• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.59-66
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• 2019

Purpose: Several radiologic reference lines have been used to evaluate individuals with a clubfoot but there is no consensus as to which is most reliable. The aim of this study was to identify which radiologic parameters have relevance to the predictability of additional surgery after Ponseti casting on clubfoot and the effect of clubfoot treatments that contain Ponseti casting and additional surgery. Materials and Methods: A total of 102 clubfeet (65 patients, 37 bilateral) were reviewed from 2005 to 2013. The patients were divided into two groups (Group A, those for whom the result of the Ponseti method was successful and did not require additional surgery; and Group B, those for whom the result of the Ponseti method was unsuccessful and required additional surgery), and the following parameters were measured on the plain radiographs: i) talo-calcaneal angle on the anteroposterior and lateral view, ii) talo-1st metatarsal angle on the anteroposterior view, and iii) Tibio-calcaneal angle on the lateral view with the ankle full-dorsiflexion state. Each radiograph was reviewed on two separate occasions by one orthopedic doctor to characterize the intra-observer reliability, and the averages were analyzed. Next, 20 cases were chosen using a random number table, and two orthopedic doctors measured the angle separately to characterize the interobserver reliability. Results: Groups A and B included 73 clubfeet (71.6%) and 29 clubfeet (28.4%), respectively. The initial talo-calcaneal angle and tibiocalcaneal angle in the lateral view were significantly different among the groups. In addition, inter- and intra-observer biases were not detected. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view were significantly different after treatment in both groups. Conclusion: Congenital clubfeet treated with the Ponseti method showed successful results in more than 70% of patients. The initial talocalcaneal angle and tibio-calcaneal angle on the lateral view were the radiologic parameters that could predict the need for additional surgical treatments. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view could effectively evaluate the changes in clubfoot after treatment.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.79-84
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• 2007

Purpose : Tibial internal torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Tibial internal torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The aim of this study is to evaluate the therapeutic effect of Tibial Counter Rotator (TCR) in patients with tibial internal torsion. Method : One hundred forty nine children (274 limbs) with tibial internal torsion participated in this study. Transmalleolar angle were measured with gravity goniometer. When tibial internal torsion was detected, TCR was applied at least for 3 hours a day during sleep. The patient's progress was followed monthly and transmalleolar angle was reevaluated by the same examiner. Results : Transmalleolar angle was significantly increased in patients with tibial internal torsion during TCR application (P<0.001). Conclusion : TCR can be one of the effective methods for correcting tibial internal torsion in children under 12 years old of age.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.34 no.6
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• pp.720-728
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• 2001

Cercaria yamagutii Ito, 1957 (C. yamagutii) was found in Lunatia fortuni (L. fortuni) and Neverita didyma (N. didyma) collected from the tideland of Sim-po located at the estuary of the Mankyong River, Chonbuk. It was finally confirmed that the parasite is Acanthoparyphium tyosenense Yamaguti, 1939 (A. tyosenense) and its life history was clarified in this study. Mactra veneriformis (M. veneriformis) was artificially infected with C. yamagutii isolated from L. fortuni and N. didyma. It began to intrude into M. veneriformis through the inhalent canal. Five hours after infection, the tails of the cercaria began to be separated from the main body and the cercaria started to form cysts. Mature cysts were formed 340 hours (14 days) after infection. The cysts were $300\sim360{\mu}m$ in diameter and the encysted metacercarias were $790\sim800\times300\sim310{\mu}m$ in size. The metacercarias were administered orally to Larus crassiostris (L. crassiostris), and adult worms of $84.5\sim112.5\times55\sim65{\mu}m$ were found full of eggs with $2.20\~3.70$ mm long and $0.40\~0.59$ mm wide after 10 days. In a field study, it was observed that the infection rate of A. tyosenense is $99.5\%$ in M. venerifomis, $76.3\%$ Solen strictus (S. strictus), and $37\%$ Ruditapes philippinarum (R. philippinarum), No difference was found among different host sizes, It was concluded that the first intermediate hosts of A. tyosenense Yamaguti were L. fortuni, N. didyma, Tympanotonus microptera, Cerithidea (Cerithidea) largillierti, Cerithidea (Cerideopsilloa) cingulata, the second intermediate hosts M. venerifomis, S. strictus and R. philippinamn, and the final hosts L. crassiostris and Melanitta fusca stejnegeri.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.13-19
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• 2001

Background : The incidence of malignant melanoma is currently increasing at a rate greater than any other cancer occuring in human. At this time, early diagnosis and surgical excision were the mainstay of treatment for patients with malignant melanoma. We reviewed the results of average 4 years of follow-up after surgical excision of total 16 cases of malignant melanoma since 1985. Materials and Methods : There were 16 patients (mean age 58.5 years, 5 men, 11 women). The site of the primary lesion was foot and toe (6), back (3), hand (2), thigh (2), shoulder (1), lower abdomen (1) and lip (1). The lymph node was involved at 9 patients. The histologic diagnosis was made with H-E, S-100 stain, and HMB-45 stain as a special stain. Results : Histologically, there were Clark's stage I for 3 patients, II in 4, III in 2, IV in 3, and stage V in 4 patients. The wide excision only greater than 2cm margin was performed for 4 patients. The wide excision and lymph node dissection were performed for 4 patients. The amputation was only performed for 3 patients, and the amputation and lymph node dissection were performed for 5 patients. After surgical excision, chemotherapy was done with Taxol for each 2 patients of stage IV and V. After long term follow-up for mean 4 years, 4 patients died related with melanoma, 1 patient was recurred, and 11 patients were cured. Conclusion : The incidence of malignant melanoma was rare in Korea, but early involvement of lymph node at initial diagnosis was found in many cases (9/16, 56%). And then, early detection and appropriated excision as well as careful dissection of adjacent lymph nodes will offer the patient the best chance for cure.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.103-113
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• 1999

The authors surveyed the inhabitants of a rural area to assess the patterns of medical utilization on dermatoses. Seven hundred and sixty new outpatients of dermatoses were examined and surveyed with formed questionnaire from March 1997 to February 1999. The results are as follows; 1. Among 760 new outpatients, the number of male patients was 283(37.2%) and that of female patients was 477(67.3%). 2. The most common dermatoses was Tinea pedis(34.9%), and follows senile pruritus, contact dermatitis, housewife eczema, seborrheic dermatitis, numular dermatitis, atopic dermatitis, Tinea corporis, Tinea ungium, acne vulgaris, impetigo, keratolysis exfoliativa, chronic urticaria, Tinea cruris and Molluscum contagiosum in orders. 3. Drug store was the most frequent places where patients initially visited for their skin diseases(39.6%) and followed by non dermatologic clinic, dermatologic clinic and general hospital in orders. 4. One hundred and twenty one(15.9%) patients have been experienced folk treatment. It was founded that the topical vinegar application or soaking was the most common method. Many patients felt no symptom improvement after the folk treatment(48.8%). Seventeen point four percent of patient felt symptom worsened. The results of this study suggest that many of the rural inhabitants are lack of understanding on their dermatoses. So many physician who are in charge of the primary care in rural area have to pay attention to the common dermatoses and educate patients on their medical utilization.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.155-160
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• 1997

Purpose : Tethered cord syndrome is characterized by progressive motor and sensory disturbances in lower extremities, foot deformities caused by a pathologic fixation of spinal cord resulting in excessive stretching of the spinal cord. It is also frequently associated with urological symptoms include urinary frequency, incontinence, enuresis, urgency and recurrent urinary tract infection. Because there is few report in the literature about urological manifestations of theterd cord syndrome, we conducted a retrospective study on the patients diagnosed as tethered cord syndrome to delineate the characteristics of urologic manifestations in tethered cord syndrome and to establish the policy to evaluate patients who is suspected of tethered cord syndrome. Method : A retrospective study was conducted by reviewing the medical records of nine patients who was diagnosed as tethered cord syndrome from November 1991 to July 1996 in Yeungnam University Hospital. Result : 1) The age distribution of nine patients was as follows; 5 patients were under 2 years, 1 case from 2 to 6 years and 3 cases from 6 to 10 years. 2) Of 9 patients 6 had voiding frequency, urinary incontinence, enuresis, urgency and loss of micturation sense. Radiologic urodynamic studies revealed neurogenic bladder in 5 patients, hydronephrosis and hydroureter in 3, vesicoureteral reflux in 3. 3) Of 6 patients with urological abnormal manifestations 4 underwent spinal cord surgery (detethering). In spite of surgical intervention, the urological manifestations improved in only one patient. Conclusion : Urological abnormalities were common in tethered cord syndrome. Abnormal laboratory findings including urodynamic study were found even before the onset of urological symptoms. We have to concern tethered cord syndrome as one of common causes of voiding frequency and enuresis and to evaluate urological abnormalities as thetered cord syndrome is diagnosed.

• Journal of Hospice and Palliative Care
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• v.12 no.3
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• pp.132-138
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• 2009

Proper education of hospice professionals is essential for ensuring quality of end-of-life care. In 2005, 'End-of-life Care Task Force Team' by Ministry of Health and Welfare established '60 hours of hospice education' as basic requirement for hospice professionals. This study is aimed to determine how many of the hospice professionals meet with the criteria and whether there are significant regional variations. Methods: We analyzed the data from 46 hospice organizations, which submitted the application to the 2008 designation program of Ministry of Health, Welfare, and Family Affairs. Data included details of the educational records of each hospice professionals. Results: Total 673 hospice professionals were included in the analysis. Overall, only 41.5% (279/673) met the requirement. Nurses (46.8%; 177/378) were more likely to meet the requirement than doctors (35.8%; 38/106), social workers (32.0%; 24/75) and clergies (35.1%; 40/114). Hospice professionals of the organizations in metropolitan area received more education than those in small cities or rural area (52.4% vs. 25.0% for doctors, 50.6% vs. 43.9% for nurses, 42.9% vs. 25.5% for social workers). By geographic areas, hospice professionals in southeast regions received less education than other part of Korea (28.1% vs. 43.0${\sim}$48.8%, respectively). Conclusion: Less than half of the Korean hospice professionals has received proper amount of hospice education, and significant regional variations existed. National programs to promote the education of hospice professionals and eliminate its disparities are greatly warranted. Implementation of the 60-hour currirulum for hospice professionals, based on the train-the-trainer model, would be regarded as one potential solution.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.181-189
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• 2010

Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.909-916
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• 2001

Background : Varicose vein is a very common vascular disease and has recently become a matter of concern for thoracic and cardiovascular surgens. Material and Method : We analyzed 209 cases or 269 feet with varicose vein retrospectively, which had been treated in our hospital from April 1999 to December 2000. Result : Male : Female ratio was 1:3(Male : 52 cases, Female : 157 cases), mean age was 42.2$\pm$9.7 years old, mean duration of varicosities was 12.2$\pm$9.7 years, and mean follow up was 14.8$\pm$6.1 months from July 2001. Most common symptom was leg pain(122 cases, 58.4%). Long standing job(44 cases), pregnancy(37 cases), and family history related to varicose vein came to 79.9% as the major predisposing or precipitating factors. Anatomic classifications of main lesion were GSV (greater saphenous vein,126 cases), LSV(lesser saphenous vein,18 cases), and reticular veins and telangiectasias(65 cases). Main treatments were stripping of GSV, stab avulsion, ligation of saphenofemoral junction, sclerotherapy, and conservative treatment. Comparing A group (stripping of GSV) with B group(sclerotherapy of GSV), A group had more complications than B group; however, A group had less recurrences than B group(p 0.05). Comparing C group(stab avulsion of LSV) with D group(sclerotherapy of LSV), there were 2 cases of recurrence in D group; however, there were no statistical differences between the two groups in complication and recurrence(p>0.05). Comparing B group(sclerotherapy of GSV) with E group(sclerotherapy of reticular vein and telangiectasia), there were no differences in complication; however, B group had more recurrences than E group. Post-stripping complications were ankle numbness and tingling(2 cases), ankle pain(2 cases),ankle swelling(2 cases), and wound pain(1 case). Postsclerotherapy complications were thrombophlebitis(1 case) and skin ulcer(1 case). Conclusion: Sclerotherapy for varicose vein involving GSV had more recurrences than stripping for lesions involving GSV. Sclerotherapy for reticular vein and telangiectasia had less recurrences than sclerotherapy for lesion involving GSV. Sclerotherapy is a very convenient method without operation and admission, thus further research is demanded in case of varicose vein involving GSV.