• Title/Summary/Keyword: Below-the-knee

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The Sixteen Arhat Images of the Koryo Period at Sungbul-sa, Chunan (천안 성불사 고려시대 마애십육나한상 (天安 成佛寺 高麗時代 磨崖十六羅漢像))

  • Choe, Seong-Eun
    • Korean Journal of Heritage: History & Science
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    • v.33
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    • pp.162-181
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    • 2000
  • This paper investigates sixteen rock-cut arhat images of the Koryo period at Sungbul-sa (成佛寺) in Chunan (天安), South Chungchung Province. These images, together with a Buddha triad in the center, are carved in thin relief on the large granite wall ($375cm{\times}248cm$), and below them is engraved a huge lotus petal which looks to be supporting all the images above. According to extant textual sources, arhats were popularly worshipped in the Koryo period. The Painting of Five Hundred Arhat Images was brought to Koryo from Later Liang (後梁) of the Five Dynasties (五代) in 923. From that time on, the cult of arhat had become gradually known in Koryo. More than thirty ceremonies worshipping arhats (羅漢齊) were officially held in Koryo court. The Sixteen Arhat images (十六羅漢像) were enshrined in many temples. In Boje-sa (普濟寺), which kings and aristocrats often visited for ritual ceremonies, had its main hall dominated by the Five Hundred Arhats, called Nahan-pocheon (羅漢寶殿). However, a limited number of arhat images of the Koryo period, originally made as sets of sixteen or five hundred arhats, are now extant. The Sixteen Arhat images at Sungbul-sa are unique examples that show all sixteen images in situ. The Sixteen Arhat images, though some of them are abraded, show various postures and gesture. One of them sits with his knee bent, and one arhat is sitting on a chair with his hand held upward. Each image is carved in a niche, just as the arhat images of Northern Song China are normally represented in niches of a cave, and are quite similar in style to the arhat images of the Northern Song period at Qinglindong (靑林洞) cave, Feilaifeng (飛來峰), Zejiang province (浙江省). This similarity between the arhat images of Sungbul-sa and those of Qinglindong certifies the strong impact of Song Buddhist art on Koryo frequently mentioned in texts. The Sixteen Arhat images surround the central Buddha raising his hand up to his chest. This Buddha triad could be ascribed to be either the Maitreya Buddha triad or the Sakyamuni Buddha triad based on the Lotus Sutra (妙法蓮華經). Still, the Sakyamuni Buddha triad was more often represented with sixteen or five hundred arhats in the Koryo period, as was seen in the record of Boje-sa where the Sakyamuni triad was enshrined with five hundred arhat images. The Sixteen Arhat images of Sungbul-sa arc most likely to be a rare example of Koryo Arhat images showing the Sakyamuni Buddha triad and the Sixteen Arhats who were predicted to be Buddhas by Sakyamuni in the Lotus Sutra.

Modified Inside-Out Suture Technique for Meniscus Repair (변형된Inside-Out 술식을 이용한 반월상 연골 봉합술)

  • Ahn Jin-Hwan;Wang Joon-Ho;Yoo Jae-Chul;Kim Hyung-Gun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.118-123
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    • 2002
  • Purpose: To report modified technique of inside-out suture in repair of tear of postero medial corner of medial meniscus. Operative technique: Arthroscope is placed through anterolateral portal. Suture hook is delivered through anteromedial portal. By rotating the suture hook, it penetrates the inner portion of the torn meniscus from femoral surface to tibial surface of the meniscus for vertically oriented suture. A PDS suture is delivered through the lumen of suture hook, and the suture hook is withdrawn. The both ends of the suture are retrieved through anteromedial portal by a retriever, either grasper or crochet hook.A Zone-specific cannula is positioned below the inferior surface of the meniscus through anterolateral portal. The Looped Needle designed by the authors is delivered through the lumen of the Zone-specific cannula. The suture end of the tibial surface is placed in the loop of the Looped Needle and pulled out to the surface of posteromedial joint line. The suture end of the femoral surface is pulled out in same manner. A transverse skin incision of 1cm size is made adjacent to pulled out suture and the suture is tied. Discussion: Even though modified inside-out suture technique requires longer operation time than conventional inside-out technique, it provides vertically oriented suture and good tissue coaptation. The authors recommend this modified inside-out suture technique to be good alternative in repairing tear of the posteromedial corner of medial meniscus.

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Assessment of Elderly's Isokinetic Muscle Function, Flexibility and Balance in a Region of Seoul (서울 일부 지역 노인들의 등속성 근기능, 유연성, 균형성 측정 및 평가)

  • Kim, Suk-Won;Sohn, Jee-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.37-44
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    • 2016
  • The aim of the present study was to compare the strength, balance, and flexibility across two age groups (older adults vs. young adults). The isokinetic muscle function, ankle ROM, trunk forward flexibility, stability, and antropometric data for the elderly and 46 university students were collected. The results indicated that male older adults possessed relatively low flexibility (2.97cm) among the groups and showed better stability in the right foot than in the left foot and $35^{\circ}$ of plantar flexion ROM, which was not in the normal range. Their peak strength at the knee joint was below 50% of their counterpart. They revealed a hamstring deficit of 18.55%, ankle eversion deficit of 23.08%, and ankle inversion deficit of 19.19%. The results indicated that female older adults possessed comparable flexibility compared to female young adults. The reciprocal muscle strength ratio of both knees was under 50%, and the deficit was 14.32% (extension) and 19.73% (flexion). The ankle plantar flexion peak torque was approximately 62% (left) and 73% (right) of WS's. The ankle dorsi flexion deficit was 25.05% and the plantar flexion was 26.86%. The eversion deficit was 19.97% and the inversion was 21.09%. These results will be significant in establishing an elderly fitness enhancement program and policy.

Usefulness of Percutaneous Transluminal Angioplasty before Operative Treatment in Diabetic Foot Gangrene (당뇨병성 족부 괴저에서 수술 전 시행한 경피적 경혈관 혈관성형술의 유용성)

  • Im, Chul Soon;Lee, Myoung Jin;Kang, Jung Mo;Cho, Young-Rak;Jo, Jeong Hyun;Lee, Chan Soo
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.32-37
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    • 2018
  • Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.

A Study on the Late 19th Century Basic Costumes and Games based on Genre Paintings by Kisan Junkeun Kim - Referred from the book 「Korean Games」 - (기산 김준근 풍속화에 나타난 19세기말 일반복식과 놀이문화에 관한 연구 - 「한국의 놀이」 삽화를 중심으로 -)

  • Choi, Eunjoo
    • Fashion & Textile Research Journal
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    • v.14 no.5
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    • pp.766-777
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    • 2012
  • The 13 genre paintings by Junkeun Kim in the book "Korean Games(by Stewart Culin 1858~1929)" were used to study the late $19^{th}$ century's basic costumes and Games style in Korea. The people who appear in the paintings are 26 adult males, 2 minor males, 2 adult females and 3 kisaengs. Typical men wore 'Jeogori' which had various colors and white linings with a reached hip line, and knotted with a 'go-rum' on the right side. They also wore, white colored 'Baji' with colorful sash that were knot below knee or ankle together with 'Hang-jun' or 'Daenim'. They wore 'Beoseon'. Some men wore 'Po' whose colors were blue, green, indigo, white. The general women wore 'Jeogori' in deep green and light pink, indigo, green, red, and they matched with colors for 'Kit' and, 'Go-rum', 'Kut-dong' and its 'Go-rum' was short and narrow. It was so fit and short with narrow sleeve. It had 'Dunggun-kit'(round head collar) with white 'Dong-jung' and so it fit at neck. They wore 'Chi-ma' whose color was red, light green, or light indigo. It contrasted with 'Jeogori'. The width of 'Chi-ma' was big enough. Then white inner slacks came out under the skirt. Traditional Korean games can be classified according to age and gender. Then the games can be further classified into three categories : men's games, women's games, and games for all. The games for adult are an archery practice, hunting, shovel work with a karae, making a bow, drawing Jongkung-chart, Korean chess, playing paduk, and the Korean card game. A swing is a game for women. Games for both men and women are dice play, and domino game. Games for both adult and minor males are sledge, and tightrope walking. Through genre paintings in the $19^{th}$ century, I reached a conclusion that basic costumes are similar to 'Hanbok' at the present time and the method of wearing them has not changed much. It appears that the originality of traditional costumes has been maintained.

A Descriptive Study on Pain of Elderly (노인의 동통에 관한 조사연구)

  • 김주희;양경희;이현주
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.878-888
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    • 1996
  • The main purpose of this study was getting related to the pain charactristic data of elderly. It contains past and present health status, daily living activity level, pain frequency, causes, pain area, pain intensity, pain worse causes, and pain releave causes, pain management methods. The subject were 79 elderly whose age were over 65 years old. They were lived in their home environment. Half of them were resident of middle range city at province and the others were Seoul city. The data was collected from Dec. 1st. 1995 to Jan. 30th. 1996. Interviews were held with semi-structured questionaire after pilot study by researchers. Pain measurement tool were used graphic rating scale and Abstract of Korean Pain Language Scale. To analize the subject's general characteristics, past and present health status, daily living activity level, characteristics about pain, pain management methods statistical SPSS for win frequency were employed. The findings were as follows ; 1. There were 33(41.8%) male and 46(58.2%) female Below 69 year old were 20(25.3%), 70-79 year old were 42(53.2%), over 80 year old were 17(21.5%), mean age was 74(from 65 to 89). 2. Buddhist were 24(30.4%), Christian were 29(36. 7%), the other religious status or non religians were 26 (32.9%). 3. Past good health status were 63(79.7%), not so good status were 6(7.6%). Present good health status were 19(24.1%), moderated health status were 6(7.6%), not so good status were 14(17.7%). 4. Daily living activity limitation were 39(49.4%), nonlimitation of activity were 5(6.3%). 5. Walking limitation were 3(3.8%), nonlimitation walking were 52(65,8%). 6. Insomnia was 23(29.1%), no difficult were 38(48.1%). 7. Chronic pain complaints were 64(81%), diseases causes of pain were 25(31.6%), bad health behavior causes of pain were 27(34.2%). 8. Most pain area were back 30(29.4%), leg 17(16.7%), knee 16(15.7%), arm 13(12.7%), teeth, chest and head were each 5(4.9%), loin, trunk were each 4(3.9%), the other areas were 3(3%). 9. Pain intensity was 3.49(mean) by Korean Language Scale, 6.59(mean) by graphic rating scale. Sensitive pain was 3.5(47.9%), affective pain was 3(20.8%) It was high pain level and sensitive pain. 10. Most pain worse causes moving was 35(44.3%), pain relieving causes rest was 29(36.7%), 11. Pain management method were medication 40(42.1%), physiotherapy 23(24.2%), hospital 12(12.6%), the others 7(7.4%), none 13(13.7%). The conclusion ; Present health status of eldery was not so good. Almost half of them have some diseases. Most common diseases of eldery were arthristis, respitatory and heart problems. Foully nine percent of elderly had limitation of daily living activities. Eighty one percent of eldely had chronic pain. Most of them was back pain (30%). Pain intensity was high(score over 3.5). The worsening pain causes was moving and releiving causes was rest. Pain management method were pain medication, physiotherapy. Therefore, Nursing care plan for the elderly have to focus on pain because majority of elderly have chronic high level of pain related to the arthritis.

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Clinical Application of Focused Ultrasound in Korean Medicine (집속초음파 치료의 한의 임상 활용에 대한 고찰)

  • Yoomin Choi;Maeum Lee;Nayeon Hur;Eunhee Lee;Hyugyong Choi;Hyung-Sik Seo;Eui-Hyoung Hwang;Insoo Jang
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.79-89
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    • 2023
  • Objectives : The purpose of this study is to investigate various application methods of focused ultrasound and apply them to clinical use in Korean medicine. Methods : Search was performed using the search engines of electronic databases, including PubMed, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), China National Knowledge Infrastructure (CNKI), Wanfang Data, Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii), from inception to July 2023 without language limitation. Inclusion criteria were clinical studies including randomized controlled trials (RCTs), and animal experimental studies related with focused ultrasound treatments for acupoints or meridian sinews. Results : Total 17 papers, 7 for RCT, 6 for in vivo animal studies, and other experimental studies, were finally selected. Indications used in studies were shoulder pain, back pain, chronic back pain, and degenerative knee arthritis. In experimental studies, studies on animal models of hypoxic ischemic brain damage and hyperlipidemia were also conducted. As for the acupoints, LR3, LI4, and ST36 were used in clinical studies and, in animal experimental studies, GV20, KI1, and ST36 were used. As for the dose, 4 studies below 3 W/cm2 and 3 studies in the range of 0.625 to 5 W/cm2 in clinical studies, and all studies did not exceed 5 W/cm2. In animal experimental studies, 0.5 W/cm2, 2 W/cm2, 7.5 WW/cm2, 15 W/cm2, 10~20 W/cm2 were used. In all three studies describing the penetration depth during irradiation, it was less than 1 cm. Conclusions : We suggest that focused ultrasound is an appropriate treatment tool for stimulating the acupoints to transfer heat energy. Future studies with rigorous and well-designed RCTs for various diseases will be required to ascertain the focused ultrasound stimulate acupoints or meridian sinews.

Prognostic Factors in Patients Treated with DrugCoated Balloon Angioplasty for Symptomatic Peripheral Artery Disease

  • Sigala, Fragiska;Galyfos, George;Stavridis, Kyriakos;Tigkiropoulos, Konstantinos;Lazaridis, Ioannis;Karamanos, Dimitrios;Mpontinis, Vangelis;Melas, Nikolaos;Zournatzi, Ioulia;Filis, Konstantinos;Saratzis, Nikolaos
    • Vascular Specialist International
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    • v.34 no.4
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    • pp.94-102
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    • 2018
  • Purpose: Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods: This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was $24.2{\pm}2.3$ months. Results: Overall, 149 patients (mean age: $68.6{\pm}8.3$ years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion: PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

Biomechanical Comparative Analysis of Two Goal-kick Motion in Soccer (두 가지 축구 골킥 동작의 운동역학적 비교 분석)

  • Jin, Young-Wan;Shin, Je-Min
    • Korean Journal of Applied Biomechanics
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    • v.15 no.1
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    • pp.29-44
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    • 2005
  • The purpose of this study is to reveal the effects of two different kicks, the drop kick and the punt kick, into the kicking motion, through the kinetic comparative analysis of the kicking motion, which is conducted when one kicks a soccer goal. To grasp kinetic changing factors, which is performed by individual's each body segment, I connected kicking motions, which were analyzed by a two dimension co-ordination, into the personal computer to concrete the digits of it and smoothed by 10Hz. Using the smoothed data, I found a needed kinematical data by inputting an analytical program into the computer. The result of comparative analysis of two kicking motions can be summarized as below. 1. There was not a big difference between the time of the loading phase and the time of the swing phase, which can affect the exact impact and the angle of balls aviation direction. 2. The two kicks were not affected the timing and the velocity of the kicking leg's segment. 3. In the goal kick motion, the maximum velocity timing of the kicking leg's lower segment showed the following orders: the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.018sec) in the drop kick, and the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.015sec) in the punt kick. It showed that whipping motion increases the velocity of the foot at the time of impact. 4. At the time of impact, there was not a significant difference in the supporting leg's knee and ankle. When one does the punt kick, the subject spreads out his hip joint more at the time of impact. 5. When the impact performed, kicking leg's every segment was similar. Because the height of the ball is higher in the punt kick than in the drop kick, the subject has to stretch the knees more when he kicks a ball, so there is a significant affect on the angle and the distance of the ball's flying. 6. When one performs the drop kick, the stride is 0.02m shorter than the punt kick, and the ratio of height of the drop kick is 0.05 smaller than the punt kick. This difference greatly affects the center of the ball, the supporting leg's location, and the location of the center of gravity with the center of the ball at the time of impact. 7. Right before the moment of the impact, the center of gravity was located from the center of the ball, the height of the drop kick was 0.67m ratio of height was 0.37, and the height of the punt kick was 0.65m ratio of height was 0.36. The drop kick was located more to the back 0.21m ratio of height was 0.12, the punt kick was located more to the back 0.28m ratio of height was 0.16. 8. There was not a significant difference in the absolute angle of incidence and the maximum distance, but the absolute velocity of incidence showed a significant difference. This difference is caused from that whether players have the time to perform of not; the drop kick is used when the players have time to perform, and punt kick is used when the players launch a shifting attack. 9. The surface reaction force of the supporting leg had some relation with the approaching angle. Vertical reaction force (Fz) showed some differences in the two movements(p<0.05). The maximum force of the right and left surface reaction force (Fx) didn't have much differences (p<0.05), but it showed the tendency that the maximum force occurs before the peak force of the front and back surface (Fy) occurs.

Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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