• Physical Therapy Korea
• /
• v.16 no.2
• /
• pp.9-15
• /
• 2009

The purposes of this study were to compare abductor hallucis (AbdH) muscle activity during toe curl exercise according to position of interphalangeal joint (IPJ). Fifteen healthy subjects with neutral foot were recruit for this study. All subjects performed toe curl exercise with towel while maintaining the IPJ in flexion (condition 1) and extension (condition 2). Toe curl exercise with towel was perform three trials for five second periods in each condition. Surface electromyography (EMG) activities were recorded from three muscles (AbdH, tibialis anterior, peroneous longus) in each condition. EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities acoording to position of IPJ were compared using a paired t-test. This study showed that the EMG activity of AbdH during toe curl exercise with IPJ extension significantly increased compared to those during toe curl exercise with IPJ flexion (p<.05). However, the EMG activity of tibialis anterior and peroneus longus were not significantly different between the conditions (p>.05). These results suggest that toe curl exercise with towel must be performed with extension of IPJ in order to strengthen intrinsic muscle in subjects with overuse injuries related to excessive pronation.

• Archives of Plastic Surgery
• /
• v.43 no.1
• /
• pp.66-70
• /
• 2016

Background In this study, we characterize the morbidity at the donor-site of partial second toe pulp free flaps in terms of wound management as well as long-term outcomes. Methods A single-institutional retrospective review was performed for patients who had undergone partial second toe pulp free flap transfer to the fingertip. Patient charts were reviewed for infection, skin necrosis, wound dehiscence, and hematoma for the donor site. Additionally, a questionnaire survey was given to patients who had a follow-up of longer than 1 year to characterize long-term postoperative pain and appearance. Results The review identified a total of 246 cases. Early wound complications were significant for wound dehiscence (n=8) and hematoma (n=5) for a wound complication rate of 5.3%. The questionnaire was distributed to 109 patients, and 54 patients completed the survey. Out of these 54 patients, 15 patients continued to have donor-site pain (28%) at a mean follow-up period of 32.4 months. However, the pain intensity was relatively low in the range between 2 to 5, on a 0-10 scale. None of these patients felt this donor-site pain interfered significantly with daily activity, nor did any patient require pain medications of any type. Donor-site appearance was satisfactory to most patients. Conclusions The partial second toe pulp flap was associated with low rates of wound complications and favorable long-term outcomes. Given the functional and aesthetic gain in the recipient finger, donor-site morbidities appear acceptable in this patient population. This study can be helpful in counseling patients regarding donor-site morbidity during the informed consent process.

• Archives of Plastic Surgery
• /
• v.40 no.3
• /
• pp.226-231
• /
• 2013

Background The reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps. Methods A single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture. Results All of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series. Conclusions Flexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

• Journal of Korean Foot and Ankle Society
• /
• v.18 no.4
• /
• pp.153-158
• /
• 2014

Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

• The Journal of the Korean bone and joint tumor society
• /
• v.7 no.4
• /
• pp.151-156
• /
• 2001

The reported incidence of osteosarcoma of the foot varies between 0.2-2% of all osteosarcoma. Low grade osteosarcoma of the long bone represents only 1.9% of all osteosarcoma. A 38-year-old female had suffered painful mass in the proximal phalanx of the second toe for 1 year. Radiographic finding showed enlarged osteloytic mass which had penetrated thin cortex of the second toe and apparent increased uptake in bone scan was seen. Mass resection with autogenous bone graft using rib was performed. Histologically, the tumor was compatible with "low grade osteosarcoma". Second stage wide resection was performed. Because low grade osteosarcoma located in the proximal phalanx of the second toe is very rare, we report this unusual case with review of literature.

• Archives of Reconstructive Microsurgery
• /
• v.16 no.2
• /
• pp.63-67
• /
• 2007

This study was designed to introduce free toe tissue transfer using infiltration method of local anesthetic agent. Four toe pulp tissues were transferred to reconstruct finger tip defect in four patients who were not suitable for general anesthesia. Two flaps taken from the lateral side of the great toe was used for reconstruction of thumb defect and two flaps from the medial side of the second toe for resurfacing of the index and fifth finger. Flap sizes were various from $2.0{\times}2.0\;cm^2$ to $1.6{\times}4.0\;cm^2$. Anesthesia was induced by infiltration of 2% lidocaine hydrochloride (with 1:100,000 epinephrine) with dilution of normal saline in same volume unit, as like as in ordinary digital block. All vessels were anastomosed within 2 cm of distance from the proximal margin of the defect. Whole operative procedures were carried out by one team. All flaps were successfully taken without complication. The average operation time was 4 hours 10 minutes. The amount of anesthetic agent used in whole operative procedures was roughly 4 mL in the toe, 8 mL in the finger, and 12 mL totally. In conclusion, free toe tissue transfer using infiltration method of local anesthetic agent would be good strategy for finger tip reconstruction in the patient not suitable for general anesthesia.

• Journal of Korea Game Society
• /
• v.16 no.4
• /
• pp.79-86
• /
• 2016

Monte-Carlo Tree Search(MCTS) is a best-first tree search algorithm and has been successfully applied to various games, especially to the game of Go. We evaluate the performance of MCTS playing against each other in the game of Tic-Tac-Toe. It reveals that the first player always has an overwhelming advantage to the second player; and we try to find out the reason why the first player is superior to the second player in spite of the fact that the best game result should be a draw. Since MCTS is a statistical algorithm based on the repeated random sampling, it cannot adequately tackle an urgent problem that needs a strategy, especially for the second player. For this, we propose a strategic MCTS(S-MCTS) and show that the S-MCTS player never loses a Tic-Tac-Toe game.

• Journal of Welding and Joining
• /
• v.1 no.1
• /
• pp.37-46
• /
• 1983

This paper describes a study of fillet welded joint stressed perpendicular to the weld line. The finite element method was used to determine the stress intensity factor for cruciform joint at weld toe and root cracks according to variation of H/Tp, weld angle and main plate thickness. But, in this study, weld angle was fixed at 45.deg., since the variation of weld angle affect the stress intensity factor little, also main plate thickness was fixed. Pulsating tension fatigue test was done at the second phase of experiment. The work using the concepts of the fracture mechanics on the stable crack growth, was in the correlation of the experimental fatigue stress-life behavior because the fatigue behaviors of various joint geometries are related to the stress intensity factors calculated by F.E.M. analysis. Main results obtained are summarized as follows. 1) According to the propagation of toe crack, the variation of the stress intensity factor at root crack is obvious as H/Tp is smaller. 2) According to the propagation of root cracks, the change of the stress intensity factor of the toe is very large with propagation of root crack. 3) The calculation formula of the stress intensity factor of crack propagation at the root crack was obtained. 4) The calculation formula of the stress intensity factor at the toe cracks was obtained in similar manner. 5) From the results of experiment, the velocity of fatigue crack propagation at the weld toe and root was estimated.

• Korean Journal of Human Ecology
• /
• v.12 no.1
• /
• pp.75-84
• /
• 2003

The objective of this paper was to analyse the foot type of female university students by the direct and indirect measure of foot and the measures of foot outline. The results were as follow: 1. The length and the width of foot were small and ankle slender and the modification of the big toe slight. 2. The analysis on the 16 measure items revealed five factors; the first factor was related to the width and girth of foot, the second one to the length of foot, the third one to the transformation of the little toe, the fourth one to the height of foot, the fifth one to transformation of the big toe. 3. The grouping on the shape of foot revealed three types. The inline angle of foot was the smallest in average in the type 1, while it appeared to be middle in the other types. The wider foot shapes were grouped as type 2 because their inline and outline angles of foot were the biggest in average. In the type 3, the big toe was curved a lot, since it was the largest in average. 4. From the naked eye measuring method, classification from which toe was popped-out told that Egyptian foot was 30.9%, Greek foot 27.9%. On the other hand, the instrumental method showed that Egyptian foot was 57.3%, Squared foot 35.3% and Greek foot 7.4%. 5. The result from the analysis about the traits of foot shape by the degree of the arch formation of bottom foot, showed that 33.8% had the normal foot, 66.2% slightly flat foot or middle one. There was no one with rigid flat foot. 6. The shoes size they declared were that 240cm was 33.3%, 235cm 18.1% and 245cm 18.1%. The shape of their shoe heel were flat heel(34.8%), cuban heel(25.5%), and narrow straight heel(19.9%); and that of the shoe toe were round toe(25.4%), oval toe(20.4%) and squared toe(20.4%). 7. The discomforting parts when they wear shoes were the little toe(35.4%), the rear of foot(13.9%), and the width of foot(13.9%), which was related to their dislike of shoe with the pointed toe.

• Clinical and Experimental Pediatrics
• /
• v.45 no.10
• /
• pp.1288-1291
• /
• 2002

Fetal valproate syndrome has been described as a distinctive pattern of minor anomalies of the face and digits. This pattern has not been delineated completely but appears to involve brachycephaly with a high forehead, shallow orbit, ocular hypertelorism, small nose, small mouth, low set posteriorly rotated ears, long overlapping fingers and toes, and hyperconvex fingernail. Cleft palate and congenital heart disease have occasionally been described in babies exposed to valproate during embryogenesis. We report a neonate born from an epileptic mother receiving sodium valproate during pregnancy. This neonate presented with characteristic facial abnormalities, both elbow contractures, and overlapping of right first and second toe, forth and fifth toe, and left first and second toe. This case raises the possibility that these abnormal appearances might be caused by intrauterine valproate exposure.