• Title/Summary/Keyword: low extremities

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Ultrasound Guided Low Approach Interscalene Brachial Plexus Block for Upper Limb Surgery

  • Park, Sun Kyung;Sung, Min Ha;Suh, Hae Jin;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.18-22
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    • 2016
  • Background: The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus. Methods: A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications. Results: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be $2.8{\pm}2.6$ and $1.1{\pm}1.8$, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications. Conclusions: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.

Clinical Experience with Treatment of Angioleiomyoma

  • Woo, Kyoung Sik;Kim, Sang Hun;Kim, Han Seong;Cho, Pil Dong
    • Archives of Plastic Surgery
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    • v.41 no.4
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    • pp.374-378
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    • 2014
  • Background Angioleiomyoma, a vascular leiomyoma, is a rare, benign smooth-muscle tumor that originates in the tunica media of vessels. It occurs anywhere in the body, most frequently in the lower extremities. Methods We reviewed the medical records of 16 patients who were treated for angioleiomyoma between 2000 and 2012. The clinical features of angioleiomyoma and the correlation between symptoms and pathological subtypes were investigated. Results There were 9 males and 6 females. Ages of the patients ranged from 21 to 61. Pain was the primary symptom in 44% of the patients. Tumors were smaller than 2.0 cm in all dimensions and were located in the face in 4 patients, whereas 5 lesions occurred in the upper extremities and the remaining 7 in the lower extremities. Three histologic subtypes were identified: solid, venous, and cavernous. The subtypes did not correlate with the clinical symptoms. Conclusions Angioleiomyoma appears to be a rare tumor that occurs in the face and the extremities. The tumor usually occurs in middle age. A differential diagnosis of this tumor is difficult, but the tumor should be considered in the diagnosis of painful subcutaneous masses. Ultrasonography and magnetic resonance imaging can be helpful in the diagnosis of angioleiomyoma. These tumors can be successfully treated with simple excision, with a low recurrence rate.

A Study of Arthrokinematic Approach on the Low Back Problem with Referred Pain to the Leg (단순요통 및 하지통을 동반한 요통의 관절운동학적 치료법에 대한 고찰)

  • Oh, Seung-Kil
    • Journal of Korean Physical Therapy Science
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    • v.4 no.1
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    • pp.351-359
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    • 1997
  • The joint dysfunction is the major cause of pain in trunk and extremities according to J. McM. Mennell who mentioned that there were no pathological changes that was found in the painful joint. The referred pain due to joint dysfunction has to be differentiated from other painful conditions, particularly of the neuromusculoskeletal system. Most of the pain in the lower extremities is due to the sacroiliac joint dysfunction according to Setsuo Hakata who had developed arthrokinematic approach(AKA) for sacroiliac joint in 1989. AKA for sacroiliac dysfunction is made up of distraction & gliding technics that are no violent to recover the disturbed intra-articular movement and result in immediate relief of pain.

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Effects of Tai Chi Exercise Program on Muscle Strength, Flexibility, Postural balance and Cognition in Patients with Parkinson Disease (태극권 프로그램이 파킨슨병 환자의 하지근력, 관절의 유연성, 균형감 및 인지기능에 미치는 효과)

  • Choi, Dong-Won;Sohng, Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.2
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    • pp.177-185
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    • 2011
  • Purpose: To examine the effects of Tai Chi exercise (TCE) on muscle strength, flexibility of low extremities, postural balance and cognition in patients with Parkinson disease (PD). Method: A nonequivalent control-group pre and post-test design was used. Of the 30 participants 15 were assigned to the experimental group and 15 to the control group. The experimental group participated in 8 weeks of TCE which included one day of exercise with instructor on site and 3 days of self-exercise at home guided by a videotape. Results: The 8 weeks of TCE were found to be significantly effective in enhancing strength of low extremities, flexibility of ankles and shoulders, time of tandem stand with eye closed and level on the K-MMSE (Korean mini mental state examination). Conclusion: These results suggest that TCE has positive effects on physical fitness and cognition in patients with PD. Research over an extended period with the TCE intervention is recommended to identify further effects.

A Case of Psychogenic Tremor Improved by Complex Korean Medicine Treatment Including Cheongshimondam-tang-gamibang and Acupuncture Treatment - A Case Report (청심온담탕가미방과 침구치료를 포함한 복합한의치료로 호전된 심인성 떨림 환자 1례 - 증례보고)

  • Jihyun Lee;Seokyeong Yoon;Hyoenjun Cheon;Sungjun Joo;Jisu Lee;Jungtae Leem;Yanghee Han
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1186-1197
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    • 2022
  • Objectives: A case study about the effectiveness of integrative Korean medicine treatment in a psychogenic tremor patient. Case presentation: A 36-year-old male diagnosed with psychogenic tremor with low back pain underwent 29 days of inpatient treatment and 4 weeks of outpatient treatment. His pattern identification was a psychogenic tremor of the weakness of the heart and gall bladder (SimDamHeoGup) type. The treatments were herbal medicine and acupuncture. He took Cheongshimondam-tang for 29 days and Chunwangbosim-dan for 6 weeks when he had symptoms. He also received acupuncture for 20 minutes twice a day at GB20 (Pungji), L14 (Hapgok), HT4 (Yeongdo), PC6 (Naegwan), HT7 (Sinmun), GB34 (Yangleungcheon), ST36 (Joksamni), SP6 (Sameumgyo), and LR3 (Taechung). After 8 weeks of treatment, the Fahn Tolosa Marin rating (FTM) scale of his tremor, at rest, dropped from Grade 4 on both upper extremities, trunk, and both lower extremities at the time of admission to Grade 2 in both upper extremities and trunk, and Grade 0 in both lower extremities at the time of discharge. His Beck Anxiety Inventory (BAI) score decreased from 38 to 7, and his numerical rating scale (NRS) decreased from 8 to 1 for low back pain and from 9 to 2 for tremor. A follow-up visit to the hospital 2 months after the end of treatment confirmed continued symptom improvements and no significant side effects. Conclusions: This study suggests the possibility of treating psychogenic tremor using only Korean medicine treatments. Further studies with control groups and long-term follow-up are needed.

Effects of Skin Pressure by All-in-one on the Rhythm of Body Temperature During Sleep (올인원에 의한 인체 압박이 수면시의 체온 리듬에 미치는 영향)

  • Jeong, Jeong-Rim;Kim, Hee-Eun
    • Fashion & Textile Research Journal
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    • v.12 no.6
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    • pp.830-836
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    • 2010
  • The purpose of this research was to investigate the effects of skin pressure by wearing all-in-one on the rhythm of body temperature such as skin and rectal temperature which play a crucial role in the nocturnal rhythm. Five healthy female were participated in the study as subjects. The experimental clothing was an all-in-one, one of the foundation, which is worn for shaping the body. The total experimental periods were 5 days. On the 1st day, subjects did not wear the all-in-one (None), and they wore it for about 12 hours per day from 2nd to 5th day (Wearing1~4). Skin and rectal temperature were measured during the entire experimental days to figure out the rhythm of body temperature during sleep. When subjects wore the all-in-one, the gradients of the forearm and calf skin temperature at the sleep onset were significantly smaller than "None". It indicated that the rise of extremities' skin temperature was low on the "Wearing1~4". The decline of rectal temperature in "Wearing 1~4" was smaller than "None". Therefore, the skin pressure by all-in-one may cause the temperature of extremities' skin and rectum to change, resulting the fluctuation of the circadian rhythm, finally it could have effects on the rhythm of sleep.

Coverage of the Severely Traumatized Extremity by Emergency Free Flap - Case Report - (응급 유리 피판에 의한 사지 외상의 수복 - 증례 보고 -)

  • Kim, Tae-Young;Choi, Soo-Joong;Kwon, Bong-Cheol;Lee, Yong-Beom;Kim, Ki-Bok
    • Archives of Reconstructive Microsurgery
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    • v.19 no.1
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    • pp.61-67
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    • 2010
  • Emergency free flap has been advocated to cover the severely injured extremity for more than two decades, due to its numerous advantages such as low incidence of flap failure and infection rate and early recovery of function. But there are very few reports about these. The authors report their experience in using the emergency free flap for reconstruction of extremities. For last 10 years, 4 patients ranging from 3 to 27 years old with severely traumatized extremities were treated with emergency free flap transfers. Three were males and the other was a female. Flap size ranged from $2{\times}5\;cm^2$ to $7{\times}22\;cm^2$. The locations of the recipient site were the dorsum of the foot, the cubital fossa, the popliteal fossa and the upper arm. The number of the donor sites used was as follows: one scapular flap, two parascapular flaps, and one radial forearm flap with the radial bone. All of the flaps survived without need of re-exploration. There was no infection or flap loss. Involved joints have recovered a normal range of motion. Therefore, we consider that the emergency free flap is a very safe and reliable method to cover the severely injured extremities.

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The Study on Musculoskeletal Effects of Heel Types (구두 굽의 형태가 인체의 근골격계에 미치는 영향에 관한 연구)

  • Lee, Chang-Min;Jeong, Eun-Hui
    • Journal of the Ergonomics Society of Korea
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    • v.23 no.1
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    • pp.39-48
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    • 2004
  • In terms of women engaged in clerical job. working time of the workers who mainly keep standing with their high-heeled shoes on has been increasing. According]y. they are exposed to many kinds of foot deformation caused by loads of lower back and lower extremities due to high-heeled shoes. The type of heels they usually wear are diverse though the hight is same. In this study. we investigated most women's favorite styles of shoes concerned with heights. types and contact areas of the heels. Hence. we designed three kinds of shoes for an experiment: their contact areas with ground are 1 cm2. 2-4 cm2 and over 9 cm2 according to the heel heights. respectively. To investigate the biomechanical effects. analysis of motion and EMG were applied to the experiments. In addition. foot pressure distribution was measured for more detailed analysis. Six healthy young women were participated in this experiments. The result showed the heel becoming higher and narrower increased not only fluctuation of CBM(Center of Body Mass). but also the load of low back muscle and lower extremities. Accordingly. there was significant difference among types of the heel in terms of the role supporting load of the body. though the height is same. Especially. the difference among the pressures on a foot was most significant. In conclusion. we verified biomechanical effects are related with the contact area of a heel with ground as well as the hight.

Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman

  • Park, Seong Hoon;Kim, Joo Hyun;Suh, In Suck;Kim, Kwang Yong;Jeong, Hii Sun
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.18-22
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    • 2017
  • Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

A Study of Gait Patterns in Patients with Low Back Pain (요통환자의 보행패턴에 관한 연구)

  • Lee, Cu-Rie
    • Journal of Korean Physical Therapy Science
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    • v.5 no.1
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    • pp.573-581
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    • 1998
  • Gait is a highly complex activity in which many variables can be observed and measured. Walking is a repetitious sequence of limb to move the body and to maintain stability. Normal gait is rhythmic and characterized by alternating propulsive and retropulsive motions of the lower extremities. Pathological gait patterns have four functional categories (deformity, muscle weakness, impaired control, pain). The purpose of this study was to assess the quantitive gait variables(the width of the base, length of a step, stride length, cadence, velocity) in patients with low back pain. Patients walked more slowly, took shorter steps and did not show the symmetrical gait patterns.

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