• The Journal of Korean Medicine
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• v.39 no.4
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• pp.121-125
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• 2018

Objectives: This study was carried out to analyse Hand Greater Yang Skin in human. Methods: Hand Greater Yang meridian was labeled with latex in the body surface of the cadaver. And subsequently body among superficial fascia and muscular layer were dissected in order to observe internal structures. Results : A depth of Skin encompasses a common integument and a immediately below superficial fascia, this study established Skin boundary with adjacent structures such as relative muscle, tendon as compass. The Skin area of the Hand Greater Yang in human are as follows: The skin close to 0.1chon ulnad of $5^{th}$ nail angle, ulnad base of $5^{th}$ phalanx, ulnad head of $5^{th}$ metacapus(relevant muscle: abductor digiti minimi muscle), ulnad of hamate, tip of ulnar styloid process(extensor carpi ulnaris tendon), radiad of ulnar styloid process, 2cm below midpoint between Sohae and Yanggok(extensor carpi ulnaris), between medial epicondyle of humerus and olecranon of ulnar(ulnar nerve), The skin close to deltoid muscle, trapezius muscle, platysma muscle, inner muscles such as teres major muscle, infraspinatus muscle, supraspinatus muscle, levator scapulae muscle, splenius cervicis muscle, splenius capitis muscle, sternocleidomastoid muscle, digastric muscle, stylohyoid muscle, zygomaticus major muscle, auricularis anterior muscle. Conclusions: The Skin area of the Hand Greater Yang from the anatomical viewpoint seems to be the skin area outside the superficial fascia or muscles involved in the pathway of Hand Greater Yang meridian, collateral meridian, meridian muscle, with the condition that we consider adjacent skins.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.145-153
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• 2022

Objective: The purpose of this study was to evaluate the Electromyography (EMG) of the upper limb during reaching tasks according to two heights in the sitting position. Design: Cross sectional design Methods: Fifteen hemiplegia, fifteen elderly, and fifteen healthy subjects have participated in this study. The targets (90% length of the subject's arm) were located at the two heights (the eye and xiphoid process). We have recorded EMG signals of seven upper limb muscles (anterior deltoid (AD), posterior deltoid (PD), pectoralis major (Pec), infraspinatus (Inf), supraspinatus (Sup), biceps brachii (Bi), triceps brachii (Tri)). The dependent variables were movement time(s), modulation ratio, working ratio, and the co-contraction ratio of the hemiplegia, elderly, and healthy at the reaching task. Two-way repeated-measures ANOVA (2-heights) was analyzed with the LSD post hoc test. Results: The study results were as follows: (1) The movement time to the target during reaching movement was significantly longer for the hemiplegia and elderly groups compared to the healthy group. (2) The modulation rate was significantly higher at eye height than the xiphoid height in AD, PD, Pec, Inf, Bi muscles, and the hemiplegia group and elderly group were significantly lower than the healthy group. Additionally, the modulation ratio showed a significant interaction between heights and groups. Conclusions: It is expected that the variables using the muscle contraction characteristics, the evaluation method of this study, can be used as an electromyography-based feedback method that can be objectively evaluated and quantified in clinical practice.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.393-401
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• 2019

The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.

• The Journal of the Society of Stroke on Korean Medicine
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• v.11 no.1
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• pp.89-98
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• 2010

This study was performed to investigate the effectiveness of trigger point needling and oriental medical treatment to shoulder pain patients in stroke sequelae with three aspects of pain and range of motion, muscle strength. Trigger point needling was applied to 3 patients on supraspinatus, infraspinatus, deltoid, subscapularis muscle. For evaluating treatment, visual analog scale(VAS), passive range of motion(PROM), muscle strength evaluation(MSE) were checked. After treatment, VAS score of 1 cases were decreased. PROM of 1 case was improved and MSE of 2 cases were improved slightly. These results suggest that trigger point needling and oriental medical treatment were effective on shoulder pain patients in stroke sequelae and it is necessary to research more case with shoulder pain in stroke sequelae.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.302-305
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• 2023

The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Despite a successful closed reduction, two more dislocations occurred in 3 weeks. Magnetic resonance imaging revealed an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, an engaging Hill-Sachs lesion, and large tears of the supraspinatus and infraspinatus tendons. The patient underwent arthroscopic rotator cuff repair and ALPSA repair with a remplissage procedure. Intraoperatively, no tendency for instability was found; however, a widened glenohumeral joint space and inferior subluxation of the humeral head without functional compromise was observed on the day after surgery and disappeared spontaneously on radiographs 2 weeks later. To the authors' knowledge, this is the first report documenting the occurrence of transient postoperative inferior subluxation of the shoulder in a patient with MG.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.211-216
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• 2015

Background: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. Methods: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. Results: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. Conclusions: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.19-25
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• 1998

Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.197-201
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• 2016

Background: The purpose of the study was to compare the degree of degeneration of the articular and bursal layers of delaminated supraspinatus tendons based on histological examination. Methods: Fifty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from the lateral torn edges of the articular and bursal layers of the delaminated tear. Harvested samples were stained with H&E dye and evaluated based on a semi-quantitative grading scale. Results: There were no significant differences in the seven histological characteristics of tendon degeneration: fiber structure, fiber arrangement, round nuclei, regional variations in cellularity, vascularity, collagen stainability, and hyalinization between the articular and bursal layers of the delaminated rotator cuff tear (all p>0.05). Total degeneration scores of articular and bursal sides were $13.1{\pm}3.85$ points and $13.2{\pm}3.42$ points, respectively, and were not significantly different (p=0.958). Conclusions: The study demonstrates that tendon degeneration was similar in the articular and bursal sides of the delaminated full-thickness rotator cuff tear, suggesting that degeneration would be a main etiology for the rotator cuff tear not only in the articular side but also in the bursal side. Considering potential disadvantages of subacromial decompression, this study tentatively suggests routine use of subacromial decompression as well as the need for halting or recovery from rotator cuff degeneration for better rotator cuff repair.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.202-208
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• 2016

Background: Our study aimed to make a comparative analysis of clinical outcomes of arthroscopic decompression for rotator cuff calcific tendinitis by location of calcific deposits and by its size. Methods: We enrolled a total of 38 patients, comprising 39 affected shoulders, who underwent arthroscopic decompression for calcific tendinitis. As our clinical scores, we evaluated the UCLA, the ASES, and the VAS scores and analyzed them by calcific location, by calcific deposit size, by the presence or absence of calcific remnants, and by whether concomitant cuff repair was performed. Results: The clinical scores of those whose calcific deposit had an area greater than $77.0mm^2$ and of those whose calcific deposit had an area smaller than $77.0mm^2$ did not significantly differ (p=0.21 in ASES; p=0.19 in UCLA; p=0.17 in VAS). Nor did the clinical scores significantly differ with respect to the location of calcification (p=0.23). Further, the clinical scores did not significantly differ between those who had calcific remnants and those who did not and between those who received additional cuff repair and those who did not. Conclusions: We found that the clinical outcomes after arthroscopic decompression of calcific tendinitis were not significantly associated with the cuff tendon in which the calcium deposits are found; the location of the calcium deposits in the supraspinatus tendon (if found in this tendon); the size of calcific deposits; the presence of calcific remnants; and concomitant cuff repairs.

• The Journal of Korean Medicine
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• v.36 no.4
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• pp.1-7
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• 2015

Objectives: The aim of this study was to observe the effect of Embedding therapy on frozen shoulder. Methods: 57 patients with frozen shoulder were treated with Embedding therapy. It was performed once a day, once per a week. 15~20 Embedding thread were used in one time Embedding therapy. The total number of Embedding therapy was 10. Trapezius muscle including the Gyeonjeong ($GB_{21}$), Deltoid muscle including the Nosu ($SI_{10}$), Supraspinatus muscle including the Byeongpung ($SI_{12}$), Infraspinatus muscle including the Cheonjong ($SI_{11}$) and gokwon($SI_{13}$), Lavator scapular muscle including the Gyeonjunsu ($SI_{15}$), Rhomboides major muscle including the Pungmun ($BL_{12}$), Rhomboides minor muscle including the Daejeo ($BL_{11}$) and Teres major muscle including the Gyeonjeong ($SI_{19}$). VAS scale, SPADI scale and ROM were compared between before and after treatment to evaluate the effect of Embedding therapy. Results: VAS scale decreased significantly (p=0.003). SPADI Scale decreased significantly (pain (p=0.006), disability(p=0.005)). ROM angle range increased significantly(flexion (p=0.005), extension(p=0.005), abduction(p=0.003), adduction(p=0.003), external rotation (p=0.005), internalrotation(p=0.005)). 29.8% patients were very much satisfied, 62.0% patients were satisfied and 8.0% patients were answered so so about Embedding therapy. Conclusion: The Embedding therapy could be effective to improve symptoms of frozen shoulder.