• 대한한방내과학회지
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• 제41권2호
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• pp.256-266
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• 2020

Objectives: This report presents the case of a 21-year-old woman with lower extremity paresthesia in both feet due to polyneuropathy. Methods: The patient was treated using a Korean traditional complex treatment approach that included herbal medication, acupuncture, electroacupuncture, and moxibustion. We evaluated the improvements in the pain symptoms in both feet using the numeric rating scale (NRS); we also assessed for gait disturbance and used Digital Infrared Thermographic Imaging (D.I.T.I.) to evaluate minute changes in body temperature in diseased areas. Results: After administering the Korean traditional complex treatment, we observed a decrease in pain levels in both feet based on the NRS scores. We also observed improvements in gait disturbance and D.I.T.I. Conclusions: This case showed that the use of a Korean traditional complex treatment approach, consisting of herbal medication, acupuncture, electroacupuncture, moxibustion, had a positive effect on decreasing polyneuropathy symptoms.

• The Korean Journal of Pain
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• 제14권2호
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• pp.271-275
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• 2001

Buerger's disease is a nonatherosclerotic occlusive inflammatory disease of the small and medium arteries, and veins of the distal leg or arm. Percutaneous lumbar sympathectomy is used to lower extremity occlusive vascular disease as well as Buerger's disease. Lumbar sympathectomy improves blood flow and provides pain relief in the lower extremity. We report two cases of lumbar sympathectomy using radiofrequency thermocoagulation in patients with Buerger's disease. After no paresthesia and muscle contracture at 50 Hz, 1 volt and 2 Hz, 3 volts, respectively, radiofrequency lesioning was performed for 90 sec at $80^{\circ}C$. After the procedure, both patients showed skin temperature increases greater than $2^{\circ}C$ on the affected extremity. Both patients received relief from pain and symptoms without complications. We consider that lumbar sympathectomy using radiofrequency thermocoagulation is a safe and effective procedure that can relieve pain in patients with Buerger's disease.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.648-651
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• 2006

Purpose: Tarsal tunnel syndrome is characterized by pain and paresthesia of the entire posterior tibial nerve and its branches of the lower extremity. The cause of the tarsal tunnel syndrome is usually unknown but, rare case of space occupying benign tumors such as a ganglion may be one of the causes. We report our experiences of surgical treatment of the tarsal tunnel syndrome caused by ganglion we have encountered recently. Methods: A 54-year-old male patient presented with paresthesia, burning pain, positive Tinnel's sign without preceeding trauma, infection or any other causes of event. With surgical intervention, we completely removed the space occupying ganglion and with performed surgical release of the posterior tibial nerve and its branches. Results: At a 14-month follow up examination, the symptoms of paresthesia, burning pain, sensory disturbance was much improved compared to the preoperative conditions. Takakura's rating scale was elevated from 4(Poor) to 8(Good). Conclusion: We report our surgical experience of a rare case of tarsal tunnel syndrome caused by a ganglion, with a review of literature.

• Journal of Chest Surgery
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• 제33권10호
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• pp.792-797
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• 2000

Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.691-698
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• 2021

Background The reverse sural artery (RSA) flap is widely used for lower extremity reconstruction. However, patients sometimes suffer from donor site complications such as scar contracture and paresthesia, resulting in dissatisfaction with the aesthetic outcomes. This study investigated the characteristics of donor site morbidity associated with RSA flaps and described our experiences of dealing with complications by performing resurfacing surgery using thoracodorsal artery perforator (TDAP) flaps. Methods From April 2008 to August 2018, a total of 11 patients underwent contracture release and resurfacing surgery using TDAP flaps due to donor morbidity associated with RSA flaps. All affected donor sites were covered with a skin graft, the most common of which was a meshed split-thickness skin graft (six cases). Results Eight of the 11 patients (72.7%) suffered from pain and discomfort due to scar contracture, and seven (63.6%) complained of a depression scar. The donor sites were located 6.3±4.1 cm below the knee joint, and their average size was 140.1 cm². After resurfacing using TDAP flaps, significant improvements were found in the Lower Extremity Functional Scale (LEFS) scores and the active and passive ranges of motion (AROM and PROM) of the knee joint. The LEFS scores increased from 45.1 to 56.7 postoperatively (P=0.003), AROM increased from 108.2° to 118.6° (P=0.003), and PROM from 121.4° to 126.4° (P=0.021). Conclusions Planning of RSA flaps should take into account donor site morbidity. If complications occur at the donor site, resurfacing surgery using TDAP flaps achieves aesthetic and functional improvements.

• The Journal of Korean Physical Therapy
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• 제32권2호
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• pp.80-87
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• 2020

Purpose: Some patients who have undergone surgery due to lumbar disc herniation still complain of leg pain and other abnormal sensations. Therefore, the study examined the effects of the neurodynamics on pain and other abnormal nerve sensations in post-operated patients with lumbar disc herniation. Methods: The participants of this study comprised 20 adults (10 males and 10 females) who were diagnosed with lumbar disc herniation. The subjects were classified into two groups of 10 patients each in the lower extremity neurodynamics (LEN) and lumbar stabilization exercise (LSE) groups. Each intervention was applied twice a day for one week and was composed of two different exercise patterns; one was applied by a therapist, and the other was performed by the patients themselves. The data were analyzed using assessment methods of Digital Infrared Thermal Imaging (DITI), Toronto clinical neuropathy scoring system (TCNSS), Sympathetic Skin Response (SSR) test, and Oswestry Disability Index (ODI) scale. Results: Significant differences in TCNSS, DITI, ODI scale were observed between the LEN and LSE group (p<0.01). On the other hand, there was no significant difference in the SSR test between pre and post-treatment (p>0.05). Conclusion: The results indicated that neurodynamics treatment is effective in pain reduction and abnormal sensations, such as leg muscle cramps, in post-operated patients with lumbar disc herniation.

• Annals of Clinical Neurophysiology
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• 제10권2호
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• pp.109-111
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• 2008

Ossification of the ligamentum flavum (OLF) usually occurs in the lower thoracic spine, and is rare in the cervical region. We report the case of a 67-year-old woman who presented a seven month's history of progressive weakness and paresthesia in her right upper extremity. MRI and CT scans of the spine revealed the presence of ossified ligamentum flavum from C3-C4. A cervical laminectomy resulted in a good post-operative improvement of muscle strength.

• The Korean Journal of Pain
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• 제28권4호
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• pp.275-279
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• 2015

Facet joint synovial cysts are usually associated with osteoarthritis of the adjacent facet joint and/or spondylolisthesis. In between the conservative and operative ends of the treatment spectrum lie minimally invasive techniques such as cyst rupture using epiduroscopy. In this report, we describe an 82-year-old male patient presenting with low back pain radiating to his lower left extremity and associated paresthesia. Magnetic resonance imaging of the lumbar spine revealed a synovial cyst at left L4/5 facet joint. Using epiduroscopy, the cyst was mechanically ruptured by popping it with the tip of the scope. The patient remained symptom-free at his successive visits until 12 months after the procedure, and was opened for desired follow up.

• 대한한방내과학회지
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• 제41권1호
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• pp.69-80
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• 2020

Objective: The aim of this study was to report the improvement of stroke symptoms in patients using Mokdanpisaback-san. Methods: This study was carried out on patients hospitalized at the Department of Korean Internal Medicine of Jecheon Korean Medicine Hospital of Semyung University from October 2014 to September 2019. A retrospective study was performed on 43 patients who were diagnosed with stroke and Soyangin and treated with Mokdanpisaback-san. Results & Conclusion: 1. Mokdanpisaback-san is effective in improving various symptoms of stroke, including dysarthria, dysphagia, movement disorder, paresthesia, quadriplegia, and dizziness. 2. Mokdanpisaback-san significantly improves the motor disorders of stroke, including lower extremity muscle strength, standing, and walking disorders. 3. Mokdanpisaback-san does not affect the liver or kidney function.

• Journal of Acupuncture Research
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• 제17권3호
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• pp.116-124
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• 2000

This clinical study was carried out 15 cases with lumbar spinal stenosis patients, who had been admitted and diagnosed by Computed Tomography from June, 1999 to May, 2000, in the department of acupuncture and moxibustion. Hanseo University Oriental Medical Nospital. The results obtained from this study were as follows; 1. We investigated 10 female and 5 male patients. The age distribution was from early 20's to 70's, among which 30's and 50's were most common. 2. The most common duration of symptom was less than a year(46.7%). 3. Regarding to the number of the involved levels, one was 12 cases(80%), two was 3 cases(20.0%). In the one level cases, L4~5 was the most common involved site. 4. Regarding to the clinical symptoms, low back pain was the most common, followed by lower extremity radiating pain, intermittent claudication, lower extremity paresthesia. 5. In orthopaedic examinations, positive sign in Milgram test was 80.0%, positive sign in straight leg raising test was 40.0%, and positive sign in Braggard test was 33.3%. Inneurologic examinations, sensory loss was seen in 60.0%, motor weakness and decreased deep tendon reflex were 26.7% in each. 6. According to clinical symptom scale proposed by Chae(1989), grade I1I was the most common (53.3%), followed by grade II, grade IV, grade I . 7. According to treatment outcome scale proposed by Chae(1989), Good was the most common (73.3%), followed by Excelleat, Fair and Poor.