• Journal of the Korean Orthopaedic Association
• /
• v.55 no.3
• /
• pp.244-252
• /
• 2020

Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

• Journal of Nutrition and Health
• /
• v.41 no.8
• /
• pp.742-753
• /
• 2008

The purpose of this study is to investigate risk factors of pre-hypertension and hypertension in rural residents. Nine hundred and ninety four subjects aged 40-70 yrs in Chungnam-do participated in this study. The subjects (n = 824) were classified into three groups of hypertensive, pre-hypertensive, and normotensive according to the Joint National Committee (JNC)-7 criteria. The weight, body mass index (BMI), waist-hip ratio (WHR), and serum total protein, albumin, BUN, and triglyceride (TG) were positively correlated with SBP and DBP. After adjusted by age, sex and BMI, the total protein, albumin and TG were significantly correlated with SBP and DBP (p < 0.01). There was no significant difference in eating habits according to the level of blood pressure. The serum albumin, creatinine, Glu-FBS, Glu-PP l20, and triglyceride were higher in both prehypertensive and hypertensive group than in the normotensive group. However, mean serum cholesterol was not different among three blood pressure groups. In this study, the common risk factors of pre-hypertension and hyper-tension were male, age of fifties, lower education level, ex-smoking, higher drinking frequency, higher BMI, body fat %, waist circumference, WHR, serum albumin and diabetes, even though the degree of risks in these variables were higher in the hypertensive group. The higher BUN was a risk factor of prehypertension, while the family history, prediabetes, serum total protein, Glu-PP l20 and higher alcohol drinking amount were the risk factors of hypertension. This result suggests that maintaining good health habit and normal range of blood parameters as well as controlling body weight have to be paid attention in order to prevent hypertention, and further reseasch on the relationship of blood pressure and BUN are needed.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.1
• /
• pp.39-44
• /
• 2005

Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.

• The Korean Journal of Food And Nutrition
• /
• v.28 no.2
• /
• pp.302-312
• /
• 2015

This study was conducted to evaluate the effects of constitutional diets in comparison with general low calorie diets in obese women. The subjects were 52 adult obese women that participated in a calorie restriction diet program (control group, n=16) or a constitutional diet program (experimental group, n=36) for 8 weeks. The subjects in the experimental group were classified as negative (Yin) or positive (Yang) constitution. The obesity management program focused on the calorie restriction diet (300~400 kcal reduction per day) for the control group, whereas, for a constitutional diet without calorie restrictions was allowed for the experimental group. Daily intakes of nutrient and food were assessed using a 24 hr recall method. Body measurements and blood biochemical parameters were measured at baseline and after 8 weeks. After the intervention, weight, body fat, BMI, waist circumference and hip circumference decreased significantly in both the control and experimental group. Energy intake increased from 1,679.6 kcal to 1,810.6 kcal along with significant increase in protein, carbohydrate, fiber, calcium, phosphorus, iron, zinc, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin and vitamin C in the experimental group. Calcium intake increased from 54.0% to 72.4% of DRI in the experimental group. Hemoglobin concentrations were significantly decreased in the control group, but were increased in the experimental group. In addition, blood glucose, serum total cholesterol and triglyceride were significantly decreased in the experimental group. In conclusion, consumption of a constitutional diet without calorie restrictions for 8 weeks was effective for weight reduction with improvement of blood glucose, serum cholesterol and triglyceride.

• Pediatric Infection and Vaccine
• /
• v.18 no.1
• /
• pp.31-39
• /
• 2011

Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

• Journal of Nutrition and Health
• /
• v.41 no.3
• /
• pp.254-263
• /
• 2008

This study was conducted to analyze the effect of isoflavone intake on prevention of chronic disease in middle and old aged man. In this study we used FFQ (Food frequency questionnaire) and the isoflavone intake level of the subjects was 25.10 mg per day. We divided the subjects into three group -high, medium, low isoflavone intake level- and investigated the relation among isoflavone intake level and clinical/anthropometric characteristics. The intake of isoflavone was inversely related with the body fat in male subjects. And we also divided the subjects into 2 groups with normal and abnormal clinical/anthropometric risk factor. The isoflavone intake level of the abnormal group with high TG, high WHR and high body fat was lower than the normal group. The main food source of isoflavone was soybean curd, bean sprout, soybean paste, soybean and soy milk, and we also investigated the relation between frequency of soybean food and anthropometric and clinical variables. The frequencies of soybean curd, soybean paste, soybean broth, soy milk, bean sprouts, peanuts, soybean and dambuk as well as intake of isoflavone were inversely correlated with some anthropometric and clinical variables such as blood pressure, TG, BMI, % body fat, and waist-hip ratio, whereas positively correlated with HDL cholesterol, muscle mass and bone density. We suggest that high consumption of soy products and isoflavone is associated with decreased blood lipid and body fat in middle and old aged man and might be useful for prevention cardiovascular diseases. From this study, we obtained valuable basic information on recommended isoflavone intake level and guidelines for the prevention of some chronic diseases/health problems.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.8 no.1
• /
• pp.46-50
• /
• 2009

Purpose: This study was designed to analyze? the chronic pain of adolescent Taekwondo athletes, to research the understanding about chronic pain of coaches and athletes, to? reduce the development of chronic pain. Materials and Methods: From March. 2006 to June 2007, 210 athletics and 12 coaches of elementary, middle and high school in Kwang-ju city were surveyed. They was evaluated by physical examination, simple radiographs and MRI. Results: In 210 athletics, 162(77.1%) athletes had chronic pain. 19(11.7%) athletes had over three regions of pain, 74(45.7%) athletes had two regions of pain, 69(42.6%) athletes had one region of pain. In 274 cases of 164 athletes, the most common region was foot and ankle(145 cases, 52.9%), followed by hand(47 cases, 17.2%) and knee(38 cases,13.9%), hip(25 cases, 9.1%), and lumbar area(19 cases, 6.9%) The chronic pain was classified by injury type. Contusion of foot was 103 cases(most common), sprain of ankles was 40cases, Contusion of hands and wrists was 28 cases, and so on. The etiologies of injury that causes the chronic pain were match injury in training that is most common, intensive exercise and match injury in competition. Conclusion: The chronic pain was common in adolescent Taekwondo athletes. The ankle and foot were the most common region of chronic pain and the match injury was the most common injury, caused the chronic pain. Although athletes had considerable mental stress about chronic pain, the treatment of chronic pain and rest were insufficient. Therefore the variable effort to prevent injury and to treatment injury must be considered importantly.

• Journal of Life Science
• /
• v.31 no.10
• /
• pp.913-921
• /
• 2021

Limb-girdle muscular dystrophy (LGMD) which is characterized by progressive muscle weakening of the hip and shoulder shows both dominant and recessive inheritances with many pathogenic genes including TTN. This study performed to identify genetic causes of a male patient with late onset (45 years old) autosomal recessive LGMD and atrial flutter. By application of the whole exome sequencing, we identified bi-allelic variants of TTN gene in the patient. One allele had a single missense variant of [c.24124G>T (p.V8042F)], while the other allele consisted of three missense variants of [c.29222G>C (p.R9741P) + c.67490A>G (p.H22497R) + c.75376C>T (p.R25126C)]. The p.V8042F allele was transmitted from his mother, while the other haplotype allele was putatively transmitted from his father. His two unaffected sons had only the p.R9741P. These variants have been not reported or rarely reported in the public human genome databases (1,000 Genome, gnomAD, and KRGDB). Most variants were located in the highly conserved immunoglobulin or fibronectin domains and were predicted to be pathogenic by the in silico analyses. The TTN giant protein plays a key role in muscle assembly, force transmission at the Z-line, and maintenance of resting tension in the I-band. In conclusion, we think that these bi-allelic compound heterozygous mutations may play a role as the genetic causes of the LGMD phenotype.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.1
• /
• pp.30-38
• /
• 2009

Purpose: To investigate the physical and biochemical parameters related with elevated serum alanine aminotransferase (ALT) levels in obese children. Methods: One hundred forty-two obese or overweight children who visited the out-patient clinics of Chungnam National University Hospital between January 2006 and August 2008 were enrolled. Physical measures and biochemical tests were performed in all patients. Liver sonography was performed in 43 patients. They were divided into the following 2 groups based on ALT levels: group I, normal ALT levels (n=65); and group II, elevated ALT levels (n=77). We compared the physical measures, biochemical results, and ultrasonographic findings of the livers in both groups. Other causes of elevated serum ALT levels were ruled out. Results: The male-to-female ratios were 1.6:1 in group I and 7.6:1 in group II. Among physical parameters, the waist circumference-to-height ratio and hip circumference-to-height ratio were significantly higher in group II (p=0.001 and 0.046, respectively). Among biochemical parameters, aspartate aminotransferase (AST), ${\gamma}$-glutamyltransferase (${\gamma}$-GT), and total cholesterol levels were significantly higher in group II (p<0.001, 0.001, and 0.001, respectively). The AST/ALT ratio was <1 (mean, 0.55) and statistically lower in group II. There was a positive correlation between the serum ALT level and ${\gamma}$-GT (p<0.001, r=0.750), and a positive correlation between the serum ALT level and the waist circumference-to-height ratio in group II (p<0.001, r=0.401). Conclusion: The results suggest that the waist circumference-to-height ratio and ${\gamma}$-GT may be associated with elevated alanine aminotransferase activity in obese children.

• Journal of Nutrition and Health
• /
• v.40 no.6
• /
• pp.517-525
• /
• 2007

This study was performed to assess the effects of physiological factors and lifestyles on bone mineral density (BMD) in 64 postmenopausal women. Sixty four subjects were selected out of 223 postmenopausal women in Seoul and Kyunggido. The BMD of the lumbar spine (L2 ${\rightarrow}$ L4) and femoral neck were measured dual energy X-ray absorptiometry (DEXA). Subjects were assigned to one of three groups such as normal (T-score > -1, n = 20), osteopenia (-2.5 < Tscore ${\leq}$ -1, n = 24), and osteoporosis (T-score ${\leq}$ -2.5, n = 20). Anthropometric measurements and questionares were administered to these women. The mean age, height, weight and BMI were 62.09 yrs, 153.78 cm, 56.09 kg and 23.70 $kg/m^2$ respectively. The BMDs of lumbar spines (L2 ${\rightarrow}$ L4), femoral neck were 0.84 $g/cm^2$, 0.71 $g/cm^2$ respectively. Years after menopause and age of last delivery of the osteoporosis and osteopenia group were significantly longer than the normal group (p < 0.05). The hours of exercise and outdoor activity of the normal group were longer than the osteoporosis and osteopenia group, but there were no significant differences among the three groups. The BMDs of these two sites were positively correlated with weight, BMI, hip and body fat and negatively correlated with LBM, TBW. These results show there are no consistent effects on bone mineral density, adjusting for age and BMI, of physiological factors and lifestyles in postmenopausal women. Therefore. this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight.