• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2322-2328
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• 2013

The aim of this study was to quantify the sedative effects of high spinal anesthesia, according to patient age, by also evaluating respiratory and hemodynamic changes. A prospective study was performed in 60 patients who were electively scheduled for lower limb or lower abdominal surgery. They were allocated into one of 2 groups according to their age: older age (51-80 years) and young age (20-50 years). In all groups, the lowest intraoperative bispectral index (BIS) values significantly lower than preoperative values. Patients in the older age group had significantly lower intraoperative BIS values than younger patients. The sedative effect of high spinal anesthesia is greater in older patients than in young patients, with an increase in respiratory instability. Our study showed a negative correlation between age and lowest BIS value; the lowest BIS value was reduced in older patients.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.597-603
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• 2017

Objective : Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. Methods : Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6-7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9-10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. Results : We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. Conclusion : This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.

• Journal of Korean Medical Ki-Gong Academy
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• v.19 no.1
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• pp.25-42
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• 2019

Objective : This study is a report on treatment effect of Korean medical treatment to ALS(Amyotrophic Lateral Sclerosis) patient. The purpose of this case study is to improvement of Korean medical treatment and evaluate prognosis and clinical course of ALS patients. Methods : The patient was treated by acupuncture, Su-Gi therapy, herbal medication, physical treatment. To determine the effects of Korean medical treatment, we evaluated every four days used by Korean version of Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (KALSFRS-R), Amyotrophic Lateral Sclerosis Severity Scale(ALSSS). Results : Before mental contraction caused by everyday life nursing management, symptoms such as lumbar pain, getting hoarse, lower limb powerless & spasticity, upper limbs powerless, neckache, tongue-tied etc. were improved after above treatment. K-ALSFRS-R and ALSSS scores were also increased till patient's mental contraction Conclusions : The Korean medical treatment is effective on local symptoms of ALS, and there is also functional improvement of ALS diagnosed by external examination. It is necessary to have more examination about ALS.

• Korean Journal of Applied Biomechanics
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• v.20 no.4
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• pp.479-486
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• 2010

The purpose of this study was to determine the effects of high-heeled shoe on the quiet standing and gait balance. Twenty women (mean height: $161.6{\pm}3.3\;cm$, mean body mass: $53.8{\pm}6.3\;kg$, mean age: $23.8{\pm}2.7$ yrs..) who were without history or complain of lower limb pain took part in this study. They were asked to stand quietly on a force platform for 30 sec and walk on it at their preferred walking speed (mean speed $3.14{\pm}0.5\;km/hr$.) with wearing three different high-heeled shoe, 3, 7, 9 cm high for collecting data. Data were randomly recorded to collect two trials for quiet standing and five trials for walking The parameters to have been analyzed for comparison between three conditions of the height of high-heeled shoe were COP(Center of Pressure) range, COP velocity, sway area, and free moment on the static balance and COP range, COP velocity, and free moment on the dynamic balance. In this study, high-heel height affected on the COP range and velocity in the ante-posterior direction during walking, dynamic balance, but didn't affect on the quiet standing, static balance.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.406-409
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• 2018

Aortocaval fistula (ACF) occurs in <1% of all abdominal aortic aneurysms (AAAs), and in 3% to 7% of all ruptured AAAs. The triad of clinical findings of AAA with ACF are abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass. Other findings include pelvic venous hypertension (hematuria, oliguria, scrotal edema), lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. Surgery is the main treatment modality. We report successful surgical treatment in a patient with a ruptured AAA with ACF who presented with cardiogenic shock.

• Journal of Korean Physical Therapy Science
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• v.26 no.1
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• pp.9-14
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• 2019

Background: Pes planus, or flat foot, causes lower limb malalignment and foot pain during walking or exercise. Therefore, a highly reliable evaluation method to accurately diagnose flat feet is necessary. This study investigated the intra-and inter-rater reliability of the navicular drop test in different postures. Design: Cross sectional study. Methods: Forty healthy volunteers performed the navicular drop test in three different combinations of non-weight-bearing and weight-bearing postures (standing/standing, sitting/sitting, and sitting/standing). Two examiners alternately performed the measurements five times in each subject, and in each posture. Significant differences in measurements were obtained among the three postures, with the highest navicular drop being observed in the sitting/standing posture. Results: Inter-rater reliability was high in the sitting/standing and sitting/sitting postures. Intra-rater reliability was high in all three postures. In the sitting/sitting and sitting/standing postures, large navicular drop values and high inter- and intra-rater reliability were observed. Conclusion: Therefore, the sitting/standing and sitting/sitting postures are recommended for use in navicular drop tests to diagnose flat feet.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.106-112
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• 2016

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

• The Journal of Korea Robotics Society
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• v.12 no.2
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• pp.132-143
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• 2017

While working in an industrial environment which requires extended periods of upright posture; workers tend to develop muscle fatigue due to the constant load on lower-limb muscles. In addition, when working while bending knees; muscle fatigue of lower back and hamstrings is increased due to the abnormal posture. This can lead to damage of muscles, induce musculoskeletal disorders, and reduce long-term working efficiency. Recent medical studies have shown that long-term working in an upright posture can induce musculoskeletal disorders such as foot fatigue, edema, pain and varicose veins. Likewise, medical and rehabilitation expenses have grown due to the increase in musculoskeletal conditions suffered by workers. For this problem, we aim to develop a device that can reduce the physical fatigue on the lower limbs by supporting the weight of workers during the extended periods of upright and bending postures in the industrial environments. In this paper, we have designed and manufactured a wearable weight support system; with a user intention algorithm that the users can maintain various postures. For validation of the developed system, we measured the muscle activity of the users wearing the system with EMG sensors.

• Journal of the Korean Society for Precision Engineering
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• v.25 no.11
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• pp.107-118
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• 2008

In this study, lower extremity joint kinematics and kinetics and lumbar lordosis were investigated for two different symmetrical lifting techniques(squat and stoop) using the three-dimensional motion analysis. Twenty-six male volunteers lifted boxes weighing 5, 10 and 15kg by both squat and stoop lifting techniques. There were not significant differences in maximum lumbar joint moments between the two techniques. The hip and ankle contributed the most part of the support moments during squat lifting, and the knee flexion moment played an important role in stoop lifting. The hip, ankle and lumbar joints generated power and only the khee joint absorbed power in the squat lifting. The knee and ankle joints absorbed power, the hip and lumbar joints generated power in the stoop lifting. The bi-articular antagonist muscles' co-contraction around the knee joint during the squat lifting and the eccentric co-contraction of the gastrocnemius and semitendinosus were found to be important for straightening up during the stoop lifting. At the time of lordotic curvature appearance in the squat lifting, there were significant correlations in all three lower extremity joint moments with the lumbar joint. Differently, only the hip moment had significant correlation with the lumbar joint in the stoop lifting. In conclusion, the knee extension which is prominent kinematics during the squat tilling was produced by the contributions of the kinetic factors from the hip and ankle joints(extensor moment and power generation) and the lumbar extension which is prominent kinematics during the stoop lifting could be produced by the contributions of the knee joint kinetic factors(flexor moment, power absorption, bi-articular muscle function).

• Archives of Plastic Surgery
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• v.48 no.6
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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.