• The Journal of the Korean bone and joint tumor society
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• v.4 no.1
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• pp.22-29
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• 1998

A limb-sparing operation has a definitive role in the treatment of osteosarcoma in the lower extremity of skeletally-immature patients. After a limb-sparing operation, leg length discrepancy remains as a major disability that should be corrected. This study was designed to suggest methods of tumor resection and proper timing of leg length equalization in skeletally immature osteosarcoma patients. From September 1990 to January 1998, we reviewed eight osteosarcoma patients in an immature skeletal age. There were 4 males and 4 females, and their mean duration of follow-up was 50.37 months (range : 25 to 88 months). Mean skeletal age was 8 years (range : 8 months to 11 years). The patients were classified according to the methods of tumor resection ; intercalary resection in 1 case, transepiphyseal resection in 1, intra-articular resection in 5, and extra-articular resection in 1. The results were as follows ; 1. The leg lengthening was begun when a patient's leg length discrepancy reached 4-5cm. 2. The age of final lengthening with permanent reconstruction was 14 years in males and 12 years in females (about 2 years before skeletal maturity). 3. When reconstruction was performed with a temporary spacer, the site of lengthening Was in the soft tissue, not in bone, and then a permanant reconstruction was done. 4. Reconstruction with a biologic spacer to preserve the joint function was a reasonable method for equalization of leg length. In conclusion, the appropriate choice of reconstructive method and the age at which to correct the leg length discrepancy in a skeletally-immature osteosarcoma patients are important factors for maintaining leg length at full maturity.

• Journal of Pharmacopuncture
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• v.4 no.2
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• pp.105-112
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• 2001

In Oriental Medicine, mononeuropathy belongs to or . Common peroneal neuropathy(CPN) is the most frequently encountered mononeuropathy in the lower extremity. It is usually caused by direct surgery injury, compression, leg crossing, trauma, traction etc, occasionally by nerve tumor. A 47-year-old healthy man was complained of the sudden development of left foot drop and sensory manifestation owing to suspected compression and habitual leg-crossing. Acupuncture along with bee-venom acupuncture, moxibustion was performed mainly at Stomach and Gallbladder Meridian specially ST36, ST37, ST40, GB34 and GB39. Nerve conduction study and electromyography was also performed three times. Symtoms was relieved fast, and full recovery took about 110 days. Acupuncture and bee-venom acupuncture are considered to be beneficial to CPN. More clinical trials and studies are needed.

• Korean Journal of Applied Biomechanics
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• v.24 no.4
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• pp.399-415
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• 2014

The aim of this study was to investigate the effect of resistance training with and without whole-body vibration(WBV) on the biomechanical properties of the plantarflexor in the elderly women (>60 yrs., n=35). Thirty-five volunteers were randomly assigned to a resistance training with WBV group (RVT, n=14), a resistance training without WBV (RT, n=11), and a non-training control group (CON, n=10). The RVT and the RT groups participated in the training sessions three times a week for 8 weeks, followed by a 4-week detraining period. The CON group was instructed to refrain from any type of resistance training. To assess strength and activation of the plantarflexor muscles, maximum isometric ankle plantarflexion torque and muscle activation of the triceps surae muscles were measured using dynamometry, twitch interpolation technique and electromyography at four different ankle joint angles. Also, the lower extremity function was assessed by vertical jumping. The measurements were performed prior to, 2 and 8 weeks after the training and after a 4-week detraining period. Following the 8-week training sessions, an increase in the isometric plantarflexion strength was found to be greater for the RVT compared with the RT group (p<.05). Muscle inhibition was significantly decreased after training than before training only for the RVT (p<.05). Following the detraining period, a decrease in isometric plantarflexors strength and a increases in muscle inhibition were significantly less in the RVT compared with the RT group. In conclusion, the exercise with WBV is a feasible training modality for the elderly and seems to have a boosting effect when used with conventional resistance training.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.2
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• pp.201-211
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• 2014

PURPOSE: The purpose of this study was to investigate the inter-rater absolute reliability and the concurrent validity of the Tinetti-gait scale that was translated into Korean for chronic stroke patients. METHODS: Fifty-two patients with post-stroke participated in this study. Inter-rater reliability was analyzed by Intraclass Correlation Coefficient ($ICC_{3,1}$) and Kappa coefficient, and absolute reliability was analyzed by the Standard Error of Measurement (SEM), and the Minimal Detectable Change (MDC). Concurrent validity was analyzed by correlating between the Tinetti-gait scale and physical functions. The physical functions were measured by using the Dynamic Gait Index(DGI), 10m walking test(10WT), One Leg Standing Test of affected/non-affected side(OLST), Sit to Stand test(STS), (Fugl Meyer assessment of Lower Extremity(FM-LE). RESULTS: The inter-rater reliability of the Tinetti-gait scale was high; $ICC_{(3,1)}=.91$ (95% CI=.85~.95) (very reliable), the range of Kappa coefficient were .73~.92 (substantial~good). The inter-rater agreement of the each item in Tinetti-gait scale ranged from .74 to .92 (95 % CI=.59~.95) (reliable~very reliable). The SEM and MDC were .56 and 1.55, respectively. In the results of concurrent validity, there were moderate positive correlation between Tinetti-gait scale and DGI (r=.78), 10WT (r=.74), OLST (r=.65~.73), FM-LE (r=67). And there was moderate negative correlation between Tinetti-gait scale and STS (r=-79) (p<.01). CONCLUSION: The Tinetti-gait scale(Korean version) was a reliable and valid tool to measure gait ability in patients with chronic stroke. Thus, it could be a useful tool for examining a gait ability of post-stroke patients. Further study should be conducted to investigate the usability to predict fall risk of post-stroke patients of the Tinetti-gait scale.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.9
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• pp.4008-4014
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• 2011

The purpose of this study was to identify the effect of muscular strength, sensation, and spasticity of the hip joint on balance using clinical tools in chronic stroke patients. Thirty-two subjects participated. It were measured muscular strength of the hip flexor, extensor, abductor, and adductor using manual muscle testing, light touch sensibility, and spasticity of the quadriceps using the modified Ashworth scale in the paretic lower extremity. Also, static and dynamic balance were measured by the functional balance scale. Collected data was analyzed by stepwise multiple regression. Muscular strength of the hip abductor, light touch sensibility, and spasticity were associated with static balance(p<0.05) and explanatory power was 80.5%. Muscular strength of the hip abductor and light touch sensibility were associated with dynamic balance(p<0.05) and explanatory power was 77.9%. Thus, it is suggested that muscular strength of the hip abductor and light touch sensibility is considered when providing evaluation and intervention programs for the future in the balance.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.471-478
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• 2021

Background: The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods: Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results: Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions: The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

• Vascular Specialist International
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• v.34 no.4
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• pp.109-116
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• 2018

Purpose: Diabetic foot wound (DFW) is known as a major contributor of nontraumatic lower extremity amputation. We aimed to evaluate overall amputation rates and risk factors for amputation in patients with DFW. Materials and Methods: From January 2014 to December 2017, 141 patients with DFW were enrolled. We determined rates and risk factors of major amputation in DFW and in DFW with peripheral arterial occlusive disease (PAOD). In addition, we investigated rates and predictors for amputation in diabetic foot ulcer (DFU). Results: The overall rate of major amputation was 26.2% in patients with DFW. Among 141 DFWs, 76 patients (53.9%) had PAOD and 29 patients (38.2%) of 76 DFWs with PAOD underwent major amputation. Wound state according to Wagner classification, congestive heart failure, leukocytosis, dementia, and PAOD were the significant risk factors for major amputation. In DFW with PAOD, Wagner classification grades and leukocytosis were the predictors for major amputation. In addition, amputation was performed for 28 patients (38.4%) while major amputation was performed for 5 patients (6.8%) of 73 DFUs. Only the presence of osteomyelitis (OM) showed significant difference for amputation in DFU. Conclusion: This study represented that approximately a quarter of DFWs underwent major amputation. Moreover, over half of DFW patients had PAOD and about 38.2% of them underwent major amputation. Wound state and PAOD was major predictors for major amputation in DFW. Systemic factors, such as CHF, leukocytosis, and dementia were identified as risk factors for major amputation. In terms of DFU, 38.4% underwent amputation and the presence of OM was a determinant for amputation.

• The Korean Journal of Pain
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• v.32 no.3
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• pp.196-205
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• 2019

Background: Hypertonic saline (HS) injections for decompressive neuroplasty (DN) can cause pain. We assessed whether a continuous infusion of HS through an infusion pump would reduce injection-related pain compared with repeated bolus administrations. Methods: Fifty patients scheduled for DN were randomized to either the bolus injection or the continuous infusion group. After appropriately placing the epidural catheter, 4 mL of 5% NaCl was injected as four boluses of 1 mL each at 15-minute intervals or infused over 1 hour using an infusion pump. The severity of pain induced by HS injection, as measured by the 11-point numerical rating scale (NRS), was the primary outcome. The severity of low back or lower extremity pain, as measured by the 11-point NRS and Oswestry Disability Index (ODI), 3 months following the procedure, was the secondary outcome. Results: Data from 21 patients in the bolus group and 23 in the continuous infusion group were analyzed. No statistically significant difference in injection-related pain was identified between the two groups during the initial HS administration (P = 0.846). However, there was a statistically significant reduction in injection-related pain in the continuous infusion group compared to the bolus injection group from the second assessment onwards (P = 0.001, < 0.001, and < 0.001, respectively). No significant between-group differences in the NRS and ODI scores 3 months post-procedure were noted (P = 0.614 and 0.949, respectively). Conclusions: Our study suggests that administering HS through a continuous infusion is a useful modality for reducing HS injection-related pain during DN.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.344-349
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• 2019

Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.250-257
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• 2019

Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.