• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.86-93
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• 2011

Purpose: The purpose of this study was to analyze the characteristics of the injuries of the national elite Taekwondo players with the best performance in the international championship competition. Materials and Methods: Fifty-two athletes who got the injury in the 2011 Gyeongju World Taekwondo Championship competition were included in this sturdy. 950 members of national team of 146 countries participated in this game, 1,063 matches were performed. We analyzed the characteristics of the injuries such as injury rate by gender, age, weight class, injured region and injury type. Results: Fifty-two athletes of 950 athletes in 1,063 matches got injured and injury rate was 5.47 per 100 participants and 24.47/1,000 athlete-exposures. Injury rate of female athletes was higher than mail, but there was no significant statistical difference (p=0.512). Injury rate of over 30 years old was 17.39 per 100 participants, and injury rate of over 87 kg in male weight class and 68 to 73kg in female weight class were highest than other groups, but there was no significant statistical difference (p=0.838). Overall injury rate of the lower extremity was 13.17/1,000 A-E, higher than upper extremity or head and neck or trunk, but injury rate of the hand was 5.17/1,000 A-E, highest as a specific injured region, followed by the knee, 4.70/1,000 A-E (p=0.714). Injury rate of the sprain was 10.81/1,000 A-E, highest as an injury type, the second most common injury type was the fracture, 5.40/1,000 A-E in men, and was the contusion, 9.63/1,000 A-E in women (p=0.033). As one of the most serious injury, 4 of 8 fractures were occurred in hand. Conclusion: Overall injury rate of the elite Taekwondo players in 2011 Gyeongju World Taekwondo Championship was 5.47 per 100 participants and 24.46 per 1,000 athlete exposures. Although the most common type of injury was the sprain of the knee and ankle, the fractures were more commonly occurred in hand.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.131-138
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• 2003

Purpose: We analyzed our malignant peripheral nerve sheath tumor (MPNST) cases to find out their oncologic results following by each treatment modalities. Materials and Methods: Thirty four patients with MPNST were registered in Korea Cancer Center Hospital from Feb. 1986 to Nov. 1996. Seventeen cases were male and 17, female. Average age was 41 years (range 18 to 74). Location of the tumor was as follows; 17 in lower extremity, 11 upper extremity, 4 trunk, and 2 retroperitoneum. Following the AJC classification, stage IA were 2 cases, stage IIA 2, stage IIB 6, stage III 16 and stage IV 8. Twenty six patients took operations and adjuvant chemotherapy and/or radiation therapy, 3 operation only and 3 adjuvant chemotherapy or radiation therapy. Average follow up period was 33.5 months (5.6 to 146.1). Kaplan-Meiyer method was done for survival curve, and log rank test for comparison analysis. Results: Fourteen cases were continuous disease free, 2 no evidence of disease, 2 alive with disease and 14 dead of disease states at final follow up. Actual 5-year and 10-year survival rates were 53.5%, 35.7%. Local recurrence rate after operation was 24.1%. 5-year survival rates of stage I/II/III were 100/85.7/55.9% and 2-year survival rate of stage IV was 14.3% (p=0.04). In 21 cases operated with stage II-III, wide margin (15cases) had 76.0% 5-year survival rate, and marginal or intralesional marigin (6cases) had 40.0%. The actual 5-year survival rate of the group which were done 4 or more cycles chemotherapy (8cases) was 71.4% and the actual 3-year survival rate less than 4cycles chemotherapy (6cases) was 83.3% (p=0.96). In 19 cases operated with stage II-III and which had no radiotherapy, marginal or intralesional margin (5cases) had 3 cases of local recurrences (60.0%), though wide margin (14cases) had 4 cases recurrences (28.6%). There was no local recurrence in 8cases which had pre-or post-operative radiotherapy. Conclusions: Surgical margin is an important factor in local recurrence. Resection margin has a tendency to influence the survival despite insufficient statistical significance. Conventional chemotherapy has no defnite statistical sigficance in the effect on local control and survival. Preoperative and postoperative radiotherapy has some positive effect on local control.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.87-91
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• 2004

Purpose: The purpose of this study is to investigate the incidence and patterns of fractures occurred in Inline skating accident. Materials and Method: We evaluated 20 patients, 20 cases(from september 2002 to August 2003) with fractures occurred during Inline skating. The incidence, sex, age, fracture site, associated injuries, causes of Inline skating injuries were analysed. The cases were male in 18(90$\%$), and female in 2(10$\%$). The most common distribution of age was in twenties and thirties. Result: The patients(12cases 60$\%$) with upper extremity fracture were more common than patients(8cases 40$\%$) with lower extremity fracture. Patients who had fracture in ankle were 35$\%$(7cases), forearm 20$\%$(4cases), wrist 20$\%$(4cases), elbow 15$\%$(3cases), thigh 5$\%$(1cases). According to the The Lauge-Hansen classification in ankle fractures there were four patients of supination-external rotation type, two patients of supination-abduction type, and 1 patient of pronation-external rotation type. In forearm and hand fractures, there were three distal radius fractures, one radio-ulnar shaft fracture, 2 scaphoid fractures, and two meta-carpal fractures. In elbow fractures, there were two supracondyle fractures, and one lateral condyle fracture. There were three epiphyseal plate injuries (Salt-Harris type II) in children, and all of them were treated by conservative method. Six fractures were intra-articular fractures. The most common associated injury was contusion(8cases 42.1$\%$). The number of patients who only rode Inline skating less than 3months(8cases 40$\%$) was the greatest. The number of non-contact injury(14cases, 70$\%$) in Inline skating was more than contact(6cases,30$\%$) injury. 11cases(55$\%$) had operative treatment, and 9cases(45$\%$) had conservative treatment, and there was not any complication. The more detailed study is required since the materials were only limited to fracture patients, and the follow up period was short. Conclusion: The most common age for fracture in Inline skating was in twenties, and thirties, and ankle was the most common fracture site.

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.1-12
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• 2001

Study design : A retrospective study of lumbar disc herniations using results of follow-up computed tomographic scan examinations. Objective : Lumbar disc herniations is one of the cause low back pain and lower extremity pain. To clarify the lumbar disc herniations morphological changes over time(mean 5.3 years) in order to establish a strategy for treatment. Methods : Sixteen patients with lumbar disc herniations who underwent follow-up computed tomographic scan examinations were studied. The changes over time in herniated disc size(herniation ratio) were evaluated using this scan technique. The initial computed tomographic scan allowed classification of the herniations according to herniation ratio: small, medium and large. Results : Comparison with follow-up computed tomographic scans showed that of the 16 patients, in 14 patients(88%), the herniation ratio(HR) was decreased and among them, 8 patients had complet resolution of herniated disc. In 2 patients with small herniations, the HR of one case was increased, the other was decreased. In 8 patients with medium herniations, the HR of one case had no change, the others was decreased. In 6 patients with large herniation, the HR of all patients was decreased. Interestingly, 4 of the 16 patients showed calcification change of herniated disc. Conclusion : There is no doubt that herniated disc size is decreased over time. The largest herniations were those which had the greatest tendency to decrease in size. But in some cases, the HR was increased, or calcification change was showed.

• Archives of Plastic Surgery
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• v.41 no.2
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• pp.122-125
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• 2014

Background Cutaneous malignant melanoma has a poor prognosis. The detrimental effect of incisional biopsies on the outcome of malignant melanoma has been debated. The aim of this study was to determine the effect of the presence and type of biopsy on the prognosis of malignant melanoma. Methods The medical records of 109 malignant melanoma patients treated at Tokushima University Hospital from 1983 to 2007 were reviewed. After excluding 28 cases with stage 0 disease or incomplete data, 81 cases were analyzed in detail with respect to patient sex, age, tumor site, clinical stage at diagnosis, presence of ulceration or lymph node metastasis, and prognosis. The five-year survival and five-year disease-free survival rates of patients who underwent incisional or excisional biopsies were compared with those who did not undergo a biopsy. Results The male-to-female ratio was 1:1.19. The mean age was 61.3 years (range, 19-93 years). The most common site was a lower extremity, and the most common clinical stage was stage II. No significant differences in clinicopathological features, five-year survival rates, and five-year disease-free survival rates were observed among the three groups. Conclusions The presence and type of biopsy neither affected the metastatic rate nor the prognosis of malignant melanoma. The use of incisional biopsies is not encouraged because tumor thickness cannot be measured accurately. However, they may be helpful for confirming the diagnosis if an excisional biopsy cannot be performed.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.204-208
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• 2016

For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

• Journal of the Korean Society for Nondestructive Testing
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• v.25 no.4
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• pp.247-253
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• 2005

This study investigated the effects on foot and ankle roll-over characteristics according to different heel heights during walking. Fifteen female volunteers who have neither musculoskeletal nor foot problems were participated in gait analyses, wearing four different pairs of shoes in different heel heights. To obtain roll-over shape of foot/ankle complex, we used trajectories of knee and ankle joints as well as the renter of pressure between initial contact and opposite initial contact. Results revealed that the entire roll-over shape moved distally as the heel height increased but roll-over characteristics showed uniformly with different heel heights. In addition, we found that nondisablea persons automatically adapted to their foot/ankle complex to varying heel heights within 6cm, by moving the origin of roll-over shape distally to maintain roll-over characteristics. However, since the balance of the gait only by the ankle joint could not be achieved beyond the heel height of 6cm, compensations at the knee and the hip joints occurred simultaneously. Roll-over characteristics in human walking would provide simpler and wider understanding of human walking, and furthermore could be applied to the wide understanding of prosthetics and orthotics of the lower extremity as well as orthopaedic shoes.

• Korean Journal of Applied Biomechanics
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• v.12 no.2
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• pp.361-380
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• 2002

The purposes of this study were to a analysis of friction relation between tennis outsole and tennis playing surfaces. Tennis footwear is an important component of tennis game equipment. It can support or damage players performance and comfort. Most importantly athletic shoes protect the foot preventing abrasions and injuries. Footwear stability in court sports like tennis is incredibly important since it is estimated that as many as 45% of all lower extremity injuries occur in the foot and ankle. The friction force is the force exerted by a surface as an object moves across it or makes an effort to move across it. The friction force opposes the motion of the object. Friction results when two surfaces are pressed together closely, causing attractive intermolecular forces between the molecules of the two different surfaces. The outsole provides traction and reduces wear on the midsole. Today's outsoles address sport specific movements (running versus pivoting) and playing surface types. Different areas of the outsole are designed for the distinct frictional needs of specific movements. Traction created by the friction between the outsole and the surface allows the shoe to grip the surface. As surfaces, conditions and player motion change, traction may need to vary. An athletic shoe needs to grip well when running but not when pivoting. Laboratory tests have demonstrated force reductions compared to impact on concrete. There is a correlation between pain, injury and surface hardness. These are a variety of traction patterns on the soles of athletic shoes. Traction like any other shoe characteristic must be commensurate and balanced with the sport. The equal and opposite force does not necessarily travel back up your leg. The surface itself absorbs a portion of the force converting it to other forms of energy. Subsequently, tennis court surfaces are rated not only for pace but also for the percentage of force reduction.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.774-780
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• 2004

Although traumatic thoracic aortic rupture is potentially a fatal condition requiring surgical attention, the presence of concomitant injury involving other parts of the body may greatly increase the risk of cardio-pulmonary bypass. We report our experience of treating associated injuries prior to the thoracic aortic rupture in these patients. Material and Method: From 1997 to 2003, the medical records of 24 traumatic aortic rupture patients were retrospectively reviewed and checked for the presence of associated injury, surgical method, postoperative course, and complications. Surgical technique comprised thoracotomy with proximal anastomosis under deep hypothermic circulatory arrest followed by side arm perfusion to reestablish cerebral circulation. CSF drainage was performed to prevent lower extremity paraplegia. Result： Major concomitant injuries (n=83) were noted in all of the reviewed patients, Of these, there were 49 thoracic injuries, 18 musculoskeletal injuries, and 13 abdominal injuries, Operations for associated injuries (n=16) were performed in 12 patients on mean 7.6$\pm$12.6 days following the injury. The diagnosis of aortic rupture at the time of injury was detected in only 18 patients. Delayed surgery of the thoracic aorta was performed on average 695$\pm$1350 days after injury and there were no deaths or progression of rupture in any of these patients during the observation period. There were no operative deaths and no major postoperative complications. Conclusion: Treating concomitant major injuries prior to the aortic injury in traumatic aortic rupture may reduce surgical mortality and morbidity.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.91-97
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• 1995

Synovial sarcoma is a malignant soft tissue tumor which is the most prevalent in adolescents and young adults between 10 and 40 years of age. It occurs primarily in the para-articular regions, usually in close association with tendon sheath, bursae and joint capsules. Favorable clinical factors are young age of the patients, tumor size smaller than 5cm, and distal rather than proximal location in the extremities. We analysed clinical findings of 13 cases of synovial sarcoma that had been experienced from January 1983 to December 1992. There were 8 females and 5 males, whose age was averaged as 28 years and 10 months ranging from 6 years to 54 years. The mean follow-up was 3 years(range : 9 months- 9 years 1 month). Palpable mass was frequent clinical symptom and lower extremity especially around the knee was the most prevalent site. Treatment modalities were the combination of surgery, radiotherapy and chemotherapy. Distant metastasis occured in 5(38%) cases : 4 cases to lung and 1 case to neck, and 2 cases had local recurrences. At final follow-up 6 cases were continous disease free, 2 alive with disease and 5 died of disease. The Kaplan-Meier's estimated 5 year survival rate of total 13 cases was 66% and satisfactory results were obtained with mass size smaller than 5cm.