• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.125-131
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• 2022

This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.108-114
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• 2022

Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.

• Genomics & Informatics
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• v.20 no.3
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• pp.30.1-30.9
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• 2022

Hereditary spastic paraplegia is a not common inherited neurological disorder with heterogeneous clinical expressions. ALDH18A1 (located on 10q24.1) gene-related spastic paraplegias (SPG9A and SPG9B) are rare metabolic disorders caused by dominant and recessive mutations that have been found recently. Autosomal recessive hereditary spastic paraplegia is a common and clinical type of familial spastic paraplegia linked to the SPG11 locus (locates on 15q21.1). There are different symptoms of spastic paraplegia, such as muscle atrophy, moderate mental retardation, short stature, balance problem, and lower limb weakness. Our first proband involves a 45 years old man and our second proband involves a 20 years old woman both are affected by spastic paraplegia disease. Genomic DNA was extracted from the peripheral blood of the patients, their parents, and their siblings using a filter-based methodology and quantified and used for molecular analysis and sequencing. Sequencing libraries were generated using Agilent SureSelect Human All ExonV7 kit, and the qualified libraries are fed into NovaSeq 6000 Illumina sequencers. Sanger sequencing was performed by an ABI prism 3730 sequencer. Here, for the first time, we report two cases, the first one which contains likely pathogenic NM_002860: c.475C>T: p.R159X mutation of the ALDH18A1 and the second one has likely pathogenic NM_001160227.2: c.5454dupA: p.Glu1819Argfs Ter11 mutation of the SPG11 gene and also was identified by the whole-exome sequencing and confirmed by Sanger sequencing. Our aim with this study was to confirm that these two novel variants are direct causes of spastic paraplegia.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.417-426
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• 2021

Background Soft tissue coverage plays a vital role in replacing the vascularity of the underlying bone in Gustilo type IIIB fractures. The aim of this article was to evaluate the feasibility of local pedicled flaps in type IIIB fractures at a tertiary care center. Methods We included all cases of open Gustilo-Anderson type IIIB fractures of the tibia treated with local flap coverage from January 2017 to February 2019. We carried out a retrospective analysis to investigate the relationships of complications, hospital stay, and cost-effectiveness with the choice of flap, infective foci, site and size of the defect, and type of fixation. Results Out of 138 Gustilo type IIIB fractures analyzed in our study, 27 cases had complications, of which 19 (13.76%) involved flap necrosis, four (2.89%) were infections, three (2.17%) involved partial necrosis, and one (0.72%) was related to bone spur development. Flap complications showed a statistically significant association with the perforator flap category (propeller flaps in particular) (P=0.001). Flap necrosis showed a significant positive correlation with cases treated within 3 weeks after trauma (P=0.046). A significant positive correlation was also found between defect size and the duration of hospital stay (P=0.03). Conclusions Although local flaps are harvested from the same leg that underwent trauma, their success rate is at least as high as microvascular flaps as reported from other centers. Amidst the local flaps, complications were predominantly associated with perforator flaps.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.233-238
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• 2022

Background: This study investigated the distribution of valve incompetence in patients with chronic venous disease (CVD) and its correlation with the clinical category of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification. Methods: In total, 1,386 limbs with clinically suspected CVD were categorized according to the CEAP classification and consecutively underwent duplex ultrasonography between April 2017 and December 2020. Results: There were 362 limbs in male patients and 1,024 limbs in female patients. The limbs were classified as C0s-C1 (608 limbs, 43.8%), C2 (727 limbs, 52.5%), or C3-C6 (51 limbs, 3.7%). The prevalence of saphenous vein incompetence in CEAP C0s-C1 limbs was 43.6%. The saphenofemoral junction (SFJ) was competent in 37% of CEAP C2-C6 limbs. The CEAP C3-C6 category was not correlated with reflux patterns of the saphenous vein system (Cramer's V=0.07), incompetent SFJ (Cramer's V=0.07), deep vein reflux (Cramer's V=0.03), or the distribution of incompetent segments in the great saphenous vein (GSV) (Cramer's V=0.11). Conclusion: Duplex ultrasonography is necessary to formulate a proper treatment plan for limbs categorized as CEAP C0s-C1. The SFJ was competent in more than one-third of CEAP C2-C6 limbs with GSV reflux; as such, flush ligation of the GSV may be unnecessary in these patients. The CEAP C3-C6 category showed no correlations with reflux patterns of the saphenous vein system, SFJ reflux, deep vein reflux, or the distribution of incompetent segments in the GSV.

• Physical Therapy Korea
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• v.29 no.1
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• pp.48-53
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• 2022

Background: The gastrocnemius tightness can easily occur. Gastrocnemius tightness results in gait disturbance. Thus, various interventions have been used to release a tight gastrocnemius muscle and improve gait performance. Moreover, focal muscle vibration (FMV) has recently been extensively researched in terms of tight muscle release and muscle performance. However, no study has investigated the effects of FMV application on medial gastrocnemius architectural changes. Objects: In this study, we aimed to investigate the effects of FMV on medial gastrocnemius architecture in persons with limited ankle dorsiflexion. Methods: Thirty one persons with <10° of passive ankle dorsiflexion participated in this study. We excluded persons with acute ankle injury within six months prior to study onset, a history of ankle fracture, leg length discrepancy greater than 2 cm, no history of neurological dysfunction, or trauma affecting the lower limb. The specifications of the FMV motor were as follows: a fixed frequency (fast wave: 150 Hz) and low amplitude (0.3-0.5 mm peak to peak) of vibration; the motor was used to release the medial gastrocnemius for 15 minutes. Each participant completed three trials for 10 days; a 30-second rest period was provided between each trial. Medial gastrocnemius architectural parameters [muscle thickness (MT), fiber bundle length (FBL), and pennation angle (PA)] were measured via ultrasonography. Results: MT significantly decreased after FMV application (p < 0.05). FBL significantly increased from its baseline value after FMV application (p < 0.05). PA significantly decreased from its baseline value after FMV application (p < 0.05). Conclusion: FMV application may be advantageous in reducing medial gastrocnemius excitability following a decrease in the amount of contractile tissue. Furthermore, FMV application can be used as a stretching method to alter medial gastrocnemius architecture.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.349-356
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• 2022

Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

• Journal of Acupuncture Research
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• v.39 no.2
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• pp.134-138
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• 2022

Distal femur osteotomy (DFO) is a controlled surgical break of the femur performed to allow realignment of the limb. Redistribution of the load aims to correct the abnormal mechanical weight-bearing axes in patients with abnormal alignment of the lower extremities, and degenerative changes in the knee joint. This report describes a complex Korean medicine treatment for a patient complaining of knee pain and stiffness following a DFO. Post-operative care for the patient lasted 78 days with treatment including pharmacopuncture, acupuncture, herbal medicine, cupping therapy, and physiotherapy. The effectiveness of the treatments was evaluated using the numerical rating scale, range of motion of the knee, and by physical examination. After treatment, these evaluation indicators improved, suggesting that the complex Korean medicine treatment received by the patient was an appropriate treatment for knee pain and stiffness following a DFO.

• 한국체육학회지인문사회과학편
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• v.53 no.2
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• pp.531-540
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• 2014

The purpose of this study was to investigate the differences between two inflatable kayak by recording performance related variables during the kayak forward stroke motion. A total of 5 elite high school kayak players were recruited to participate while their kinematics and muscle activations were recorded while performing inside their high school swimming pool. Boat velocity, boats swaying angle, the average angular velocity and were used to evaluate the boats performance. The player's trunk rotational range of motion, knee flexion-extension angle range of motion, maximum trunk rotation angle, the knee flexion-extension angular velocity, and the upper and lower limb muscle activations were calculated and analyzed for the player's efficiency evaluation. There were no significantly different variables for the player's kinematics and their muscle activations for the two conditions. The B kayak was significantly faster than the A kaya. In addition there were no significant differences between the remaining variables for the two kayaks. In conclusion, the B kayak was faster than the A kayak, but neither of the kayaks had an influence on the player's performance variables.

• Physical Therapy Korea
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• v.30 no.1
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• pp.23-31
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• 2023

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.