Transactions of the Korean Society of Automotive Engineers
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v.17
no.1
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pp.96-104
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2009
An anatomically detailed elderly human body model is under development. Using the anthropometric database of domestic nation-wide size survey, SizeKorea, a standard size and shape of 50th %tile elderly was constructed. Through the local recruitment process, a male volunteer with 71 years of age, 163cm of height and 63kg of weight has been selected. The exterior (skin) and interior (skeleton and organ) geometries were acquired from whole body 3D laser scan and various medical images such as CT, X-ray, and Ultrasonic of the volunteer. A particular attention has been paid into the combining process of exterior and interior geometries especially for joint articulation positions since they were measured at different postures (sitting vs. supine). A whole ribcage of PMHS which possessed similar anthropometry and age of standard 50th %tile elderly was prepared and dissected for the precise gauge of cortical rib bone thickness distributions. After completing the morphological construction of elderly human body, the finite element modeling will be processed by meshing elements and assigning mechanical properties to various biological tissues which reflect the aging effect.
Purpose: The great toe presents a reconstructive challenge for plastic surgeons. The big toe has much importance not only for the gait and the stability, but also for appearance aspects. Few reports have documented the reconstruction of big toe defects and we report a unique case of free flap reconstruction technique. Methods: A 41-year-old man with right great toe open fracture with soft tissue necrosis was referred from the orthopedic surgery department. On physical examination, there was the skin necrosis circumferentially and the fratured bone was severely fragmented. The metatarsophalangeal (MTP) joint of the big toe was intact. After the wound debridement, we harvested the innervated anterolateral thigh flap and transposed to the defected area. After five months, we finally retouched the flap by the dorsal defatting and distal debulking. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for eight months without any recurrence such as the osteomyelitis. Finally, he kept the normal gait and posture with weight bearing on the reconstructed great toe and foot. Conclusion: The anterolateral thigh flap is described for the reconstruction of the great toe. It involves two stage procedure with the minimal donor site morbidity and provides a good cosmetic result.
It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.
Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.
Objective : The purpose of this study is to investigate the clinical results of anterior and posterior stabilization by one stage posterolateral approach for the unstable fracture of thoracolumbar and lumbar spine. Methods : By posterolateral approach with curved skin incision, unilateral facet and pedicle were removed. Through this route, corpectomy was performed, and then this space was replaced with mesh cage filled up with autologous bone graft. Both side pedicle screw fixation was followed to upper and lower levels. Results : Six of seven patients of this study showed neurological improvement. The other one patient showed no neurological change. One patient had postoperative infection, another patient had postoperative kyphosis. The other patient had epidural hematoma on operation site after surgery. And all patinets on this study made to have spinal stability except one patient happened postoperative kyphosis. Conclusion : In the unstable fracture of thoracolumbar and lumbar spine, one stage anterior and posterior stabilization and fusion by posterolateral approach seems to be an effective procedure, if we have more care and supplementation.
Every year fish skin, bone and intestines are discarded as processing waste material. The use of fish processing waste material is more economical and environmental-friendly. The leather-like material was produced using shark intestine. Physical charactistics such as tensile strength, elongation, tongue tearing strength, and bursting strength of the leather-like material were measured, and compared with those of a commercial leather product. The values of tensile strength, elongation, tongue tearing strength, and bursting strength of the leather-like material were $3.3kg/mm^2$, $53\%$, 13.0kg/mm and $18kg/cm^2$, respectively. Elongation $(l09\%)$ of the leather-like material coated with lacquer was higher than that of a commercial leather material, and the other factors were similar. The tensile strength and tongue tearing strength of the leather-like material was higher than those of shoes leather, but bursting strength was lower. These results suggested a potential value to use the leather-like material from shark intestines as a substitute for commercial leathers.
Vitamin D is present in two forms, ergocalciferol (vitamin $D_2$) produced by plants and cholecalciferol (vitamin $D_3$) produced by animal tissues or by the action of ultraviolet light on 7-dehydrocholesterol in human skin. Both forms of vitamin D are biologically inactive pro-hormones that must undergo sequential hydroxylations in the liver and the kidney before they can bind to and activate the vitamin D receptor. The hormonally active form of vitamin D, 1,25-dihydroxyvitamin D3 $[1,25(OH)_2D]$, plays an essential role in calcium and phosphate metabolism, bone growth, and cellular differentiation. Renal synthesis of $1,25(OH)_2D$ from its endogenous precursor, 25-hydroxyvitamin D (25OHD), is the rate-limiting and is catalyzed by the $1{\alpha}$-hydroxylase. Vitamin D dependent rickets type I (VDDR-I), also referred to as vitamin D $1{\alpha}$-hydroxylase deficiency or pseudovitamin D deficiency rickets, is an autosomal recessive disorder characterized clinically by hypotonia, muscle weakness, growth failure, hypocalcemic seizures in early infancy, and radiographic findings of rickets. Characteristic laboratory features are hypocalcemia, increased serum concentrations of parathyroid hormone (PTH), and low or undetectable serum concentrations of $1,25(OH)_2D$ despite normal or increased concentrations of 25OHD. Recent advances have showed in the cloning of the human $1{\alpha}$-hydroxylase and revealed mutations in its gene that cause VDDR-I. This review presents the biology of vitamin D, and $1{\alpha}$-hydroxylase mutations with clinical findings.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.19
no.2
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pp.192-201
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2006
Objectives : Recently, He-Ne laser has been used for clinical purpose. We study the medical basis of He-Ne laser therapy and We make a proposal concerning the clinical application of using He-Ne laser in Medicine. Methods : We have selected data related to He-Ne laser therapy and study how to use He-Ne laser in clinic. Results : In biology, He-Ne laser therapy has been effects of an improve in skin regeneration an improve in peripheral and central nerve regeneration an improve in muscle regeneration, an anti-inflammation an alleviation of pain and a bone repair. In oriental medicine, He-Ne laser has been used to laser acupuncture and laser oriental physical treatment. In clinic, He-Ne laser have been used to care several parts like as facial palsy, facial spasm, trigeminal neuropathy, rhinitis and tinnitus. Recently, there is argument that He-Ne laser therapy is suitable to medical insurance. Conclusions : Laser therapy in oriental medicine is widespread and We can apply He-Ne laser to facial palsy, facial spasm, trigeminal neuropathy, rhinitis, tinnitus by using laser acupuncture or laser oriental physical treatment. Till now the whole mechanisms are not fully understood, so we hope to study these mechanisms actively and make suitable to medical insurance device in the near future.
Son, Sang-wook;Lee, Kye-ho;Lee, Jai Hyuen;Myong, Na-Hye;Yoo, Dong-soo
Investigative Magnetic Resonance Imaging
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v.20
no.1
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pp.66-70
/
2016
Introduction: Distant metastases of mucoepidermoid carcinoma (MEC) are reported with the most common sites being the soft tissue of skin, lung, liver, and bone. We report here a very rare case of MEC with multiple metastases to the kidney, adrenal gland, skull and gluteus maximus muscle. Case report: A 63-year-old male patient presented with left-sided headache. Radiologic evaluations including CT and MRI showed ill-defined soft tissue lesion involving the left infratemporal fossa and left sphenoid sinus, and multiple enlarged lymph nodes in neck and mediastinum. PET-CT demonstrated multiple hypermetabolic lesions in and around the left kidney, left adrenal gland, right ischium, right gluteus maximus and skull base. These lesions were confirmed as MEC with multiple metastases through biopsy. Discussion: Only one case of metastasis to the skull has been previously reported, and moreover, there has not been a case of metastatic MEC to the kidney, adrenal gland and gluteus maximus muscle so far in the medical literature. It is important to acknowledge the possibility of every unusual MEC metastases, since the presence of metastasis has statistically significant influence on the survival of MEC.
In oriental medicine, there is the fundamentals to lead a stirring life, and it is an important matter that make a study of fundamentals for treatment. The su-wen(素問) mentions the fundamentals of sheng(生之本), the fundamentals of qi(氣之本), the fundamentals of feng-cang(封藏之本), the fundamentals of ba-ji(罷極之本) and the fundamentals of cang-lin(倉廩之本). They are terminologies expressing physiological functions of the five viscera - heart, lungs, kidneys, liver and spleen. The five viscera are expressed through face, fur, hair, nail and lips. And the five viscera are closely connected with blood, skin, bone, muscle and flesh. Through the changes of personal appearance, we can recognize those of their internal organs. In oriental medicine, they are called as the cang-xiang(藏象). Heart is the fundamentals of sheng(生), and it is related to spirit, blood and blood vessel. Lungs are the fundamentals of qi(氣), because they master the extensive meaning of qi(氣). Kidneys are the fundamentals of feng-cang(封藏) which means seclusion. Liver is the fundamentals of ba-ji(罷極) that have several view by concept. Spleen, stomach, large and small intestines, paunch and bladder are the fundamentals of cang-lin(倉廩), that is to say, gastrointestinal tract that ingest diet and digest it.
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