• Journal of Korean Foot and Ankle Society
• /
• v.23 no.2
• /
• pp.58-66
• /
• 2019

Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.

• The Journal of the Korea Contents Association
• /
• v.21 no.2
• /
• pp.667-675
• /
• 2021

This study conducted a systematic review of evidence-based interventions to confirm the importance of gait in dementia patients and to inform the necessity of various interventions necessary for gait. Based on PRISMA's guidelines and evidence-based intervention, a systematic review were conducted, and papers published in domestic journals for the past 10years were collected, and the dependent variables measured along with the intervention type and gait were analyzed. For data search, research papers from January 2011 to June 2020 were collected through RISS, KISS, the National Library of Korea, and the Library of Congress. The main search terms were 'dementia patient', 'walking', and 'walking ability'. Searched 57 papers on dementia patients and gait that meet the literature selection criteria. Among them, papers overlapping with papers before 2010, papers whose dependent variable is not related to gait ability were excluded, and finally, other than dementia diseases. As for the type of gait intervention, there were many programs related to exercise such as fall prevention and physical activity, and the dependent variables measured along with gait were physically and psychologically diverse. Although domestic studies for dementia patients are conducted in a variety of directions and methods, there are few studies on the improvement of function and gait of the lower extremity part of the body. Therefore, it is necessary to study the multifaceted and various intervention methods for walking in dementia patients.

• Journal of Internet Computing and Services
• /
• v.21 no.6
• /
• pp.41-50
• /
• 2020

The consequences of wearing high heels can be different according to the heel height, gait speed, shoe design, heel base area, and shoe size. This study aimed to focus on the knee extension and flexion range of motion (ROM) during gait, which were challenged by wearing five different shoe heel types and two different self-selected gait speeds (comfortable and fast) as experimental conditions. Measurement standards of knee extension and flexion ROM were individually calibrated at the time of heel strike, mid-stance, toe-off, and stance phase based on the 2-minute video recordings of each gait condition. Seven healthy young women (20.7 ± 0.8 years) participated and they were asked to walk on a treadmill wearing the five given shoes at a self-selected comfortable speed (average of 2.4 ± 0.3 km/h) and a fast speed (average of 5.1 ± 0.2 km/h) in a random order. All of the shoes were in size 23.5 cm. Three of the given shoes were 9.0 cm in height, the other two were flat shoes and sneakers. A motion capture software (Kinovea 0.8.27) was used to measure the kinematic data; changes in the knee angles during each gait. During fast speed gait, the knee extension angles at heel strike and mid-stance were significantly decreased in all of the 3 high heels (p<0.05). The results revealed that fast gait speed causes knee flexion angle to significantly increase at toe-off in all five types of shoes. However, there was a significant difference in both the knee flexion and extension angles when the gait in stiletto heels and flat shoes were compared in fast gait condition (p<0.05). This showed that walking fast in high heels leads to abnormal knee ROM and thus can cause damages to the knee joints. The findings in this preliminary study can be a basis for future studies on the kinematic changes in the lower extremity during gait and for the analysis of causes and preventive methods for musculoskeletal injuries related to wearing high heels.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.5
• /
• pp.397-404
• /
• 2020

Purpose: The purpose of this study was to evaluate the treatment outcome of leiomyosarcoma (LMS) of the somatic soft tissue and investigate the prognostic factors. Materials and Methods: Seventy-two patients with soft tissue LMS (extremities and trunk) between 2001 and 2017 were reviewed retrospectively. The local recurrence and metastasis after treatment were examined. The survival rates and prognostic factors affecting survival were investigated. Only patients followed-up more than one year were included. The mean follow-up time was 41 months (range, 7-163 months). Results: The overall survival rates at five-year and 10-year were 73.6% and 66.2%, respectively. The tumor size (p=0.018), grade (p=0.017), and local recurrence (p=0.04) affected survival. Metastases developed in 31.9% (23/72) and the median post metastasis survival was 15.6 months (range, 3-78 months). Conclusion: LMS of the soft tissue developed mainly at the lower extremity. The tumor size, grade, and local recurrence were associated with survival. Post metastatic survival was generally poor despite treatment.

• The Journal of Internal Korean Medicine
• /
• v.44 no.2
• /
• pp.231-243
• /
• 2023

Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.

• Journal of The Korean Society of Integrative Medicine
• /
• v.12 no.3
• /
• pp.189-199
• /
• 2024

Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 m/s) were unaffected by turning direction, while slower speeds (<0.58 m/s) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

• Journal of Chest Surgery
• /
• v.37 no.1
• /
• pp.64-71
• /
• 2004

Background: Video-assisted sympathicotomy is a safe and effective method for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side-effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the relationship between temperature change measured by DITI (digital infrared thermographic imaging) and clinical results according to the level and extent of sympathicotomy in essential hyperhidrosis. we tried to obtain a more precisely and objectively, the distribution and degree of compensatory sweating by DITI and also for ascertaining the clinical usefulness. Material and Method: From January 2000 to June 2002, the thoracoscopic sympathicotomy was performed in 28 patients suffering from essential hyperhidrosis in Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into four groups, Group I: patients having undergone T2 sympathicotomy, Group II: patients having undergone T3 sympathicotomy, Group III: patients having undergone T3,4 sympathicotomy, and Group IV: patients having undergone T2,3,4 sympathicotomy. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory and plantar sweating, and temperature changes of entire body measured by DITI Result: There was no difference in age and follow-up period among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However, the rate of long-term satisfaction were 85.8%, 85.8%, 42.9%, and 28.6% in group I, II, III, and IV (p<0.05). More than embarrassing compensatory sweating was present in 14.2%, 14.2%, 57.1%, 71.4% in group I, II, III, and IV (p<0.05) In regard to plantar sweating, decrease in sweating was expressed in each of four groups, but was not significant between groups. An apparent increase of temperature measured by DITI indicated sufficient denervation and predicted long-lasting relief of essential hyperhidrosis and also decrease in temperature of trunk and lower extremity by DITI had correlated well with postoperative satisfaction, and also postoperative compensatory sweating. Conclusion: We suggested that the incidence and degree of compensatory sweating was closely related to the site and the extent of thoracic sympathicotomy. Resection of the lower interganglionic neural fiber of the second thoracic sympathetic ganglion on the third rib is the most practical and minimally invasive treatment than other surgical methods. We were also to anticipated the distribution and degree of compensatory sweating by DITI precisely and objectively and for ascertaining the clinical usefulness.

• Journal of agricultural medicine and community health
• /
• v.30 no.1
• /
• pp.63-74
• /
• 2005

Objectives: The present study aimed to provide the fundamental data for guiding establishment of measures among the rural elderly population with physical disabilities. The specific goals of this report are to reveal the prevalence of their disabilities, its tendency according to their increasing age, and to assess the background explanations. Methods: The self-administered questionnaires have been performed 432 persons of rural residents age 40 and greater in Kumsan-Gun and Chongyang-Gun, Chungchongnamdo Province. The questionnaire items included presence or not. of disabilities. specific causes for disabilities, anthropometric measures, and amount of physical activities. Results: The proportion of disabilities was higher in women than men, and the functional degree of their limbs decreased with the increasing age. The proportion of disabling extremities was higher in the lower extremities than in the upper ones. Joint diseases were the most prevalent causes for disabilities of extremities. Concerning the degree of depression, 41.2% of study subjects were normal, 47.5% had mild depression, 6.3% moderate, and 5.1% severe depression, with no statistical difference based on age and sex. The worse are the functional degree of both extremities, the greater the degree of depression the subjects had. The odds ratio for presence of disabilities of extremities was 2.6 times higher in women than in men for sex and for age, 50's were 3.5 times, 60's 4.3 times, 70's 4.9 times than 40's, respectively, with increasing tendency with increasing age. The odds ratio for depression was 1.2 times greater in subjects with disabilities than in normal population with no statistical difference. Conclusions: More efforts are needed to establish elderly specific measures for providing proper public health services centering on maintenance of physical functioning among elderly population.

• Journal of the Korean Applied Science and Technology
• /
• v.41 no.3
• /
• pp.813-824
• /
• 2024

This study was conducted to evaluate the long-term effects of training on the physical development and exercise performance of adolescent weightlifters, aiming to provide effective training and management strategies for improving competitive performance. In order to achieve the objectives of the study, adolescent weightlifters from middle and high schools in Chungcheongnam-do province [male middle school-aged athletes, n=5; female middle school-aged athletes, n=5; male high school-aged athletes, n=12; female high school-aged athletes, n=8] were examined over approximately 10 months of weightlifting-based training to analyse the changes in body composition, physical fitness (muscular strength, muscular endurance, agility, flexibility, dynamic balance, coordination), and isokinetic muscular function (trunk and lower extremity). As a result, it was found that the physical development of middle and high school-aged athletes underwent physical development primarily characterized by an increase in lean body mass. Additionally, back muscle strength and power, which contribute to rapid and efficient force transmission between the upper and lower body, as well as grip strength necessary for controlling the barbell with a stable grip, are significant factors. These aspects were notably enhanced through specialized training and competitive experience for weightlifting performance at the high school level. On the other hand, changes in factors beyond the primary physical attributes contributing to weightlifting performance were limited, suggesting differences in effectiveness likely stemming from the specific composition of training programs or the athletes' experience and skill levels. Collectively, the findings from this study, which evaluates the physical characteristics and exercise abilities of adolescent weightlifters, are expected to contribute to improved competitive performance of weightlifters.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.610-618
• /
• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.