• Title/Summary/Keyword: Lower Extremities

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A Decreasing Trend of Industrial Injuries at a Large Scale Textile Company (대기업섬유업체(大企業纖維業體)에 있어서의 산업재해감소추이(産業災害減少推移))

  • Hong, Soon-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.65-73
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    • 1984
  • To assess the status of industrial injuries, a large scale textile company located around Taegu city was selected. And it was investigated from January 1981 to December 1982. After the department for workers safety was established, frequency rate of injury was 9.70 in 1981 and 4.15 in 1982, incidence rate per 1,000 workers was 27.11 in 1981 and 12.96 in 1982, and then, intensity rate was 0.33 in 1981 and 0.01 in 1982. The average duration of working loss was 36.64 days in 1981 and 3.34 in 1982. The incidence rate per 100 workers was 2.3 in annual average, 2.7 in men and 2.0 in women. The monthly incidence rate per 1,000 workers was highest as 3.6 in June; daily incidence rate, lowest as 1.8 on Sunday; and the highest as 14.7 from 10 to 12 o'clock in a day. The frequency by injured parts of body was highest as 42.3% on finger and 14.4% on the other part of hand, and the lower extremities as 14.4% followed. According to the kind of injuries, the laceration was the highest as 46.1%, the next was contusion as 15.4%, and the third was superficial injuries as 6.7%, According to the cause of injuries, the machinery accidents showed the highest as 47.1% and the accidents due to hand tool followed as 16.3%. By underlying cause of injuries, the environmental factors were 13.5% and the human factors 86.5%. The psychologic factors among human factors were the most common as 60.6%.

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Treatment of Squamous Cell Carcinoma in Extremity & Trunk (사지와 체부에 발생한 편평상피 세포암의 치료)

  • Shin, Duk-Seop;Kim, Beom-Jung
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.7-13
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    • 2012
  • Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Benefit of Ultrasound-guided Therapeutic Medial Branch Blocks after Percutaneous Epidural Neuroplasty (신경 성형술 후 초음파 유도하 내측 분지 차단술의 유용성)

  • Moon, Sang Ho;Lee, Song;Jung, Jae-Hyun;Shin, Won Shik
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.33-38
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    • 2014
  • Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

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A Study of Nerve Conduction Velocity of Normal Adults (정상성인의 신경전도속도에 관한 연구)

  • Choi, Kyoung-Chan;Hah, Jung-Sang;Byun, Yeung-Ju;Park, Choong-Suh;Yang, Chang-Heon
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.151-163
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    • 1989
  • Nerve conduction studies help delineate the extent and distribution of the neural lesion. The nerve conduction was studied on upper(median, ulnar and radial nerves) and lower(personal, posterior tibial and sural nerves) extremities in 83 healthy subjects 23 to 66 years of age. and normal values were established(Table 1). The mean motor terminal latency (TL) were : median. 3.6(${\pm}0.6$)milliseconds ; ulnar. 2.9(${\pm}0.5$) milliseconds ; radial nerve. 2.3(${\pm}0.4$) milliseconds. Mean motor nerve conduction velocity(MNCV) along distal and proximal segments: median. 61.2(${\pm}9.1$) (W-E) and 57.8(${\pm}13.2$) (E-Ax) meters per second ; ulnar. 63.7(${\pm}9.1$) (W-E) and 50.(${\pm}10.0$) meters per second. Mean sensory nerve conduction velocity(SNCV) : median. 34.7(${\pm}6.7$) (F-W), 63.7(${\pm}7.1$) (W-E) and 62.8(${\pm}12.3$) (E-Ax)meters per second ; ulnar. 38.0(${\pm}6.7$)(F-W), 63.4(${\pm}7.5$) (W-E) and 57.0(${\pm}10.1$) (E-Ax)meters per second ; radial, 45.3(${\pm}6.8$) (F-W) and 64.2(${\pm}11.0$) (W-E) meters per second ; sural nerve, 43.4(${\pm}6.1$) meters per second. The amplitudes of action potential and H-reflex were also standardized. Mean H latency was 28.4(${\pm}3.2$) milliseconds. And. the fundamental principles, several factors altering the rate of nerve conduction and clinical application of nerve stimulation techniques were reviewed.

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Association between MIR149 SNPs and Intrafamilial Phenotypic Variations of Charcot-Marie-Tooth Disease Type 1A (샤르코-마리-투스병 1A형(CMT1A)의 가족내 표현형적 이질성과 MIR149 SNP에 대한 연관성 연구)

  • Choi, Yu Jin;Lee, Ah Jin;Nam, Soo Hyun;Choi, Byung-Ok;Chung, Ki Wha
    • Journal of Life Science
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    • v.29 no.7
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    • pp.800-808
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    • 2019
  • Charcot-Marie-Tooth disease (CMT) is a group of rare peripheral neuropathies characterized by progressive muscle weakness and atrophy and areflexia in the upper and lower extremities. The most common subtype of CMT is CMT1A, which is caused by a tandem duplication of the PMP22 gene in the 17p12 region. Patients with CMT1A show a loose genotype-phenotype correlation, which suggests the existence of secondary genetic or association factors. Recently, polymorphisms of rs71428439 (n.83A>G) and rs2292832 (n.86T>C) in the MIR149 have been reported to be associated with late onset and mild phenotypic CMT1A severity. The aim of this study was to examine the intrafamilial heterogeneities of clinical phenotypes according to the genotypes of these two SNPs in MIR149. For this study, we selected 6 large CMT1A families who showed a wide range of phenotypic variation. This study suggested that both SNPs were related to the onset age and severity in the dominant model. In particular, the AG+GG (n.83A>G) and TC+CC genotypes (n.86T>C) were associated to late onset and mild symptoms. Motor nerve conduction velocity (MNCV) was not related to the MIR149 genotypes. These results were consistent with the previous studies. Therefore, we suggest that the rs71428439 and rs2292832 variants in MIR149 may serve as genetic modifiers of CMT1A intrafamilial phenotypic heterogeneity, as they have a role in the unrelated patients. This is the first study to show an association using large families with variable clinical CMT1A phenotypes. The results will be helpful in the molecular diagnosis and treatment of patients with CMT1A.

Comparison of the Injury Mechanism, Pattern and Initial Management Approach for Orthopedic Injuries According to the Injury Severity in Moderate-to-Severe Injured Patients (중등도 이상의 손상 환자에서 손상 중증도에 따른 정형외과적 손상에 대한 수상기전, 손상유형, 초기 치료적 접근의 비교)

  • Lee, Eui-Sup;Sohn, Hoon-Sang;Kim, Younghwan;Shon, Min Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.383-396
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    • 2020
  • Purpose: This study compared the injury mechanism, site, type, initial management approach of orthopedic injury, and outcomes according to the injury severity in moderate-to-severe injured patients. Materials and Methods: During 57-month, excluding the period when the authors' emergency/trauma center was not operating, from 2014 to 2019, a retrospective study was conducted on 778 patients with orthopedic injuries among patients with an Injury Severity Score (ISS)>9 scored. The patients were classified into moderate-injured group (group-1, 679) and severe-injured group (group-2, 99) according to the injury severity based on the ISS and physiologic parameters. The injury mechanism and non-orthopedic injury were evaluated. Orthopedic injuries were assessed according to the injury pattern and the number of anatomical regions and bone sites involved. The management approach for the orthopedic injuries in two groups was compared. Outcomes (hospital stay, systemic complications, and in-hospital mortality) were evaluated, and the risk factors for mortality were analyzed. Results: In group-2, the incidence of younger males, high-energy mechanisms, and accompanying injuries was significantly higher than in group-1. The number of anatomical regions and bone sites involved increased in group-2. The involvement of the pelvis, spine, and upper extremity was significantly higher in group-2, whereas group-1 was involved mainly by the lower extremities. Depending on the patient's condition, definitive or staged management for orthopedic injuries may be used. Group-1 was treated mainly with definite fixation after the physiological stabilization process, and group-2 was treated with staged management using temporary external fixation. The hospital stay was significantly longer in group-2. The overall systematic complications and in-hospital mortality was approximately 4.9% and 4.5%. A higher injury severity was associated with higher in-hospital mortality (2.9%, 15.2%; p<0.0001). Increasing age and high ISS are independent risk factors for mortality. Conclusion: A higher severity of injury was associated with a higher incidence of high-energy mechanism, younger, male, accompanying injuries, and the frequency and severity of orthopedic injuries. Severe polytrauma patients were treated mainly with a staged approach, such as external fixation. The hospital stay, systematic complications, and in-hospital mortality were significantly higher in severe-injured patients. Age and ISS are strong predictors of in-hospital mortality in polytrauma.

Effect of Bronchial Artery Embolization(BAE) in Management of Massive Hemoptysis (대량 객혈환자에서 기관지 동맥색전술의 효과)

  • Yeo, Dong-Seung;Lee, Suk-Young;Hyun, Dae-Seong;Lee, Sang-Haak;Kim, Seok-Chan;Choi, Young-Mee;Suh, Ji-Won;Ahn, Joong-Hyun;Song, So-Hyang;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Kim, Ki-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.53-64
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    • 1999
  • Background : Massive and untreated hemoptysis is associated with a mortality of greater than 50 percent. Since the bleeding is from a bronchial arterial source in the vast majority of patients, embolization of the bronchial arteries(BAE) has become an accepted treatment in the management of massive hemoptysis because it achieves immediate control of bleeding in 75 to 90 percent of the patients. Methods: Between 1990 and 1996, we treated 146 patients with hemoptysis by bronchial artery embolization. Catheters(4, 5, or 7F) and gelfoam, ivalon, and/or microcoil were used for embolization. Results: Pulmonary tuberculosis and related disorders were the most common underlying disease of hemoptysis(72.6%). Immediate success rate to control bleeding within 24hours was 95%, and recurrence rate was 24.7%. The recurrence rate occured within 6 months after embolization was 63.9%. Initial angiographic findings such as bilaterality, systemic-pulmonary artery shunt, neovascularity, aneurysm were not statistically correlated with rebleeding tendency(P>0.05). Among Initial radiographic findings, only pleural lesions were significantly correlated with rebleeding tendency(P<0.05). At additional bronchial artery angiograpy done due to rebleeding, recanalization of previous embolized arteries were 63.9%, and the presence of new feeding arteries were 16.7%, and 19.4% of patients with rebleeding showed both The complications such as fever, chest pain, headache, nausea and vomiting, arrhythmia, paralylytic ileus, transient sensory loss (lower extremities), hypotension, urination difficulty were noticed at 40 patients(27.4%). Conclusion: We conclude that bronchial artery embolization is relatively safe method achieving immediate control of massive hemoptysis. At initial angiographic findings, we could not find any predictive factors for subsequent rebleeding. It may warrant further study whether patients with pleural disease have definetely increased rebleeding tendency.

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