• Journal of Trauma and Injury
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• v.26 no.1
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• pp.14-17
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• 2013

Purpose: The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen. Methods: A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery. Results: There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery. Conclusion: Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.1-15
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• 2021

Objective: The purpose of this study was to examine the differences in joint position sense (JPS), force sense (FS), and performance level of the upper extremities according to the injury and pain experiences of Korean elite archers. Methods: A total of 15 subjects were briefed about the purpose of this study and agreed to participate voluntarily. JPS was evaluated using the laser-point attached to the wrist while aiming at the target. The difference when relocating while aiming was used as JPS factor. FS was evaluated using load cell through reproduces same muscle strength. Fear-Avoidance Beliefs Questionnaire (FABQ) was used to evaluate psychosocial factors, Kerlan-Jobe Orthopedic Clinic overhead athlete scores (KJOC) and numerical rating scale (NRS) was used to evaluate pain. and performance was evaluated by tournament match score. Results: There is a strong correlation between the current pain and KJOC. Moreover, moderate correlation between KJOC and FABQ also current pain and both upper trapezius and lower trapezius in elite archers. The mean (SD) between groups based on current pain display relatively large margin in force sense than without pain group. The result presents that there is a significant difference in performance and pain. There is a significant difference in the force sense of the upper and lower trapezius and pain. Conclusions: Result present there is a significant difference in functional level in the average comparison between groups according to the presence of absence of current pain. There is a significant difference in the force sense of the upper trapezius as well as lower trapezius and without pain group present a relatively low joint position sense error compared to the groups.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.586-592
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• 2023

Background One-stage reconstruction with "thin perforator flaps" has been attempted to salvage limbs and restore function. The deep inferior epigastric perforator (DIEP) flap is a commonly utilized flap in breast reconstruction (BR). The purpose of this study is to present the versatility of DIEP flaps for the reconstruction of large defects of the extremities. Methods Patients with large tissue defects on extremities who were treated with thin DIEP flaps from January 2016 to January 2018 were included. They were minimally followed up for 36 months. We analyzed the etiology and location of the soft tissue defect, flap design, anastomosis type, outcome, and complications. We also considered the technical differences in the DIEP flap between breast and extremity reconstruction. Results Overall, six free DIEP flaps were included in the study. The flap size ranged from 15 × 12 to 30 × 16 cm². All flaps were transversely designed similar to a traditional BR design. Three flaps were elevated with two perforators. Primary closure of the donor site was possible in all cases. Five flaps survived with no complications. However, partial necrosis occurred in one flap. Conclusion A DIEP flap is not the first choice for soft tissue defects, but it should be considered for one-stage reconstruction of large defects when the circulation zone of the DIEP flap is considered. In addition, this flap has many advantages over other flaps such as provision of the largest skin paddle, low donor site morbidity with a concealed scar, versatile supercharging technique, and a long pedicle.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.80-86
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• 2010

Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

• Journal of Korean Medicine for Obesity Research
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• v.13 no.1
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• pp.33-45
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• 2013

Objectives: This study was aimed to find out the characteristics of ordinary symptoms between the control and patient groups, diagnosed as overweight or obesity, in Soyang, Taeeum, and Soeum Constitutions and among those 3 groups. Methods: As a prospective cross-sectional study based on medical records, 9213 patients, who visited Kyung Hee University Medical Center from May in 2007 to June in 2010, were included. To diagnose the constitution, Revised Questionnaire for the Sasang Constitution Classification II and examinations by oriental medical doctors who majored in Sasang Constitution Medicine were performed. Based on the World Health Organization criteria for Asian obesity assessment, body mass index (BMI) was classified into 3 groups; more than 25 as obesity, 23 to 25 as overweight, and less than 23 as normal. Ordinary symptoms questionnaire, which consists of 46 questions in 8 categories, were given to the subjects. One-way ANOVA test in continuous variables and chi-square test in categorical variables were carried out to analyze statistical significance. Results and Conclusions: 1) In general characteristics, we could find out the significant differences in age, sex, height, weight, BMI, waist circumference, blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood sugar, and hemoglobin A1c among the 3 Constitutional groups. 2) Soyang Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 3) Taeeum Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 4) Soeum Constitution of overweight and obesity has tendency to have higher appetite and less fatigue in the ordinary symptoms, compared with the control group. 5) Soeum Constitution showed the slightest increase in appetite, preference about room temperature water, less number of feces, and feeling of chill and warmer extremities in ordinary symptoms, compared with Soyang and Taeeum Constitutions. Taeeum Constitution showed the distinct increase in appetite and sweating in ordinary symptoms, compared with Soyang and Soeum Constitutions.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.148-154
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• 2003

Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.5 no.1
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• pp.59-74
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• 1999

66 patients with low back pain were evaluated to determine if any differences of weight bearing were existed between the same side leg that feel pain(pain side leg) and that without pain (non-pain side leg) of lower extremities while weight bearing. 66 patients were divided into 3 groups according to pain pattern such as low back pain only(26), radiating pain only(21) and low back pain with radiating pain (19). Control group were 28 normal persons. The weight bearing was rated by Limloader(Model LLD-2000, Ver 1.2) and analyzed by paired and independent t-test, one-way ANOVA, Dunan's analaysis and Pearson's correlation analysis. The results of this study were as follows : 1. In patient group, significant difference of weight bearing rating between pain side leg and non-pain side leg was found. There was borne significantly less weight bearing rating(14.68%) on the pain side leg(P<.001). 2. In normal group, there was no significant difference between left and right leg(P>.05). But there was significant difference(3.21%) in absolute difference of both leg(p<.001). 3. The difference of 1 and 2 was 11.47% : more difference of weight bearing rating between both legs in patient group than that of the control group(p<.001). 4. There were significant differences of weight bearing rating in those 3 groups : low back pain group(10.30%), radiating pain group (17.90%) and low back pain with radiating pain group (17.10%) (p<.001). 5. There was significant correlation between pain intensity and difference of weight bearing rating(p<.05). The severer pain intensity. the more difference of weight bearing rating was found. 6. There was no significant correlation between the age, height and duration of symptom, etc(p>.05).

• Journal of Korean Neurosurgical Society
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• v.55 no.2
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• pp.110-113
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• 2014

Perineurial cysts (Tarlov cysts) are lesions of the nerve root that are often observed in the sacral area. There is debate about whether symptomatic perineurial cysts should be treated surgically. We presented three patients with symptomatic perineurial cyst who were treated surgically, and introduced sacral recapping laminectomy. Patients complained of low back pain and hypesthesia on lower extremities. We performed operations with sacral recapping technique for all three. The outcome measure was baseline visual analogue score and post operative follow up magnetic resonance images. All patients were completely relieved of symptoms after operation. Although not sufficient to address controversies, this small case series introduces successful use of a particular surgical technique to treat sacral perineural cyst, with resolution of most symptoms and no sequelae.

• The Korean Journal of Pain
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• v.29 no.4
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• pp.274-276
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• 2016

Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

• The Journal of Korean Physical Therapy
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• v.21 no.1
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• pp.35-40
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• 2009

Purpose: The purpose of this study was to investigate change of muscle activities during level walking, stairs and ramp climbing in old adults. Methods: Twelve old adults were recruited and agreed this study. Muscle activity was measured by MP150 system (BIOPAC System Inc., Santa Barbara, USA). Statistical analysis was used one-way ANOVA to know the difference according to gait conditions (level walking, stairs and ramp ascending) Results: In stance phase, muscle activities of low extremities with old adults were generally significant difference in ramp ascending. In swing phase, rectus femoris and biceps femoris activity in old adults generally more increased during stairs ascending and tibialis anterior and gastrocnemius activity in old adults generally increased during ramp ascending. Conclusion: These results indicate that stair and ramp climbing is different muscle recruit pattern to level walking.