• Archives of Plastic Surgery
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• v.33 no.6
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• pp.715-722
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• 2006

Purpose: The main advantages of the perforator flap are minimal donor site morbidity, preservation of any main source artery and its thin characteristics. Most perforator flaps for hand reconstruction need primary and secondary procedures such as a flap debulkiness and liposuction etc. However, flap thickness of calf area is thinner than any other perforator flaps. Methods: We performed an anatomical study and clinical application of medial sural artery perforator flap. We found that there are two or more medial sural perforators located on a straight line drawn from the mid-point of popliteal crease to the mid-point of medial malleolus. Most pathway of medial sural artery comes along with this line. It is possible to observe the first perforators almost exactly 8 cm from midpoint of popliteal crease in a distal half circle drawn with a radius of 2 cm. Results: We report 12 cases in 11 patients of hand reconstruction with medial sural perforator free flap from Febrary 2003 to Febrary 2006. Complete healing was possible in 11 cases. Total flap loss for venous insufficiency was in 1 patient. During the follow-up, good contour and full range of motion was observed on hand reconstruction with medial sural perforator free flap. Conclusion: In the authors' experience, this anatomical study made it possible to prepare a diagram of the exact location of the medial sural perforators. This flap can be used to achieve acceptable functional and aesthetic results for hand reconstruction because of its thin characteristics.

• Journal of radiological science and technology
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• v.22 no.2
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• pp.41-46
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• 1999

Osteoporosis, which causes mainly fracture of the spine, proximal femur and distal radius by minimal trauma, is a major public health problem and its prevalence is steadily increasing in Korea according to the development of public health care. There are reliable methods for diagnosis based on bone densitometry. Early detection and intervention are important for reducing the incidence of fractures. A consensus definition of osteoporosis, based on bone density measurement, has been developed by the World Health Organization(WHO). In this study, bone mineral density(RMD) was measured by dual energy x-ray absorptiometry(DEXA) at the proximal femur and lumbar spine in 132 post-menopausal women. The purpose of this study is to find influential factors on the BMD of the proximal femur and the lumbar spine and to analyze correlation between BMD and the problematic factors. We obtained the following results : 1. Mean BMD score, T-score and Z-score of the proximal femur were $0.81(g/cm^2)$, -2.45(S.D.) and -2.09(S.D.) respectively and in the lumbar spine were $0.83(g/cm^2)$, -2.02(S.D.), -2.43(S.D.) respectively. 2. In correlation analysis between BMD and many factors, correlation coefficients were -0.467, 0.212, -0.321 and 0.241 in age, height, duration after menopause respectively. BMI and the residuals were comparatively small. 3. Correlation coefficients to age matched BMD, in height and body weight were 0.222 and 0.241, in age and duration after menopause were -0.268, -0.282. 4. The fracture threshold of proximal femur BMD to the 90th percentile was $0.845(g/cm^2)$. 5. At the result of multiple regression analysis, age, body weight, $BMI(kg/m^2)$ and duration after menopause described as significant variables.

• The korean journal of orthodontics
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• v.17 no.1
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• pp.135-148
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• 1987

To investigate the relationship between craniofacial growth and bone maturity of the hand wrist in normal occlusion, the author took cephalogram and handwrist radiogram of 391 students (male 192, female 199) and assessed the measurements of cephalogram according to skeletal maturity stages of the hand and wrist. In this study, four skeketal stages and 36 linear, angular measurements of the cephalometrics were selected. In hand-wrist X-ray the bones used to determine skeletal maturity were the middle phalanges of the third finger, and distal epiphysis of the radius. In cephalogram, the landmark used to measure the angle and length were N, S, Po., Ar., Go., Me., Gn., Pog., Point B, Point A, ANS, PNS, Or., U1, L1, U6, L6 etc.. The results were as follows, 1. The table of mean, standard deviation, p-value from measurements were made in each group and both sex. 2. The increased measurements according to skeletal maturity were anterior cranial bese length, posterior cranial base length, ramus height, anterior facial height, posterior facial height, L1 to mandibular plane (mm), facial plane angle. In contrast to, decreased measurements were genial angle, facial cnvexity and facial plane angle. 3. Denture pattern measurements (IMPA, FMIA, occlusal plane to Go-Gn, interincisal angle, U1 to SN plane, U1 to SN plane, U1 to facial plane, L1 to facial plane etc.) .had nothing to do with skeletal maturity. 4. Skeletal maturity had close relationship with craniofacial growth, but had little to do with tooth development.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.409-417
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• 1998

The 123 left hand-wrist radiographs and menarcheal ages attained by direct questioning to patients or her mothers are used, in order to exploit the relationship between the bone maturity and the menarcheal age of girls in adolescence. The results were as follows, 1. The mean age at menarche was $12.31{\pm}0.99$. 2. The onset of menarche occurred at SMI 7 and SMI 8 ($73.33\%$). The onset of menarche was correlated with skeletal age rather than chronological age. 3. There was statistically significant difference among the time passed from menarche according to skeletal maturity level. 4. The distal epiphyseal union of radius began at about 20 months after menarche. 5. In comparision of the time intervals from menarche to radial epiphyseal fusion among early, average, and late menarcheal age groups, late group had lesser time interval than other two groups.

• Physical Therapy Korea
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• v.3 no.2
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• pp.19-28
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• 1996

The purpose of this study was to asses and compare the effects of superficial heating on the pain threshold at limbs in healthy adult and adult hemiplegia. We used hot pack for superficial heat and applied to healthy adult(n=12) and adult hemiplegia(n=12) on lumbar region. Pain treshold was quantatively measured by an electrical stimulator and measured before hot pack application, immediatly and post 30 minutes after hot pack application on the distal parts of limbs(styloid process of radius, medial malleoulus of tibia). The results were as follows 1) A statically significant defference in pain treshold were not found at limbs of healthy adult and adult hemiplegia that have an affected side and a non-affected side before hot pack application, immediatly and post 30 minutes after hot pack apllication(p>0.05). 2) In comparance of pain threshold of upper and lower limbs in the all subjects, pain threshold was significantly increase at lower limbs(p<0.01). 3) In comparance of pain threshold of limbs between healthy adult and adult hemiplegia, pain threshold was showed a significant defferance at the upper and lower limbs of affected side before hot pack application(p<0.05, p<0.01).

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1143-1146
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• 2003

Rickets is a nutritional disorder which is caused either by deficiency of vitamin D or by a defective activation of vitamin D. In these days, even though the incidence of rickets has decreased through adequate nutritional support, we sometimes experience rickets in babies receiving a prolonged special diet as therapy for chronic diarrhea, or those subject to a in receiving the prolonged elimination of milk because of allergy. But there are no reports about rickets caused by absolute elimination of milk because of allergies in Korea. We report here a case of rickets developed after feeding on Sunsik( a mixture of several grain and fruits powder) during a seven months period in an 8-month-old male patient. This male infant manifested vomiting, poor feeding, decreased serum calcium and 25-hydroxycholecalciferol levels, and markedly increased serum alkaline phosphatase and parathyroid hormone levels. Skeletal X-rays showed cupping and fraying in distal metaphyses of radius and ulna, and generalized osteopenia. The patient improved with vitamin D and calcium therapy.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.31-38
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• 1992

The management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In certain some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. The traditional bone grafts have high incidence in recurrence rate, delayed union, bony resorption, stress fracture despite long immobilization and stiffness of adjuscent joint. We have attemped to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle as a living bone graft. From Apr. 1984 to Nov. 1990, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 4 cases, using Vascularized Fibular Graft, which occur at the distal radius in 3 cases and at the proximal tibia in 1 case. An average follow-up was 2 years 8 months, average bone defect after wide segmental resection of lesion was 11.4cm. These all cases revealed good bony union in average 6.5months, and we got the wide range of motion of adjacent joint without recurrence and serious complications.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.753-760
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• 2015

Background A number of conditions can alter a person's fingernail configuration. The ratio between fingernail width and length (W/L) is an important aesthetic criterion, and some underlying diseases can alter the size of the fingernail. Fingernail curvature can be altered by systemic disorders or disorders of the fingernail itself. Although the shape and curvature of the fingernail can provide diagnostic clues for various diseases, few studies have precisely characterized normal fingernail configuration. Methods We measured the W/L ratio of the fingernail, transverse fingernail curvature, hand length, hand breadth, and distal interphalangeal joint width in 300 volunteers with healthy fingernails. We also investigated whether age, sex, height, and handedness influenced the fingernail W/L ratio and transverse fingernail curvature. Results In women, fingernail W/L ratios were similar across all five fingers, and were lower than those in men. The highest value of transverse fingernail curvature was found in the thumb, followed by the index, middle, ring, and little fingers. Handedness and aging influenced transverse fingernail curvature, but not the fingernail W/L ratio. Fingernails were flatter on the dominant hand than on the non-dominant hand. The radius of transverse fingernail curvature increased with age, indicating that fingernails tended to flatten with age. Conclusions Our quantitative data on fingernail configuration can be used as a reference range for diagnosing various diseases and deformities of the fingernail, and for performing reconstructive or aesthetic fingernail surgery.

• Childhood Kidney Diseases
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• v.23 no.2
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• pp.111-115
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• 2019

Vitamin D dependent rickets type 1A (VDDR1A) is an autosomal recessive disorder caused by mutations in CYP27B1. Clinical findings are growth retardation, hypotonia, muscle weakness, hypocalcemic seizures, and radiological features of rickets. We aimed to present the VDDR1A case with a genetic study of CYP27B1. The 14-month-old boy was admitted to the hospital due to a seizure. Serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), 25(OH) vitamin D, and 1,25(OH)2 vitamin D values were 5.1 mg/dL, 3.7 mg/dL, 705 IU/L, 429 pg/mL, 24.9 ng/mL, and 8.8 pg/mL, respectively. Radiological study showed cupping and fraying of the distal ulna and radius. The molecular genetic study revealed that the patient had a compound heterozygous mutation, $Phe443Profs^*24$ and c.589+1G>A, in CYP27B1. Genetic analysis of the family members presented that the mother was heterozygous for the mutation c.589+1G>A, and that the father was heterozygous for $Phe443Profs^*24$. The patient was treated with calcium lactate and calcitriol. Until now, six Korean patients with VDDR1A have been studied. Including this case, Korean patients with VDDR1A were found to have only three different mutations in 14 alleles, indicating that the mutation in the CYP27B1 gene is homogeneous in the Korean population.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.27-32
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• 2014

Objective: The aim of this study was to compare the radial bone strength, sitting balance ability and global self-esteem of wheelchair martial arts practitioners and healthy control participants. Design: Cross-sectional study. Methods: Nine wheelchair martial art practitioners with physical disabilities and 28 able-bodied healthy individuals participated in the study. The bone strength of the distal radius was assessed using the Sunlight Mini-Omni Ultrasound Bone Sonometer; sitting balance was quantified using the modified functional reach test (with reference to a scale marked on the wall); and the self-administered Rosenberg self-esteem (RSE) scale was used to measure the global self-esteem of the participants. The velocity of the ultrasound wave (speed of sound, m/s) traveling through the outer surface of the radial bone was measured and was then converted into a T-score and a Z-score. These ultrasound T-score and Z-score that represent bone strength; the maximum forward reaching distance in sitting (cm) that represents sitting balance; and the RSE total self-esteem score that indicates global self-esteem were used for analysis. Results: The results revealed that there were no statistically significant between-group differences for radial bone-strength, maximum forward reaching distance, or self-esteem outcomes. Conclusions: The wheelchair martial arts practitioners had similar radial bone strength, sitting balance performance and self-esteem to able-bodied healthy persons. Our results imply that wheelchair martial arts might improve bone strength, postural control and self-esteem in adult wheelchair users. This new sport-wheelchair martial arts-might be an exercise option for people with physical disabilities.