• Archives of Plastic Surgery
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• v.46 no.1
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• pp.75-78
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• 2019

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

• Clinical Pain
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• v.20 no.2
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• pp.122-126
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• 2021

When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

• Korean Journal of Applied Biomechanics
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• v.25 no.2
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• pp.141-147
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• 2015

Objective : This study aimed to understand how increased heart rates at the time of drop landing during a step test would affect biomechanical variables of the lower extremity limbs. Background : Ballet performers do more than 200 landings in a daily training. This training raises the heart rate and the fatigability of the lower extremity limbs. Ballet performance high heart rate can trigger lower extremity limb injury. Method : We instructed eight female ballet dancers with no instability in their ankle joints(mean ${\pm}$ SD: age, $20.7{\pm}0.7yr$; body mass index, $19.5{\pm}1.2kg/m^2$, career duration, $8.7{\pm}2.0yr$) to perform the drop landing under the following conditions: rest, 60% heart rate reserve (HRR) and 80% HRR. Results : First, the study confirmed that the increased heart rates of the female ballet dancers did not affect the working ranges of the knee joints during drop landing but only increased angular speeds, which was considered a negative shock-absorption strategy. Second, 80% HRR, which was increased through the step tests, led to severe fatigue among the female ballet dancers, which made them unable to perform a lower extremity limb-neutral position. Hence, their drop landing was unstable, with increased introversion and extroversion moments. Third, we observed that the increasing 80% HRR failed to help the dancers effectively control ground reaction forces but improved the muscular activities of the rectus femoris and vastus medialis oblique muscles. Fourth, the increasing heart rates were positively related to the muscular activities of the vastus medialis oblique and rectus femoris muscles, and the extroversion and introversion moments. Conclusion/Application : Our results prove that increased HRR during a step test negatively affects the biomechanical variables of the lower extremity limbs at the time of drop landing.

• Korean Journal of Applied Biomechanics
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• v.18 no.1
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• pp.21-30
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• 2008

The purpose of this study was to investigate the variability to compare local dynamic stability via a linear and nonlinear analysis during walking. Twenty four elderly males, 12 healthy elderly and 12 patients with osteoarthritise walked on a treadmill for 100 consecutive strides. Lyapunov exponent and correlation dimension and coefficient variation were calculated for the kinematic parameters to determine the dynamic stability during walking. The linear measures indicated that the healthy elderly demonstrated significantly higher variability in the ankle joint displacement. The nonlinear analysis revealed that COD for the knee joint angle were higher in patient with osteoarthritise. There were no coincidence in results between linear and nonlinear techniques over two groups. In light of nonlinear analysis, it was concluded that patients with osteoathritise showed higher local instability during walking.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.9
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• pp.3834-3842
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• 2011

The purpose of this study is to analyze the kinematic characteristics of children with Down syndrome got congenitally joint laxity and muscle hypotonic. The subjects are boys with Down syndrome and don't have the other disabilities. We got three dimensional position data and then calculated spatiotemporal and kinematic variables during walking on treadmill used increasingly for gait analysis and training. In result, in order to overcome their gait instability due to their musculoskeletal characteristics they walked with hip, knee and ankle joints more flexed than the typical gait pattern, and on the propulsion phase they extend the lower limb joints less than the typical, result in propel the body less than. The reason is that the more is the propulsion by extending the joints, the greater is the reaction force from the ground on heel contact. This result is expected to be used to develop the training program for intensification of musculoskeletal system aim to improve the other musculoskeletal disabilities as well as Down syndrome.

• Physical Therapy Korea
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• v.28 no.1
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.129-134
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• 2006

Purpose: In the professional soccer team, we performed pre-seasonal physical examination and analyzed the results to establish a standardization data in relation to their position. Materials and Methods: We performed physical examination to the professional soccer team, consisted 34 player's average age 24.9 years. The examination performed were questionnaire on history, musculoskeletal examination, muscle power test, physiologic test, functional test. Results: According to the relationship between player position and injury pattern,. Knee injuries are most frequent on history. Physical examination outcome was that forward were prone to flexor hallucis longus tendinitis, midfielder for chronic ankle instability, defender for achilles tendinitis. Isokinetic test was done at dominant side, Peak torque to body weight ratio was 55.1%. Physiologic test checked body fat percentage was midfielder was superior as 19.8 (SD 2.9). Functional test out-come was that back strength 125 N. sergeant jump 59.6 cm, reaction time 208.5 sec, flexibility 19.2 m/s, side step 39.9 cm. Conclusion: Pre-seasonal physical examination gave us the standardization data and preventive measurement could be advocated from this results.