• Title/Summary/Keyword: left thigh

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The Sensory Change on the $S_2$ Area after Epidural Adhesiolysis -A case report- (경막외강 유착제거술후 발생한 $S_2$ 피부분절부위의 감각변화 -증례 보고-)

  • Lee, Sang-Chul;Jo, Dae-Hyun;Yoon, Tae-Gyoon;Lee, Byeong-Geon
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.256-259
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    • 1996
  • Epidural adhesiolysis is a convenient and safe method for the management of back pain. However, we experienced a case where a patient developed sensory change to S2 area after epidural adhesiolysis. Male patient, 43 years old, was admitted to our pain clinic for epidural adhesiolysis for back pain. Patient was experiencing pain radiating to left thigh, and sensory change and motor disturbance to the S1 area. Patient's symptoms and signs were much improved on the first day of epidural adhesiolysis. Patient, however, complained of numbness of perineal and S2 areas after the next day of injections. We postulated the cause of this complication was due to: compression of nerve root by the large volume of injectate and hematoma, and the side effect of local anesthetic, hypertonic saline and steroid.

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Clear Cell Sarcoma - 1 Case Report - (투병세포육종 -1례 보고 -)

  • Choi, Joon-Hyuk;Choi, Hae-Jeong;Kim, Mi-Jin;Shin, Duk-Seop;Cho, Kil-Ho
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.108-113
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    • 1999
  • Clear cell sarcoma is a rare soft tissue sarcoma that occurs in tendons and aponeuroses, usually in the lower extremities in young adults. The exact histogenesis is not definitely established. We experienced a case of 58 year-old female who presented with a $3.2{\times}2.2cm$ sized mass located in the subcutaneous tissue of the left lower thigh. The mass was well-circumscribed, grayish and firm. Two small satellite nodules were also seen. Histrionically, the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm and separated into compact nests or short fascicles by delicate fibrous septa. The melanin pigments and hemosiderin were seen. Tumor cells showed positive reaction for S-100 protein and HMB-45. The ultrastructural examination showed abundant mitochondria and melanosomes.

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Awake intubation in a patient with huge orocutaneous fistula: a case report

  • Kim, Hye-Jin;Kim, So-Hyun;Kim, Tae-Heung;Yoon, Ji-Young;Kim, Cheul-Hong;Kim, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.313-316
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    • 2017
  • Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.

Acute limb ischemia following perineal reconstruction in lithotomy position: take-home message for plastic surgeons

  • Sapino, Gianluca;Deglise, Sebastien;Raffoul, Wassim;di Summa, Pietro G.
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.543-546
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    • 2021
  • Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.

Effect of Capsaicin on Causalgiform Pain in the Rat

  • Kim, Kwang-Jin;Jeon, Byeong-Hwa;Kim, Won-Sik;Park, Kyung-Ran;Choi, Sae-Jin
    • The Korean Journal of Physiology
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    • v.26 no.2
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    • pp.143-150
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    • 1992
  • The purpose of this study is to obtain the effective concentration of capsaicin to relieve pain with no change in the number of C-fibers and its effective duration for pain relief. Capsaicin has been used extremely as a experimental tool and as topical medications for acute or chronic tissue injuries and partial nerve injury is the main cause of causalgiform pain disorders in humans. Here, the left sciatic nerve was ligated unilaterally at the high level of the thigh to prepare an animal model of this pain condition. The rat developed guarding behavior of the ipsilateral hind paw within a few hours after the operation and this behavior was maintained for several months thereafter, suggesting the possibility of spontaneous pain. These animals were divided into two groups(4-week & 8-week) and each group was subdivided into five groups by different concentration (0.05, 0.1, 0.5, 1.0 & 2.0%). Each capsaicin concentration was treated locally on the spinal cord-side of the ligated nerve and the foot withdrawal latency was measured. Thereafter, the dorsal roots of L5 were removed from both sides immediately after in tracardial perfusion for the counting of C-fibers by the histological procedure. There were no significant differences in the foot-withdrawal latency and the number of C-fibers between the left side treated with 0.05% capsaicin and the right side treated with the vehicle. However, latencies of the left sides treated with 0.1, 0.5, and 1.0% capsaicin increased significantly throughout 4-6 weeks with almost no change in the number of C-fibers, and the latencies showed the trends to approach slowly to those of the conditions after operation. The latency of subgroup treated with 2.0% increased by approximate 10% more than that of the right side throughout 8 weeks, and the number of C-fibers decreased by about 30% or more These results suggest that the elevated latency with capsaicin(0.1-1.0%) treatment is due to the inhibition of impulse transmission throughout the primary afferent fiber and the data from 2.0% are due to partial destruction of C-fibers. Therefore, capsaicin concentrations from 0.1% to 1.0% are probably very effective for the treatment of causalgiform pain with almost no destruction of C-fibers.

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Reaction time and EMG pattern analysis of Body guards who have trained martial arts to accidental situations (경호무도를 수련한 경호원의 우발 상황 시 경호자세의 반응시간 및 EMG 패턴 분석)

  • Jung, Sung-Sook
    • Korean Security Journal
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    • no.19
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    • pp.207-223
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    • 2009
  • The main purpose of this study was to analyze the reaction time of body guards in different stances to provide quantification of data for educational use. There were 4 martial art trained body guards participating in this study. The results of the EMG analysis and reaction time are as follows. The average reaction time of the whole body was $1.38{\pm}0.07$ seconds. In the first phase the reaction to the signal was $0.22{\pm}0.02$ seconds while in the second phase the reaction after checking was $0.62{\pm}0.10$ seconds, which produced the largest impulse. the reaction times of the third and fourth phase were gradually reduced, $0.29{\pm}0.02$ seconds and $0.26{\pm}0.02$ seconds consecutively. In the body guard posture the following muscles had a high activity level; phase one the right and left of the tibialis anterior muscle, phase two the right and left of the tibialis anterior muscle and the right of the gastrocnemius, phase three the right side of the tibialis anterior and gastrocnemius, phase four the left and right of the biceps femoris and the right side of the rectus femoris. In the first and second phase the shank muscles were used a lot, whereas in the third and fourth phase the shank and thigh muscles were used a lot showing the overall muscle activation of the lower limbs.

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A Kinematic Analysis of Uchi-mata(inner thigh reaping throw) by Kumi-kata types in Judo (유도 맞잡기 타입에 따른 허벅다리걸기의 Kinematic 분석[I])

  • Kim, Eui-Hwan;Cho, Dong-Hee;Kwon, Moon-Seok
    • Korean Journal of Applied Biomechanics
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    • v.12 no.1
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    • pp.63-87
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    • 2002
  • The purpose of this study was to analyze the kinematic variables when Uchi-mata(inner thigh reaping throw) performing by Kumi-kata(engagement position, basic hold) types A, B(A: grasping part-behind neck lapel, B: chest lapel) in Judo with three dimensional analysis technique DLT method by videography. The subjects were four male judokas who have been training in Yong-In University(YIU), on Korean Representative level and Uchi-mata is their tokui-nage(favorite technique), the throwing form was filmed on two S-VHS 16mm video camera( 30frame/sec. Panasonic). Kinematic variables were temporal, posture, and COG. The data collection was performing by Uchi-mata. Six good trials were collected for each condition (type A, B) among over 10 trials. The mean values and the standard deviation for each variable were obtained and used as basic factors for examining characteristics of Uchi-mata by Kumi-kata types. The results of this analysis were as follows : 1) Temporal variables The total time elapsed(TE) by Uchi-mata of types A, B were 1.45, 1.56 sec. respectively. Types A shorter than B. 2) Posture variables In performing of Uchi-mata, the range of flexion in type A, left elbow was $45^{\circ}$ and B was $89^{\circ}$ from Event 2(E2) to Event 6(E6). Type A and B were quite different in right elbow angle in Event1(E1). Left shoulder angle of type A was extended and type B was flexed in E4. Both types right shoulder angles were showed similar pattern. Also both hip angles(right/left) were showed similar pattern. When type A performed Uchi-mata the knee-angle of supporting foot showed $142^{\circ}$in the 1st stage of kake phase[KP], and extended to $147^{\circ}$in the 2nd stage of KP. And the foot-ankle angle of supporting foot showed $83^{\circ}$in the 1st stage of KP, and extended to $86^{\circ}$in the 2nd stage of KP. moreover, The knee angle of attacking foot showed $126^{\circ}$in the 1st stage of KP, and extended to $132^{\circ}$in the 2nd stage of KP, and the foot-ankle angle of attacking foot showed $106^{\circ}$in the 1st stage of KP, and extended to $121^{\circ}$in the 2nd stage of KP. When type B performed Uchi-mata the knee-angle of supporting foot showed $144^{\circ}$in the 1st stage of KP, and extended to $154^{\circ}$in the 2nd stage of KP. And the foot-ankle angle of supporting foot showed $83^{\circ}$in the 1st stage of KP, and extended to $92^{\circ}$in the 2nd stage of KP. moreover, The knee angle of attacking foot showed $132^{\circ}$in the 1st stage of KP, and extended to $140^{\circ}$in the 2nd stage of KP, and the foot-ankle angle of attacking foot showed $103^{\circ}$in the 1st stage of KP, and extended to $115^{\circ}$in the 2nd stage of KP. During Uchi-mata performing, type A showed pulling pattern and type B showed lift-pulling pattern. As Kumi-kata types, it were different to upper body(elbow, shoulder angle), but mostly similar to lower body(hip, knee, ankle angle) on both types. 3) C. O. G. variables When the subjects performed Uchi-mata, COG of type A, B up and down in vertical aspect was 71cm, 73.8cm in height from the foot in the 2nd stage of KP. As Kumi-kata types, it were different on medial-lateral direction aspect but weren't different in Kuzushi phase on vertical direction aspect.

A Comparison of the Difference in the Golf Swing Motion According to Somatotypes (체형에 따른 골프 스윙 동작 비교)

  • Chung, Nam-Ju;Yoon, Hee-Joong;Baik, Young-Soo
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.33-49
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    • 2002
  • This study was intended to provide basic materials for golf coaching by somatotype by analyzing and comparing the kinematic factors found in each somatotype at the time of golf swing. For this purpose, the somatotype was divided into endomorph, mesomorph and ectomorph in reference to the weight, height and upper arm circumference of each of nine professional golfers. Each of their swing motions was videotaped with the camcorder and their swing motion was analyzed by dividing it into 8 sections. The time required for the swing motion, the displacement of the center of the human body and the rotation angle of the upper body were calculated through the three-dimensional image analysis based on the DLT(Direct Linear Transformation). Based on the findings of this study, the following conclusion was drawn: The endomorphic golfers showed the longest required golf swing time, followed by the mesomorphic golfer and then the endomorphic golfer. The displacement of left-to-right movement was largest in the mesomorphic golfers, followed by the endomorphic golfers the up-to-down displacement was upward at the time of impact and that the endomorphic and mesomorphic golfers raised the sense of stability by maintaining an almost uniform height at the time of impact. As for the rotational angle of the upper body and the rotational angle of the thigh, the upper body and the thigh took a form of rotating earlier in the ectomorphic golfers at the time of impact, who showed a somewhat different characteristics compared to the endomorphic and mesomorphic golfers. It is necessary to investigate the movement of more fundamental forces in presenting the theory related to the kinematic characteristics of this swing by somatotype. Accordingly, it is thought that it is necessary to analyze the center of pressure(COP) using the ground counterforce in the future study.

Repeated Unplanned Excision of Malignant Fibrous Histiocytoma (Malignant Fibrous Histiocytoma Misdiagnosed as the Simple Cyst): A Case Report (악성 섬유성 조직구종의 반복된 무계획적 절제(단순 낭종으로 오인된 악성 섬유성 조직구종): 증례 보고)

  • Soh, Jae-Wan;Kim, Woo-Jong;Kim, Chang-Hyun;Kwon, Sei-Won;Kim, Han-Jo
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.113-117
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    • 2012
  • A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.

A Case of Thigh Stump Pain with Unidentified Complaints (다양한 증상을 호소한 대퇴 절단지통 1예)

  • Cha, Young-Deog;Kim, Il-Ho;Kim, Yu-Jae;Kim, Chun-Sook;Ahn, Ki-Rhang;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.100-105
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    • 1994
  • This is a study of decrease in both stump pain and unidentified complaints after removal of neuroma on an amputated left thigh. The patient was a 44 year old woman who received an operation after a motorcycle accident 20th of March, 1991. She started a rehabilitation program in early June of the same year. How ever the patient complained of a squeezing pain on the amputated area. This symptom became more severe after the removal of the nails in September. The pain was perceived as a mental problem and the patient was released from the previous hospital. The pain continued and on the 9th of March, 1992, the patient was introduced to our pain clinic. The patient complained about the cold sensation and pressure pain of the amputated area at the beginning. Later she also expressed various unidentified complaints. No improvement resulted after conducting an epidural block and a lumbar sympathetic ganglion block. MMPI test showed psychological instability. Local injection showed some positive effects, which led to considerations concerning the possibility of neuroma. After confirming the existence of neuroma through CT and MRI, neuromectomy was performed. After the removal of neuroma, the unidentified complaints as well as the stump pain decreased.

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