Clinical results of arthroscopic meniscal repair according to joint stability (반월상 연골의 관절경적 봉합시 관절안정성에 따른 결과)

  • Kyung Hee-Soo;Ihn Joo-Chul;Baek Seung-Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.37-42
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    • 2002
  • Purpose : The purpose of this study was to evaluate the results of arthroscopic meniscal repair according to joint stability. Materials and Methods : Twenty cases were reviewed, which had underwent arthroscopic meniscal repair. The mean age was 32.3 years old. The mean follow-up period was 59.7 months. Menisci that had underwent complete repair of associated ligament injuries (8cases, Sa) and menisci that had no associated ligament injury (9 cases, Sb) were classified as stable group (S), and the others (3 cases) as unstable group (U). Also stable group was divided into acute and chronic group. The result was evaluated with Lysholm score and IKDC method. The statistical analysis was done using Wilcoxon rank sum test and Fisher's exact test (p<0.05). Results : Group Sa had $87.5\%$ satisfactory and Lysholm score was 90.9. Group U had $66.7\%$ satisfactory, and Lysholm score was 77.7. Group Sb had $89.9\%$, satisfactory and Lysholm store was 91.4. In acute group $91.7\%$ was satisfactory, Lysholm score 92.5, in chronic group $80\%$ was satisfactory, Lysholm score 88.6. Conclusion : Joint stability was important factor for the outcome of meniscal repairs. So, it is desirable to repair meniscus injury early and the repair of associated ligament injuries should be performed together.

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A correlation between comprehensive neck dissection and increased uptake around the sternoclavicular joint on post-operative 18F-FDG PET/CT (경부절제술과 술후 시행된 PET/CT상의 흉쇄관절 섭취 증가의 상관관계 분석)

  • Oh, So Won;Lee, Doh Young;Kim, Bo Hae;Kim, Kwang Hyun;Kim, Yu Kyeong;Jung, Young Ho
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.21-27
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    • 2018
  • Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

Ligament Reconstruction for Subluxation of the Trapeziometacarpal Joint of the Thumb (무지의 대능형중수간 관절의 아탈구에 대한 인대 재건술)

  • Park Jin Soo;Chung Yung Khee;Yoo Jung Han;Na Kyong Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.134-140
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    • 2004
  • Purpose: The reconstructive surgery of the anterior oblique ligament has been recommended for patients with unstable carpometacarpal joints. We reviewed retrospectively the functional results of two patients who had been treated by6 using a harvested portion of the tendon of flexor carpi radialis as a substitute for the anterior oblique ligament. Materials and Methods: In two patients with a instability of the trapeziometacarpal joint because of a rupture of the anterior oblique ligament, reconstruction was carried out using a slip of the tendon of flexor carpi radialis and the patients had been followed up for two years. Results: The results after a follow-up of two years that both of them had significant relief from pain and symptoms. The mean grip strength recovered to 90$\%$ of the controlateral side. patients felt that they had subjective improvement and would have undergone the operation again. Conclusion: Increased awareness of this lesion can lead to an early and clear diagnosis, so that the patient may be advised adequately.

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Effect of Accelerated Rehabilitation with Anti-Gravity Treadmill Exercise on Ankle Joint Function After Surgery of Modified Brostrom Operation in Chronic Ankle Instability Patients (변형된 Brostrom 수술 후, Anti-gravity treadmill 가속재활운동이 만성발목불안정성 환자의 발목기능 회복에 미치는 영향)

  • Choi, In-Hyuk;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.228-235
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    • 2019
  • The purpose of this study was to investigate the effect of 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise on VAS, ROM, isokinetic myofunction, and dynamic stability after surgery of modified brostrom operation in chronic ankle instability patients. The subjects of this study were 12 chronic ankle instability patients who underwent modified Brostrom operation(MBO) by the same doctor. 6 weeks' accelerated rehabilitation program is scheduled to perform for 60min, everyday, and also anti-gravity program performed for 15~30min, everyday. The visual analog scale(VSA) and significantly decreased(p<.001) and ROM in all of dorsal flexion, plantar flexion, inversion and eversion significantly increased(p<.05) after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise. Both inversion and eversion peak torque at $60^{\circ}/sec$(p<.001, p<.01) and at $180^{\circ}/sec$(p<.001) significantly increased after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise respectively. In muscle defect, although inversion(p<.01) and eversion(p<.001) at $60^{\circ}/sec$ and inversion(p<.01) at $180^{\circ}/sec$ significantly decreased, eversion at $180^{\circ}/sec$ tended to decrease but did not change significantly after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise. The dynamic stability significantly increased after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise(p<.001). These results suggest that 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise has positive effect of VAS, ROM, isokinetic myofunction, and dynamic stability after surgery of modified brostrom operation in chronic ankle instability patients. Therefore, we consider that the accelerated rehabilitation with anti-gravity treadmill exercise, which is safely and fast method, has effect on more faster recovery of ankle stability, play ground and normal daily activities.

Case Study of the Stability of a Large Cut-Slope at a Tunnel Portal (터널 입구부 대절토 사면 안정성 사례 연구)

  • Park, Dong Soon;Bae, Jong-Soem
    • The Journal of Engineering Geology
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    • v.25 no.1
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    • pp.115-129
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    • 2015
  • The cut-slope of a large-sectional tunnel portal is recognized as a potential area of weakness due to unstable stress distribution and possible permanent displacement. This paper presents a case study of a slope failure and remediation for a large-scale cut-slope at a tunnel portal. Extensive rock-slope brittle failure occurred along discontinuities in the rock mass after 46 mm of rainfall, which caused instability of the upper part of the cut-slope. Based on a geological survey and face mapping, the reason for failure is believed to be the presence of thin clay fill in discontinuities in the weathered rock mass and consequent saturationinduced joint weakening. The granite-gneiss rock mass has a high content of alkali-feldspar, indicating a vulnerability to weathering. Immediately before the slope failure, a sharp increase in displacement rate was indicated by settlement-time histories, and this observation can contribute to the safety management criteria for slope stability. In this case study, emergency remediation was performed to prevent further hazard and to facilitate reconstruction, and counterweight fill and concrete filling of voids were successfully applied. For ultimate remediation, the grid anchor-blocks were used for slope stabilization, and additional rock bolts and grouting were applied inside the tunnel. Limit-equilibrium slope stability analysis and analyses of strereographic projections confirmed the instability of the original slope and the effectiveness of reinforcing methods. After the application of reinforcing measures, instrumental monitoring indicated that the slope and the tunnel remained stable. This case study is expected to serve as a valuable reference for similar engineering cases of large-sectional slope stability.

The study about the cause of the Korean professional pitchers' injury and its classification (한국 프로야구투수들의 부상 발생원인 및 분류에 관한 연구)

  • Nam Joung-Chul;Kim Sang-Su;Lee Dong-Ho
    • The Journal of Korean Physical Therapy
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    • v.14 no.4
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    • pp.172-182
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    • 2002
  • Objectives: We did research in the cause of the Pitchers' injury and their recovery process to make a detailed injury list for the purpose of finding the cause of the Korean professional pitchers' injury and its classification. We drew the conclusion through the results as following. Methods: We posed a question to the 80 pitchers playing in the first team of the eight Korean professional baseball team and analyzed the 62 pieces of question paper except the paper having a mistake. We used SAS/PC statistical package in analyzing the data. Results: In the frequency of the pitchers' shoulder injury in the last three years, the injured of all the players were 61.3$\%$ and the injury free players were 28.7$\%$. The cause of the injury was 45.2$\%$ wrong pitching motion, which was the highest value. For the shape of a pain when injured, the reverberation ache feeling when he is hit in the weight commanded an absolute majority as 19.4$\%$. Those who had muscular pain were 17.7$\%$, which was felt mostly at the pitching motion. The most trouble name of the injured shoulder was bicepstendinitis as 16.1$\%$ while the injury of shoulder joint was the lowest as 1.6$\%$. As the most widely used treatment, 25.8 percent of all the players had taken an electronical thraphy after injury. 14.5 percent of the players who had an injury to the shoulder told that they have an operation and 85 percent of them didn't. As a sort of the operation, a repairing of labrum was 44.4 percent, which is the highest value and the 77.8 percent pitchers are performing a normal pitching through rehabilitation after the operation and 22.2 percent of them are undergoing rehabilitation training. Conclusion: The research have shown that the main cause of the injury, concerning the Korean professional pitchers throwing lots of ball in both matches and practices, is overuse syndrome, bad mechanism, muscle weakness and instability of balance. I think that the role of trainer, physical therapy, and team physician taking charge of the players' injury must learn physical test method by heart exactly to check up the state of the injury definitely at the initial phase. Moreover, when the cause of the injury part after a close examination is discovered, the scientific and good surgery is essential to the rehabilitation success and making a classification of shoulder instability is useful to make a operation plan as well as the players' rehabilitation, treatment.

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Clinical Application of Autologous Adipose Tissue Derived Mesenchymal Stem Cells in Five Dogs with Stifle Joint Osteoarthrosis (무릎 골관절증을 보이는 개에서 자가지방유래 중배엽성 줄기세포 치료 다섯 증례)

  • Yoon, Hun-Young;Kang, Dong Jun;Lee, Soo-Han;Jeong, Soon-Wuk;Chung, Byung-Hyun
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.253-257
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    • 2014
  • Five dogs presented with a history of pelvic limb lameness. On physical examination of the stifle joints, five dogs had pain, lameness, patellar luxation, or ligamentous instability. Craniocaudal and mediolateral radiographic projections revealed osteophytes or subchondral cystic lesions on the stifle joints. Based on a previously described Osteoarthrosis (OA) scoring technique, five dogs showed high OA scores. Combination of surgery and implantation of autologous adipose tissue derived mesenchymal stem cells (aAT-MSCs) or percutaneous injection of aAT-MSCs was determined with informed consent. $1{\times}10^6$ aAT-MSCs suspended in PBS was injected in the stifle joints. The follow-ups were completed 12 months after surgery. The follow-up information was based on physical examination by veterinarians. The lameness, pain on manipulation, and OA scores improved six or 12 months after implantation of aAT-MSCs. There was a radiographic evidence of decreased osteophytes and subchondral cystic lesions. These results suggest that implantation of aAT-MSCs can be considered an option for management of cases of OA in the stifle joints.

A study on the micromotion between the dental implant and superstructure (임플란트와 상부구조물 사이의 micromotion에 관한 연구)

  • Kim, Ji-Hye;Song, Kwang-Yeob;Jang, Tae-Yeob;Park, Ju-Mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.1
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    • pp.17-25
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    • 2003
  • Treatment with implants of single tooth missing cases is both functional and esthetic. Although the success rate of single-tooth implant treatments is increasing, sometimes it makes some problems. Problems with single-tooth implant treatments include soft tissue complications, abutment screw fracture, and most commonly, abutment screw loosening, and these involve the instability of the dental implant-superstructure interface. This study investigated and compared dental implant screw joint micromotion of various implant system with external connection or internal connection when tested under simulated clinical loading, Six groups (N=5) were assessed: (1) Branemark AurAdapt (Nobel Biocare, Goteborg, Sweden), (2) Branemark EsthetiCone (Nobel Biocare, Goteborg, Sweden), (3) Neoplant Conical (Neobiotec, Korea), (4) Neoplant UCLA (Neobiotec, Korea), (5) Neoplant 5.5mm Solid (Neobiotec, Korea), and (6) ITI SynOcta (Institute Straumann, Waldenburg, Switzerland). Six identical frameworks were fabricated. Abutment screws were tightened to 32-35 Ncm and occlusal screw were tightened to 15-20 Ncm with an electronic torque controller. A mechanical testing machine applied a compressive cyclic load of 20kg at 10Hz to a contact point on each implant crown. Strain gauge recorded the micromotion of the screw joint interface once a second. Data were selected at 1, 500, 5,000, 10,000, 20,000, 30,000, 40,000 and 50,000 cycle and 2-way ANOVA test was performed to assess the statistical significance. The results of this study were as follows; The micromotion of the implant-superstructure in the interface increased gradually through 50,000 cycles for all implant systems. In the case of the micromotion according to cycle increase, Neoplant Conical and Neoplant UCLA system exhibited significantly increasing micromotion at the implant-superstructure interface (p<0.05), but others not significant. In the case of the micromotion of the implant-superstructure interface at 50,000 cycle, the largest micromotion were recorded in the Branemark EsthetiCone, sequently followed by Neoplant Conical, Neoplant UCLA, Branemark AurAdapt, ITI SynOcta and Neplant Solid. Internal connection system showed smaller micromotion than external connection system. Specially, Neoplant Solid with internal connection system exhibited significantly smaller micromotion than other implant systems except ITI SynOcta with same internal connection system (p<0.05). In the case of external connection, Branemark EsthetiCone and Neoplant Conical system with abutment showed significantly larger micromotion than Branemark AurAdapt without abutment (p<0.05).