• The Korean Journal of Pain
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• v.7 no.2
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• pp.205-210
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• 1994

The effects of either clonidine or epinephrine into local anesthetics administered into brachial plexus sheath were evaluated in 42 patients who underwent surgery of the upper limb. All patient received 0.5 ml/kg of 2:1 mixture of bupivacaine and lidocaine injected into the brachial plexus sheath, using the subclavian perivascular technique. The patients were randomly allocated into two groups; Group I(n=25) received $150{\mu}g$ of clonidine hydrochloride, and Group II(n=27) received $200{\mu}g$ of epinephrine. The duration of analgesia and the degree of sedation reflecting the systemic effect of clonidine were assessed. The block produced by the addition of clonidine was longer($100.3{\pm}469.8$ vs $648.8{\pm}192.1$ min) and superior to that by epinephrine(p < 0.05). The highest degree of sedation was achieved about 20 minutes after block, which roughly equals the time required for intramuscular clonidine to show the similar effect. The author concludes that the injection of clonidine mixed to local anesthetics into the brachial plexus sheath prolongs analgesia than that of epinephrine, but this prolongation may be due to the systemic effect of clonidine.

• The Journal of Korean Obstetrics and Gynecology
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• v.22 no.3
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• pp.205-222
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• 2009

Purpose: The aim of this study was to review systemically journals on the studies for Complementary and Alternative Medicine in the treatment of breast cancer. Methods: Through medical websites, foreign clinical literatures about complementary and alternative medicines of breast cancer were searched. The cite used was http://www.Pubmed.gov. And then they were divided into three groups. Medication, Non-medication therapies and questionnaire reports. Results: 1. We researched 23 papers about herb medicines. Most of papers were about single herb and there were rarely about mixed composition. And there were papers about Ocimum gratissimum, elliptilimba, seeds of Livistona chinensis, golden feverfew which were not commonly used in Korea. 2. We researched 16 papers about acupuncture. Acupuncture had a possitive effect on such symptoms like flushing, nausea and vomitting and pain on upper limb caused by anticancer therapy or tamoxifen or surgery. 3. We researched 36 papers about questionnaire study. Most were about research for women who diagnosed as breast cancer or women after breast cancer surgery. Subjects were about proportion of using CAM, purpose of using it, most popular CAM therapy, satisfaction degree, and relation with age, aducation and social position. And most conclusion were that patient-doctor communication was needed. Conclusion: Afterwards we have to focus on realisitic clinical studies about breast cancer patients, especially postsurgery and people who takes anticancer therapy. And we have to be interest in acupuncture therapy on breast cancer patients.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.1-5
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• 2000

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.486-492
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• 2001

Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

• The Journal of Korean Physical Therapy
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• v.25 no.3
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• The Journal of the Korea Contents Association
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• v.8 no.9
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• pp.194-203
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• 2008

CIMT(Constraint Induced Movement Therapy) is to improve the function and use of damaged upper limbs by not only confinement of unaffected limbs' exercise but also inducement of affected limbs' one. The purpose of the study is to verify the effect of CIMT by means of motor behaviour test and immunohistochemistry, using animal models. This study was analyzed using 40 male Sprague-Dawley rats as the experimental groups and 40 ones as the control groups. The rats were divided into two random groups : one group as an experimental group which was operated on under anesthesia and removed somatomotor regions with CIMT and the other as the control group without CIMT.Postural Reflex Test, Beam Walking Test, Limb Placement Test and Immunohistochemistry were run on the day 1, 3 , 7 and day 14 following surgery to each 10 rat. As a result, this study demonstrates that CIMT might be an effect method to verify the plasticity of central nervous system as motor behaviour test made all high scores (p<.05) and BDNF was high too in experimental groups.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.101-120
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• 2024

Purpose : This study aimed to carry out a scoping review to investigate the research trends in non-pharmacological interventions for physical rehabilitation following breast cancer treatment. Methods : A scoping review was conducted according to the five steps outlined by Arksey and O'Malley and PRISMA-ScR. We searched three domestic databases (ScienceOn, Riss, KCI) and two international databases (PubMed, Cochrane Central) between January 2014 and April 2024. The keywords used were 'breast cancer surgery', 'breast cancer treatment', 'breast cancer lymphedema', 'intervention', 'management', 'therapy', 'disorder', and 'dysfunction'. Results : In terms of publication, the number of studies in the past five years has increased compared to the previous five years, with most studies focusing on patients aged 41 to 60 and who underwent surgical treatment for breast cancer. A total of 43 different types of non-pharmacological interventions were applied: 21 single interventions and 22 combination interventions. Among the intervention methods, complete decongestive treatment (CDT), resistance training, and manual lymphatic drainage were the most frequently utilized. The most common duration of intervention turned out to be 4~5 weeks and more than 8 weeks, with frequencies of 2~3 sessions per week and more than 4 sessions per week. The most frequently used dependent variables included range of motion (ROM) and disabilities of the arm, shoulder and hand (DASH) for the function and disorder of the upper limb category; arm circumference or volume and bio-impedance for the lymphedema category; visual analogue scale (VAS) and numerical rating scale (NRS) for the pain category; and the European organization for research and treatment of cancer quality of life questionnaire breast cancer module (EORTC QLQ) and functional assessment of cancer therapy-breast (FACT-B) for the quality of life category. Conclusion : The findings of this scoping review provide valuable mapping data for non-pharmacological interventions for physical rehabilitation following breast cancer treatment. We recommend further research, particularly systematic reviews and meta-analyses, to build upon these findings.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.5-11
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• 2009

Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.