• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.27-34
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• 2011

Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.80-88
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• 1997

Malignant tumors of extremeties involving major neurovascular structures have been treated by amputation. However recent development of diagnostic tools(CT, MRI etc.), surgical techniques, anticancer chemotherapeutic agents, and radiation techniques allow surgeons to treat malignant tumors in the limb without amputation. It has been reported that a local application of low-heat to the tissue with tumor can kill tumor cells. It is, however, not known if the attendant neural and vascular injuries may be recovered. The present study was, therefore, undertakn to address this question in rabbit sciatic nerves. A low-heat injury to the sciatic nerve was induced by perfusing the nerve with $60^{\circ}C$ saline for 30 minutes and the courses of functional and morphological recovery of the nerve were evaluated for 16 weeks. The results are summerized as follows : 1. In the electromyographic nerve conduction test the average amplitude was markedly attenuated at 4 and 8 weeks after the low-heat treatment, but it progressively increased to the level 89.5% of the control at 16 week post-treatment. The average latency in the control group was 0.62 msec. The latency in the experimental group was much longer than this at 4 and 8 week post-treatment, but it progressively reverted to the control level, showing 0.622 msec at 16 weeks. 2. In the needle EMG, many fibrillation potentials and positive sharp waves were appeared until 8 weeks post-treatment. After 16 weeks, however, no fibrillation potential was observed. 3. In the early phase of post-treatment period, the myelinated nerve fibers contained many vacuoles and the number of myelinated nerve fibers appeared to be considerably reduced. However, as time goes myelinated nerve fibers were regenerated, such that after 16 weeks the histologic appearance of the nerve was similar to that of the control group.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.107-112
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• 2001

Introduction: Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, is known to be closely associated with the human leukocyte antigen (HLA) DQB1*0602. Several studies have suggested that HLA-DQB1*0602 is strongly linked with narcolepsy-cataplexy. However, no studies have yet been made on whether HLA DQB1*0602 is associated with Korean patients with narcolepsy. This study was designed to investigate the frequency of HLA-DQB1*0602 of Korean patients with narcolepsy. Methods: Twenty patients were selected (mean age: $28.2{\pm}3.0$, 11 men and 9 women). The patients were confirmed to have narcolepsy by the overnight polysomnography and multiple sleep latency test (MSLT) in addition to their clinical history and symptoms at St. Vincent's Hospital and Korea University Hospital Sleep Disorders Clinic. Any subjects co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep were excluded. Clinical data was collected through a semi-structured interview for narcoleptic patients. All patients and 21 control did HLA typing for the presence of DQB1*0602. Results Obtained were as Follows: 1) Mean sleep latency was 2.4 (${\pm}2.0$ minutes) and mean frequency of sleep-onset REM period was 3.0 (${\pm}1.6$) by MSLT. 2) Characteristic symptoms of narcolepsy investigated were as follows: excessive daytime sleepiness (100%), cataplexy (100%), sleep paralysis (60%), hypnagogic hallucination (70%) and disrupted nocturnal sleep (75%). 3) Strong emotional expression such as laughing (80%) and joking (70%) triggered cataplexy which affects the knee and leg region (80%) and jaw region (30%). 4) HLA-DR2 was found in 90% of patients and 35% in controls. The frequency of HLA-DQB1*0602 in patients and controls was 90%, and 24%, respectively. Conclusions: These results, which exhibit high HLA-DQB1*0602 expression in Korean patients with narcolepsy, suggest that HLADQB1*0602 could be a strong genetic marker in narcolepsy.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.113-120
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• 2001

Objectives: Obstructive sleep apnea syndrome is common and may produce various symptoms and serious complications. A substantial number of research articles on obstructive sleep apnea syndrome have been published in Korea. However, we found such limitations as lack of sufficient sample size and lack of polysomnography-proven cases. Therefore, we aimed at studying clinical features and sleep structure in a sufficient number of Korean patients with obstructive sleep apnea syndrome diagnostically confirmed with polysomnography. Methods: We studied 801 subjects referred to the Division of Sleep Studies, Seoul National University Hospital, who were diagnosed as having obstructive sleep apnea syndrome with polysomnography. Subjects were excluded if they had central sleep apnea syndrome, periodic limb movement disorder, narcolepsy or REM sleep behavior disorder. Foreign patients were also excluded. First of all, we studied the clinical features of the subjects. Secondly, we compared sleep-related parameters of the study subjects with those of age/sex-matched normal values. Thirdly, correlations of respiratory disturbance index (RDI) with each of the sleep-related parameters were calculated. Results: Among the 801 subjects, 668 were male subjects (83.4%) and 133 female subjects (16.4%). Their mean age was 46.6 years (${\pm}13.5$). The mean body mass index (BMI) was 25.8 (${\pm}3.8$) and subjects with BMI was over 28.0 accounted for 22.8% of the total. Fifty subjects (6.2%) were found to take benzodiazepines. Mean RDI and mean nocturnal oxygen saturation of all subjects was 31.2 (${\pm}24.4$) and 94.5% (${\pm}3.6$), respectively. In comparison with normal values, the subjects showed longer sleep latency, lower sleep efficiency, decreased total slow wave sleep % (TSWS %), and decreased total REM sleep % (TREM %)(p<0.01 in all). RDI had a negative correlation with each TSWS % and TREM % (p<0.01, p<0.01). However, RDI did not have significant correlation with either sleep latency or sleep efficiency. Conclusion: In this study, 6.2% of patients diagnosed as having obstructive sleep apnea syndrome were found to take benzodiazepines, although they are generally considered to be of litte benefit or even dangerous because of the respiratory suppressing effect. The proportion of obese subjects was only 22.8% and Korean patients with obstructive sleep apnea syndrome seem to be less obese than those described in foreign journals. This study also suggests that the severity of obstructive sleep apnea syndrome may have a more significant effect on sleep architecture defined as TSWS % and TREM % than on sleep efficiency.

• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.40-46
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• 2009

Purpose : The purpose of this study was to investigate the quantitative evaluation of the corticospinal tract (CST) at the multiple levels by using functional MRI (fMRI) co-registered to diffusion tensor tractography (DTT). Materials and Methods : Ten normal subjects without any history of neurological disorder participated in this study. fMRI was performed at 1.5 T MR scanner using hand grasp-release movement paradigm. DTT was performed by using DtiStudio on the basis of fiber assignment continuous tracking algorithm (FACT). The seed region of interest (ROI) was drawn in the area of maximum fMRI activation during the motor task of hand grasp-release movement on a 2-D fractional anisotropy (FA) color map, and the target ROI was drawn in the cortiocospinal portion of anterior lower pons. We have drawn five ROIs for the measurement of FA and apparent diffusion coefficient (ADC) along the corona radiata (CR) down to the medulla. Results : The contralateral primary sensorimotor cortex (SM1) was mainly found to be activated in all subjects. DTT showed that tracts originated from SM1 and ran to the medulla along the known pathway of the CST. In all subjects, FA values of the CST were higher at the level of the midbrain and posterior limb of internal capsule (PLIC) than the level of others. Conclusion : Our study showed that co-registered fMRI and DTT has elucidated the state of CST on 3-D and analyzed the quantitative values of FA and ADC at the multiple levels. We conclude that co-registered fMRI and DTT may be applied as a useful tool for clarifying and investigating the state of CST in the patients with brain injury.

• Economic and Environmental Geology
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• v.3 no.1
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• pp.25-34
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• 1970

Very few articles are available on geologic structure and genesis of Sangdong scheelite-deposits in spite of the fact that the mine is one of the leading tungsten producer in the world. Sangdong scheelite deposits, embedded in Myobong slate of Cambrian age at the southem limb of the Hambaek syncline which strikes $N70{\sim}80^{\circ}W$ and dips $15{\sim}30^{\circ}$ northeast, comprise six parallel veins in coincide with the bedding plane of Myobong formation, namely four footwall veins, a main vein, and a hangingwall vein. Four footwall veins are discontinuous and diminish both directions in short distance and were worked at near surface in old time. Hangingwall vein is emplaced in brecciated zone in contact plane of Myobong slate and overlying Pungchon limestone bed of Cambrian age and has not been worked until recent. The main vein, presently working, continues more than 1,500 m in both strike and dip sides and has a thickness varying 3.5 to 5 m. Characteristic is the distinct zonal arrangement of the main vein along strike side which gives a clue to the genesis of the deposits. The zones symmetrically arranged in both sides from center are, in order of center to both margins, muscovite-biotite-quartz zone, biotite-hornblende-quartz zone and garnet-diopside zone. The zones grade into each other with no boundary, and minable part of the vein streches in the former two zones extending roughly 1,000 m in strike side and over 1,100 m in dip side to which mining is underway at present. The quartz in both muscovite-biotite-quartz and biotite-hornblende-quartz zones is not network type of later intrusion, but the primary constituent of the special type of rock that forms the main vein. The minable zone has been enriched several times by numerous quartz veins along post-mineral fractures in the vein which carry scheelite, molybdenite, bismuthinite, fluorite and other sulfide minerals. These quartz veins varying from few centimeter to few tens of centimeter in width are roughly parallel to the main vein although few of them are diagonal, and distributed in rich zones not beyond the vein into both walls and garnet-diopside zone. Ore grade ranges from 1.5~2.5% $WO_3$ in center zone to less than 0.5% in garnet-diopside zone at margin, biotite-hornblende-quartz zone being inbetween in garde. The grade is, in general, proportional to the content of primary quartz. Judging from regional structure in mid-central parts of South Korea, Hambaek syncline was formed by the disturbance at the end of Triassic period with which bedding thrust and accompanied feather cracks in footwall side were created in Myobong slate and brecciated zone in contact plane between Myobong slate and Pungchon limestone. These fractures acted as a pathway of hot solution from interior which was in turn differentiated in situ to form deposit of the main vein with zonal arrangement. The footwall veins were developed along feather cracks accompanied with the main thrust by intrusion of biotite-hornblende-quartz vein and the hangingwall vein in shear zone along contact plane by replacement. The main vein thus formed was enriched at later stage by hydrothermal solutions now represented by quartz veins. The main mineralization and subsequent hydrothermal enrichments had probably taken place in post-Triassic to pre-Cretaceous periods. The veins were slightly displaced by post-mineral faults which cross diagonally the vein. This hypothesis differs from those done by previous workers who postulated that the deposits were formed by pyrometasomatic to contact replacement of the intercalated thin limestone bed in Myobong slate at the end of Cretaceous period.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.225-228
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• 2007

The therapy by injection-acupuncture (AP) with bee-venom (apitoxin) and injection-AP with apitoxin combined by administration of Chinese herbal medicine was applied in 2 cases with canine intervertebral disc disease (IVDD). Case 1 was diagnosed as thoraco-lumbar IVDD (T11-T12, T12-T13, L3-L4 and L4-L5) and case 2 was diagnosed as IVDD at T10-T11 and T12-T13, respectively Injection-AP with apitoxin($Apitoxinc{(R)}$, total $200{\mu}g$ of apitoxin, 0.1 ml/acupoint) plus physical exercise (walking with gocart, TID/day) and aquatherapy (swimming treatment, BID/week) were given to each patient. The used acupoints were GV20 (Bai Hui), GB30 (Huan Tiao), ST36 (Zu San Li), GB34 (Yang Ling Quan), ST40 (Feng Long), ST41 (Jie Xi) and BL40 (Wei Zhong), the lesions, and trigger points. In addition, Chinese herbal medicine (Koda Pharmaceutical Co., Taiwan) including Zheng Gu Zi Jin Dan (正骨紫金丹 : 1 g), Shiuh Duann(續斷 : 0.2 g), Du Zhong(杜仲 : 0.2 g), Mo Yao(沒藥 : 0.2 g), Ru Xian(乳香 : 0.2 g) and Pyrite(自然銅 : 0.2 g) were orallly mdeicated BID for 0\9days in case 2. Walking was possible after session 11 for 4 weeks in case 1 and after session 6 for 2 weeks in case 2, respectively.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.87-95
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• 2018

Objective : Vibration stimulators are easier to obtain in clinical settings than other treatment tools, and it is advantageous that the arm activation training can be performed passively. Despite the following advantages, recent studies on vibration sense have not been activated yet. The purpose of this study was to investigate the effect of vibration sensation on the hands of the affected upper limb on unilateral reduction of stroke patients. Method : Patients with unilateral neglect due to stroke were enrolled in this study for about 3 weeks from October 19, 2018 to November 7, The research design used ABA design among the single-subject experimental research design, and a total of 18 circuits (4 baseline, 6 intervention, 3 baseline regression) were performed once a day on weekdays Respectively. MMES-K was used to select the subjects. Line bisection test (LBT), Albert's test and Star Cancellation Test (SCT) were used as unilateral neglect test. For the analysis, the baseline and intervention period measurements were visually analyzed using graphs and mean values were used. Result : All three evaluations showed that the number of errors missed during the training period was lower than the baseline period, and this decrease remained after training. The error was reduced by an average of $2{\pm}1.2$ omissions and an average omissions of $0.6{\pm}0.5$ omitting an average of $4.5{\pm}1$ omissions in the line break test. As a result of the Albert test, the average error decreased by $22.5{\pm}1.9$ omissions and $8{\pm}7.3$ omissions and $0.3{\pm}0.5$ omissions, respectively. In the star clearance test, the average error decreased from $26{\pm}4.6$ to $21.8{\pm}1.7$ and $20{\pm}0$, respectively. Conclusion : In this study, vibrotactile stimulation therapy showed a continuous effect on improving unilateral neglect. Based on these findings, further research should be conducted in order to improve objectivity in future studies. Further research on various arbitration methods that maximize the effect of intervention will be needed.

• Economic and Environmental Geology
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• v.54 no.2
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• pp.271-283
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• 2021

The Imjingang Belt in the middle-western Korean Peninsula has tectonically been correlated with the Permo-Triassic Qinling-Dabie-Sulu collisional belt between the North and South China cratons in terms of collisional tectonics. Within the belt, crustal-scale extensional ductile shear zones that were interpreted to be formed during collapsing stage with thrusts and folds were reported as evidence of collisional events by previous studies. In this study, we tried to understand the nature of deformation along the southern boundary of the belt in the Munsan area based on the interpretations of recently conducted structural analyses. To figure out the realistic geometry of the study area, the down-plunge projection was carried out based on the geometric relationships between structural elements from the detailed field investigation. We also conducted kinematic interpretations based on the observed shear sense indicators from the outcrops and the oriented thin-sections made from the mylonite samples. The prominent structures of the Munsan area are the regional-scale ENE-WSW striking thrust and the N-S trending map-scale folds, both in its hanging wall and footwall areas. Shear sense indicators suggest both eastward and westward vergence, showing opposite directions on each limb of the map-scale folds in the Munsan area. In addition, observed deformed microstructures from the biotite gneiss and the metasyenite of the Munsan area suggest that their deformation conditions are corresponding to the typical mid-crustal plastic deformation of the quartzofeldspathic metamorphic rocks. These microstructural results combined with the macro-scale structural interpretations suggest that the shear zones preserved in the Munsan area is mostly related to the development of the N-S trending map-scale folds that might be formed by flexural folding rather than the previously reported E-W trending crustal-scale extensional ductile shear zone by Permo-Triassic collision. These detailed examinations of the structures preserved in the Imjingang Belt can further contribute to solving the tectonic enigma of the Korean collisional orogen.