• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.196-201
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• 2013

Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.119-124
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• 2016

Background: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. Methods: Forty-three patients (mean age, $75.0{\pm}5.2years$) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. Results: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. Conclusions: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.3
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• pp.176-181
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• 2009

Synovial chondromatosis is a rare, benign, monoarticular arthropathy that is characterized by the development of highly cellular, metaplastic cartilaginous nodules in the synovial membrane. It commonly affects larger joints such as the knee, elbow, wrist, shoulder, and hip. Synovial chondromatosis of the temporomandibular joint(TMJ) is rare. Moreover, the temporal involvement of synovial chondromatosis without connection with joint is greatly rare. A 44-year-old women had experienced pain of the right TMJ area and limitation of mouth opening. MRI and CT revealed multiple calcified loose bodies and widening in right upper joint space of TMJ and osteolytic lesion in right temporal bone. Treatment consisted of removal of multiple loose bodies, resection of the osteolytic lesion through the preauricular approach. She was diagnosed with primary transitional synovial chondromatosis of TMJ with involvement of temporal bone. In spite of remaining of the loose bodies, pain and mouth opening improved and there have been no recurrence of signs and symptoms for 5 years follow up.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.53-58
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• 1994

Thermography has proven to be an effective way to monitor near-surface blood flow in the body, as well as detecting sensitive changes accompanying painful conditions. Thermography is a non-invasive technique free of biological hazards. It provides a comfortable method of diagnosis and evaluation for neuropathic disorder and its treatment. The following are 3 cases of neuropathic disorder and treatment with follow-up thermography.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• The Journal of Korean Medicine
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• v.25 no.4
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• pp.43-50
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• 2004

Objective : Obesity is associated with degenerative arthropathy giving stress on joints. It also amplifies loads of weight bearing joints by changing the gravity line of the body. Our aim is to investigate the correlation between obesity and lumbar lordosis in obese pre-menopausal Korean females. The hypothesis was tested that there is a correlation between obesity and lumbar lordosis. Methods : A cross-sectional evaluation of 44 Females (baseline age 30.77 ± 6.46) with BMI 31.53 ± 3.82 (kg/㎡) was done. Body composition was measured using bio-impedance analysis (BIA), and anthropometry was done by the same observer. A lateral whole spine X-ray was taken in standing position to measure the lumbar lordotic angle (LLA), Ferguson angle (FA) and lumbar gravity line (LGL). A Pearson correlation was used to measure the correlation between obesity and lumbar lordosis (SPSS 10.0 for windows). Results : Body mass index (BMI kg/㎡) had a negative relationship with LLA((equation omitted)=-0.469), FA((equation omitted) =-0.347) and LGL((equation omitted)=-0.389). Body fat rate had a negative relationship with LLA only(γ=-0.385). Waist circumference had a negative relationship with LLA((equation omitted)=-0.345) and LGL((equation omitted)=-0.346). WH ratio had no relationship with lumbar lordosis. Conclusion : These data show that obesity is related to mechanical structures, such as lumbar lordosis. BMI was the most useful index, which reflects a change of mechanical structure of lumbar, more than other variables in this study.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.242-247
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• 2015

Background: The size of the baseplate used in reverse total shoulder arthroplasty (RTSA) tends to be larger than the average size of the glenoid in the Korean population. The mismatch between the sizes of the baseplate and the patient's glenoid may result in improper fixation of the glenoid baseplate. This in turn may lead to the premature loosening of the glenoid component. Thus, we evaluated the short-term results of using a 25-mm baseplate in RTSA. Methods: Seventeen patients with cuff tear arthropathy underwent RTSA with a 25-mm baseplate. The mean age of the patients was 70.1 years, and the mean follow-up period was 14.0 months. We evaluated clinical outcomes preoperatively and postoperatively: the range of shoulder motion, the American Shoulder and Elbow Surgeons (ASES) score, and the Korean Shoulder Society (KSS) score. Results: We found that the mean ASES score and KSS improved from 35.0 to 74.4 (p<0.001) and from 46.9 to 71.8 (p<0.001) with RTSA. The mean forward elevation and abduction, external rotation also improved from $78.6^{\circ}$ to $134.3^{\circ}$ (p<0.05) and from $66.6^{\circ}$ to $125.0^{\circ}$ (p<0.05), from $20.2^{\circ}$ to $28.4^{\circ}$ (p=0.43). Postoperative complications were seen in 12% of patients, but neither the loosening of the glenoid baseplate nor inferior scapular notching were observed. Conclusions: In sum, the results of using a 25-mm baseplate in RTSA were similar to those of previous reports. Even though the outcomes are those of a short-term follow-up, neither the loosening of the glenoid baseplate nor the scapular notching were observed.

• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.171-175
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• 2015

Purpose: Tibiotalocalcaneal arthrodesis has been used as a treatment option for severe deformity including Charcot arthropathy, avascular necrosis of the talus, and severe osteoarthritis of the ankle and subtalar joint. The purpose of this study was to evaluate the result of the surgical outcome of tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail. Materials and Methods: Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail was performed by one surgeon in 36 cases. Clinical and radiological finding was evaluated using assessment of fusion time, 5th metatarsal-tibial angle, possibility of postoperative complication, visual analogue scale for pain and American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: Union was achieved in 33 cases at an average of 23 weeks (11~29 weeks). There were 3 cases of nonunion and 1 case of reoperation. Nail-tibial angle tended to be larger in nonunion cases. AOFAS score showed significantly poor outcome at malalignment (${\geq}5^{\circ}$), negative value of 5th metatarsal-tibial angle. Conclusion: Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail is considered a useful treatment option for severe destruction and deformity involving ankle and subtalar joint.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.66-73
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• 2008

Purpose: To report the clinical results of tibio-talo-calcaneal arthrodesis fixed with multiple cannulated screws for the cases of painful ankle and hindfoot arthropathy regardless of any deformity or instability. Materials and Methods: A retrospective analysis was performed upon 10 patients that underwent tibio-talo-calcaneal arthrodesis from October 1999 to May 2006. There were 4 males and 6 females, with an average age of 63 years (43-70). The etioloty of arthrodesis included 5 osteoarthritis, 2 Charcot joints, 1 rheumatoid arthritis, 1 Tbc arthritis and 1 residual poliomyelitis. Chief complaints were pain in 9 cases and instability in 1 case. Three patients had combined severe varus deformity. Tibio-talo-calcaneal arthrodesis using multiple cannulated screws was performed by transfibular approach for all cases and short leg cast was applied for 12 weeks postoperatively. Results: The average follow-up period was 16.5 months (12-26 months). VAS pain score was average 8.2 (7-10) and modified AOFAS score was average 25 (8-40, total 86) preoperatively. At final follow-up, VAS score was average 1.0 (0-3) and AOFAS score improved to average 66 (58-75). There were 4 complications: 2 nonunion, 1 tibia stress fracture and 1 malunion. Seven of 8 patients were satisfied with the results at final follow-up. Conclusion: Fixation with multiple cannulated screws for tibio-talo-calcaneal arthrodesis through transfibular approach is a recommendable surgical option.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.493-509
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• 1998

Osteoarthritis(degenerative joint disease), the most common arthropathy affecting the aged people, is characterized by degeneration of articular cartilage with proliferation and remodeling of subchondral bone. Osteoarthritis of the knee, which probably has greater social cost and more associated disability than osteoarthritis of any other joint, prevalence is known to increase with age, and females have higher rates than males; radiographic abnormalities are present in more than 30% of persons more than 65 years old, with approximately 40% of these persons symptomatic. Though the etiology of osteoarthritis is not entirely understood, much information is available regarding risk factors for the development of knee osteoarthritis that permit some reasonable guideline for preventive strategies. Traumatic damage or occupational or recreational overuse of knee joint may result in osteoarthritis, and obesity also is related to osteoarthritis of the knee. A variety of other possible risk factors for the development of knee osteoarthritis have been proposed, including increased bone mass, smoking, diseases such as diabetes or elevated serum uric acid, and some metabolic factors, but the contribustions of these and other factors such as smoking or race and diseases such as diabetes are as yet undetermined. The usual clinical manifestations include pain, stiffnesss, crepitus and loss of function. In oriental medicine, osteoarthritis of the knee is very similar to diseases such as Bijung(痺症), Haksulpung(鶴膝風), Youkjeolpung(歷節風) in symptoms. The diseases such as Bijung(痺症), Haksuipung(鶴膝風), Youkjeolpung(歷節風) is related to the of function liver(肝) and kidney(腎) and risk factors are regarded as Pung(風), Han(寒), sub(濕). The diagnosis of osteoarthritis of the knee has often been based on radiographic appearance and clinical manifestations. The acupuncture therapy of osteoarthritis of the knee has often been based on Stomach meridian(ST), Spleen meridian(SP), Kidney meridian(KI), Liver meridian(LR).