• Title/Summary/Keyword: Leg pain

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Current Strategy in Endovascular Management for Below-the-Knee Arterial Lesions (무릎 밑 동맥의 혈관 내 치료의 최신 지견)

  • Kyosoo Hwang;Sang Woo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.541-550
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    • 2021
  • The below-the-knee arterial tree is the thinnest of all the leg vessels and is an important path for blood flow to the foot. Hence, lesions including stenosis, especially obstruction, may lead to critical limb ischemia which represents the most severe clinical manifestation of peripheral arterial disease. It is characterized by the presence of ischemic rest pain, ischemic lesions, or gangrene attributable to the objectively proven arterial occlusive disease. Typically, the atherosclerotic disease process involving the below-the-knee arterial tree is diffuse in the majority of patients. The cornerstone of therapy is vascular reconstruction and limb salvage. Revascularization should be attempted whenever technically possible, without delay, in patients presenting critical limb ischemia and when the clinical status is not hopelessly non-ambulatory. Therefore, endovascular treatment can become the gold standard for the full range of patients including below-the-knee, limiting the clinical role of the classically trained surgeons.

Prevalence of Musculoskeletal Symptom in Rural Farmers (농촌지역주민의 근골격계 증상 경험률)

  • Oh, Hae-Ok;Kam, Sin;Han, Chang-Hyun;Hwang, Byung-Deog;Mun, Hyo-Jung;Cha, Byung-Jun;Park, Sang-Yeon
    • Journal of muscle and joint health
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    • v.8 no.1
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    • pp.86-108
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    • 2001
  • This study was performed to examine the annual experience rate of musculoskeletal symptom and its related factors in rural farmers. Six-hundred and sixty one rural farmers were investigated by questionnaire survey through interview from July 1 to July 31 in 2000. The results were as follows; The rural farmers who had experienced musculoskeletal symptom during recent 1 year was 82.7% in male, 92.1% in female. The annual experience rate of musculoskeletal symptom by part of the body in male were turned out as back; 42.3% leg and knee; 36.4%, shoulder; 21.4%, arm and hand; 12.7%, elbow; 7.7%, hip; 6.8% neck; 6.4%, ankle and foot; 6.4% in order. The annual experience rate of musculoskeletal symptom by part of the body in female were turned out as back; 59.4%, leg and knee; 48.5%, shoulder; 20.2%, arm and hand; 13.8%, hip; 10.7%, neck; 6.8%, ankle and foot; 6.3%, elbow; 5.0% in order. The annual experience rate of musculoskeletal symptom, back pain, and pain on leg and knee were significantly higher in female. In male, the experience rate of musculoskeletal symptom was different significantly according to educational level, family size, economic status, status of smoking, duration of farming, type of major agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, family size and economic status were the significant variables. It was higher in male with no or one family living together and low economic status. In female, the experience rate of musculoskeletal symptom was different significantly according to body mass index, perceived health status, type of agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, body mass index, perceived health status, and type of major agricultural affairs were the significant variables. It was higher as female farmer's body mass index was increasing and when female farmer's perceived health status was not healthier, and it was lower when female farmer did livestock farming as major agricultural affair. The experience rate of musculoskeletal symptom was higher in the busy season for farmers and treatment methods for musculoskeletal symptom were physical therapy, medication, herb medical treatment, etc. In conclusion, because most of farmers experience musculoskeletal symptom, continuous systematic study on musculoskeletal symptom of farmers and active effort to prevent and manage musculoskeletal symptom of farmers are necessary.

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Clinical Analysis of Primary Varicose Vein - review of 209 cases - (원발성 하지정맥류의 임상적 고찰 - 209례 보고 -)

  • Lee, Yuen-Jae;Park, Chul;Kim, Jong-Seok;Kim, Han-Yong;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.909-916
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    • 2001
  • Background : Varicose vein is a very common vascular disease and has recently become a matter of concern for thoracic and cardiovascular surgens. Material and Method : We analyzed 209 cases or 269 feet with varicose vein retrospectively, which had been treated in our hospital from April 1999 to December 2000. Result : Male : Female ratio was 1:3(Male : 52 cases, Female : 157 cases), mean age was 42.2$\pm$9.7 years old, mean duration of varicosities was 12.2$\pm$9.7 years, and mean follow up was 14.8$\pm$6.1 months from July 2001. Most common symptom was leg pain(122 cases, 58.4%). Long standing job(44 cases), pregnancy(37 cases), and family history related to varicose vein came to 79.9% as the major predisposing or precipitating factors. Anatomic classifications of main lesion were GSV (greater saphenous vein,126 cases), LSV(lesser saphenous vein,18 cases), and reticular veins and telangiectasias(65 cases). Main treatments were stripping of GSV, stab avulsion, ligation of saphenofemoral junction, sclerotherapy, and conservative treatment. Comparing A group (stripping of GSV) with B group(sclerotherapy of GSV), A group had more complications than B group; however, A group had less recurrences than B group(p 0.05). Comparing C group(stab avulsion of LSV) with D group(sclerotherapy of LSV), there were 2 cases of recurrence in D group; however, there were no statistical differences between the two groups in complication and recurrence(p>0.05). Comparing B group(sclerotherapy of GSV) with E group(sclerotherapy of reticular vein and telangiectasia), there were no differences in complication; however, B group had more recurrences than E group. Post-stripping complications were ankle numbness and tingling(2 cases), ankle pain(2 cases),ankle swelling(2 cases), and wound pain(1 case). Postsclerotherapy complications were thrombophlebitis(1 case) and skin ulcer(1 case). Conclusion: Sclerotherapy for varicose vein involving GSV had more recurrences than stripping for lesions involving GSV. Sclerotherapy for reticular vein and telangiectasia had less recurrences than sclerotherapy for lesion involving GSV. Sclerotherapy is a very convenient method without operation and admission, thus further research is demanded in case of varicose vein involving GSV.

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Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table (일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교)

  • Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.244-253
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    • 2019
  • Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage in Treatment of Lumbar Intervertebral Foraminal Stenosis : Comparative Study of Two Different Types of Cages

  • Cho, Chul-Bum;Ryu, Kyeong-Sik;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.352-357
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    • 2010
  • Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis$^{(R)}$ (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR$^{(R)}$ (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ${\pm}$ 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ${\pm}$ 2.3 ${\rightarrow}$ 2.3 ${\pm}$ 2.2, 6.3 ${\pm}$ 3.2 ${\rightarrow}$1.6 ${\pm}$ 1.6, and 53.7 ${\pm}$ 18.6 ${\rightarrow}$ 28.3 ${\pm}$ 13.1, respectively), which were not different between the two devices groups. In Stabilis$^{(R)}$ group, postoperative immediately increased disc and IVF heights (10.09 ${\pm}$ 4.15 mm ${\rightarrow}$ 14.99 ${\pm}$ 1.73 mm, 13.00 ${\pm}$ 2.44 mm ${\rightarrow}$ 16.28 ${\pm}$ 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ${\pm}$ 1.67 mm, 13.59 ${\pm}$ 2.01 mm, respectively). In SynFix-LR$^{(R)}$ group, immediately increased disc and IVF heights (9.60 ${\pm}$ 2.82 mm ${\rightarrow}$ 15.61 ${\pm}$ 0.62 mm, 14.01 ${\pm}$ 2.53 mm ${\rightarrow}$ 21.27 ${\pm}$ 1.93 mm, respectively) were maintained until the last follow up (13.72 ${\pm}$ 1.21 mm, 17.87 ${\pm}$ 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR$^{(R)}$ group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis$^{(R)}$ group.

A analysis of friction relation between tennis outsole and tennis playing surfaces (테니스화겉창과 테니스 스포츠바닥재간의 마찰관계상관 분석)

  • Kim, Jung-Tae
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.361-380
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    • 2002
  • The purposes of this study were to a analysis of friction relation between tennis outsole and tennis playing surfaces. Tennis footwear is an important component of tennis game equipment. It can support or damage players performance and comfort. Most importantly athletic shoes protect the foot preventing abrasions and injuries. Footwear stability in court sports like tennis is incredibly important since it is estimated that as many as 45% of all lower extremity injuries occur in the foot and ankle. The friction force is the force exerted by a surface as an object moves across it or makes an effort to move across it. The friction force opposes the motion of the object. Friction results when two surfaces are pressed together closely, causing attractive intermolecular forces between the molecules of the two different surfaces. The outsole provides traction and reduces wear on the midsole. Today's outsoles address sport specific movements (running versus pivoting) and playing surface types. Different areas of the outsole are designed for the distinct frictional needs of specific movements. Traction created by the friction between the outsole and the surface allows the shoe to grip the surface. As surfaces, conditions and player motion change, traction may need to vary. An athletic shoe needs to grip well when running but not when pivoting. Laboratory tests have demonstrated force reductions compared to impact on concrete. There is a correlation between pain, injury and surface hardness. These are a variety of traction patterns on the soles of athletic shoes. Traction like any other shoe characteristic must be commensurate and balanced with the sport. The equal and opposite force does not necessarily travel back up your leg. The surface itself absorbs a portion of the force converting it to other forms of energy. Subsequently, tennis court surfaces are rated not only for pace but also for the percentage of force reduction.

A Korean familial case of hereditary complement 7 deficiency (선천성 보체 7번 결핍을 가진 한국인 한 가족)

  • Kim, Moon Kyu;Lee, Kyung Yul;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.721-724
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    • 2009
  • Meningococcal infections can be associated with abnormalities of the complement system, which contains 5 terminal complement proteins. Furthermore, deficiencies in 1 of these 5, complement component 7 (C7), leads to the loss of complement lytic function, and affected patients show increased susceptibility to recurrent meningococcal meningitis and systemic Neisseria gonorrhoeae infection. In September 2003, an 11-year-old female patient presented at our outpatient department with high fever, lower leg pain, headache, and petechiaes. She rapidly progressed to coma but later achieved full recovery due to prompt treatment. Her final diagnosis was meningococcal sepsis and arthritis. Her elder brother also had a similar bacterial meningoencephalitis history, which encouraged us to perform analyses for complement component and gene mutations. Resultantly, both the brother and sister were found to have the same mutation in the C7 gene. Subsequently, vaccinations of the meningococcal vaccine meningococcal vaccine ($Menomune^{(R)}$) were administered. However, in September 2006, the brother expired due to acute micrococcus meningoencephalitis. At present, the 16-year-old female patient is healthy. Here, we report a Korean family with a hereditary C7 deficiency with susceptibility to meningococcal infections due to C7 gene mutation.

The Clinical Study on Effects of Bee Venom Pharmacopuncture Therapy in Patients with FBSS(Failed Back Surgery Syndrome) (척추수술 후 증후군(Failed Back Surgery Syndrome) 환자 30례에 대한 봉약침 병행치료 효과의 임상적 연구)

  • Cho, Eun;Kang, Jae-Hui;Choi, Joo-Young;Yoon, Kwang-Shik;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.28 no.5
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    • pp.77-86
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    • 2011
  • Objective : This study was designed to evaluate the effect of bee venom pharmacopuncture therapy in patients with FBSS(failed back surgery syndrome). Methods : We investigated 30 cases of patients with FBSS, who had been treated from October 2010 to July 2011. We divided patients into two groups : group I was treated by acupuncture therapy only, and group II was treated by bee venom pharmacopuncture therapy and general acupuncture. We measured the efficacy of treatments using the numerical rating scale(NRS) and grade and straight leg raising(SLR) test. Results : 1. The treatment method for group II was more effective than that of group I in reducing the NRS score on the fifteenth day after admission but there was no statistically significant difference between the results of two groups on the fifth day after admission and the tenth day after admission. 2. The treatment method for group II was more effective than that of group I in NRS improvement rate from its admission day to the fifth day after admission and from the tenth day after admission to the fifteenth day after admission but there was no statistically significant difference between the performance of two groups from the fifth day after admission to the tenth day after admission. 3. Group II had a higher grade improvement rate from the seventh day after admission to the fifteenth day after admission than group I but no statistically significant difference was observed between the results of two groups from its admission day to the seventh day after admission. 4. In SLR test improvement rate the treatments applied to group II was more effective than those applied to group I. Conclusion : The results of this study suggest that bee venom pharmacopuncture therapy is effective in reducing pain for patients with FBSS. Further clinical research is needed to verify these results and findings.

Surgical Treatment for Renovascular Hypertension and Iliac Artery Occlusion (신혈관성 고혈압 및 장골동맥 폐쇄에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kang, Tae-Soo;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.582-586
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    • 2007
  • A 48-year old male patient visited our hospital with uncontrolled hypertension and pair of the left leg. CT angiography shows atherosclerotic occlusion of both renal artery orifices and the left common iliac artery. Despite of medical treatment for 2 months, the clinical condition of the patient worsened. We performed the surgical revascularization with both renal arteries and aorto-left femoral artery bypass with using an 8 mm artificial vascular graft. He lived well without hypertension with using only angiotensin receptor blocker and an anticoagulant for 10 postoperative months. Using surgical revascularization for renovascular hypertension has decreased due to the development of intervention technology and medication, but this surgery is indicated in cases of renovascular hypertension with extensive atherosclerotic lesions. We report here on a case of surgical revacularization for medically Intractable atherosclerotic renovascular hypertension together with left common iliac artery occlusion.

A Clinical Case Study of Common Peroneal Nerve Palsy(Foot Drop) Following Entrapment Neuropathy (압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Shin, Jeong-Cheol;Lee, Dong-Hyun;Wei, Tung-Shuen;Kim, Seon-Jong;Choe, Won-Hwak;Ryu, Chung-Ryul;Yun, Yeo-Choong;Cho, Myung-Rae;Che, Wu-Suk;Na, Gun-Ho
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.1-12
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    • 2005
  • Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

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