• Physical Therapy Korea
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• v.11 no.2
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• pp.17-25
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• 2004

The purpose of this study was to assess the effect of applied insole types to lower extremities muscle fatigue during treadmill exercise. The control group and each different insole type group consisted of ten healthy male subjects. In the control group and each different insole type (soft type; 10 shore, semi-rigid type; 33 shore, rigid type; 50 shore) treadmill exercise was performed in twenty-five minutes. The electromyography (EMG) signals of four muscle (tibialis anterior, gastrocnemius medialis, rectus femoris, biceps femoris) were recording at sampling rate of 1024 Hz during treadmill exercise. The localized muscle fatigue (LMF) can be investigated using power spectral analysis. When did data analysis that excepted initial five minutes. The raw EMG signals was processed using the fast Fourier Transformation (FFT) and the median power frequency value was determined in initial ten second period and in last ten second period. Fatigue index was calculated and collected data were statistically analyzed by SPSS version 10.0 two-way using analysis of variance (ANOVA) with repeated measures ($4{\times}4$) was used to determine the main effect and interaction. Post hoc was performed with least significant difference. A level of significance was .05. Muscles fatigue index were significantly decreased in insole types (p<.05) and not significantly different in muscle (p>.05). Post hoc analysis shows that fatigue index in soft insole type, semi-rigid insole type and rigid insole type were lower than that control group (p=.028, p=.146, p=.095). There were no interaction between insole type and muscles (p>.05). The finding of this study can be used as a fundamental data when insole is applied and insole can be used to decreased of a fatigue during the dynamic exercise.

• Korean Journal of Adult Nursing
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• v.18 no.4
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• pp.612-621
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• 2006

Purpose: The purposes of this study was to identify the health status, health-related life habits, activities of daily living and biophysical index of the elderly in Korea and Japan respectively, and to compare the Korean elderly with those of the Japanese elderly. Method: Two hundred ninety five elderly from Korea and 325 elderly from Japan, aged over 65 years were conveniently recruited from welfare centers in both countries. Health status, health-related life habits, and activities of daily living were assessed by self-report questionnaires. BMI, lean body mass, body fat, body fat rate, muscle area of limbs and grip strength were measured for biophysical indices. Descriptive statistics, non paired t-test and Chi-square test were used to describe and to compare the levels of these variables. Results: The mean scores on frequencies of Korean and Japanese elders' chronic diseases were 2.9 and 0.8. The mean scores on activities of daily living were 9.8 and 12.4 respectively. The Korean elderly had higher mean scores of BMI, and body fat rate than The Japanese elderly, and showed lower mean scores of muscle areas of the lower extremities and grip strength. Hypertension was the most prevalent disease in the both groups. Conclusion: Significant differences in several variables of health status, health-related life habits, activities of daily living and biophysical index were noted between the Korean and Japanese elderly.

• Korean Journal of Computational Design and Engineering
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• v.17 no.3
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• pp.149-155
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• 2012

The ankle over-pronation causes the mechanical overloading transferred to proximal areas (i.e. knees or hips) over time. Thus, the over-pronation is recognized as a contributory factor in a wide variety of musculo-skeletal pathologies in lower extremities. Commonly, over-pronated ankles are treated using specially designed insoles that support medial heels and correct the posture of lower limbs. However, the biomechanical effects of the insoles are not yet fully understood, so there still are controversies whether such insoles really have clinical significance. In this study, in order to verify the effects of insoles and determine the best shape of the insoles, we examined how the medio-lateral knee joint reaction force changes due to insole conditions through a case study about a subject. As a result, it is revealed that the medial heel post, which drastically reduced the peak medio-lateral knee joint reaction force, has significant effects on the gait of the over-pronated patients. However, in case that the arch support is combined together, the positive effect of the medial heel post may rather decrease.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.5 no.1
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• pp.59-74
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• 1999

66 patients with low back pain were evaluated to determine if any differences of weight bearing were existed between the same side leg that feel pain(pain side leg) and that without pain (non-pain side leg) of lower extremities while weight bearing. 66 patients were divided into 3 groups according to pain pattern such as low back pain only(26), radiating pain only(21) and low back pain with radiating pain (19). Control group were 28 normal persons. The weight bearing was rated by Limloader(Model LLD-2000, Ver 1.2) and analyzed by paired and independent t-test, one-way ANOVA, Dunan's analaysis and Pearson's correlation analysis. The results of this study were as follows : 1. In patient group, significant difference of weight bearing rating between pain side leg and non-pain side leg was found. There was borne significantly less weight bearing rating(14.68%) on the pain side leg(P<.001). 2. In normal group, there was no significant difference between left and right leg(P>.05). But there was significant difference(3.21%) in absolute difference of both leg(p<.001). 3. The difference of 1 and 2 was 11.47% : more difference of weight bearing rating between both legs in patient group than that of the control group(p<.001). 4. There were significant differences of weight bearing rating in those 3 groups : low back pain group(10.30%), radiating pain group (17.90%) and low back pain with radiating pain group (17.10%) (p<.001). 5. There was significant correlation between pain intensity and difference of weight bearing rating(p<.05). The severer pain intensity. the more difference of weight bearing rating was found. 6. There was no significant correlation between the age, height and duration of symptom, etc(p>.05).

• The Korean Journal of Pain
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• v.7 no.2
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• pp.287-291
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• 1994

A 49 years old male patient was admitted to our neuro-pain clinic with symptoms of left 11th intercostal neuralgic pain and low back pain that developed 2 months prior to admission. Upon initial physical examination, motor weakness or sensory deficit were absent. Intercostal neuralgic pain improved significantly after we performed thoracic root thermocoagulation. However on the afternoon of the procedure the patient started to experience voiding difficulty, saddle anesthesia and rapidly progressing motor weakness and hypoesthesia that involved the lower back area and the lower extremities for three days. Based on these symptoms spinal cord compression was suspected and subsequently plain T-L spine X-rays and T-L spine MRI were performed. A spinal tumor that appeared metastatic in origin was seen at the T11 and T12 level. Liver ultrasonography demonstrated the presence of a $4{\times}4cm$ sized ill defined mass in the posterior segment of the right lobe. The patient was diagnosed to have hepatocellular carcinoma after needle aspiration biopsy and cytologic studies. Further orthopedic surgery was recommended but as the patient rejected any further treatment and examination, it was not possible to confirm the primary focus of the tumor. However as metastasis of a primary liver tumor to the spine is a rare occurrence, some other primary focus of metastasis or even a malignant primary tumor of the spine is more likely to explain this patient's condition.

• Archives of Plastic Surgery
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• v.42 no.5
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• pp.619-625
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• 2015

Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.77-81
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• 1980

We present one case of 26-year-old male having saddle block combined with mitral valvular disease [NYHA Class IV] with auricular fibrillation. The most common cause of emboli is atrial fibrillation. The clinical manifestations of saddle emboli are relatively slow due to development of collateral circulation and large size of lumen of the aorta. The 5month duration of saddle emboli in this case led to severe atrophic changes, coldness, peripheral cyanosis on the both lower extremities, and flexion deformity on the knee and ankle joint of the left lower extremity. We planned staged operation for the saddle block and for mitral stenoinsufficiency and tricuspid insufficiency, because of poor general condition of the patient. The thromboembolectomy of aortic bifurcation was performed through the transabdominal approach without trial of Fogarthy catheter embolectomy, because of expectation of the secondary inflammatory changes of the vessel wall and thrombi which was 3 cm X 1 cm X 0.5 cm in size with irregular surfaced solid in consistency. 1 month later, after thromboembolectomy, mitral valve replacement and tricuspid annuloplasty were performed, with successful early operative result. During operation organized thrombi [1 cm X 0.5 cm] in the left auricle was removed. We wonder if simple management using Fogarthy catheter might be possible to remove the thromboemboli instead of thromboembolectomy by aortotomy in this case.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.118-125
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• 1999

Background and Aims : Nerve conduction study is invaluable in clinical neurology, especially for assessing peripheral neuropathies. Abnormal nerve conduction studies may result not only from peripheral nerve dysfunction itself, but also from other various mechanical, technical, and physiological factors such as age, sex, height and temperature. So we conducted this study to establish the our own normal values. Methods : In this study, from March. 1997 to July. 1998, 40 Korean adults among person came to Health Promotion Center over the age of 20 without any suspicion of neurological deficits were analysed to determine the effect of compound effects of several physiological factors. Results : The nerve conduction velocities of the upper extremity and proximal segments were faster than those of the lower extremity and distal segments. Physiological factors such as age, height and temperature affect the results of nerve conduction studies in multiple regression analysis. The sex difference is recognized over peroneal motor nerve. There are no sex differences in amplitude transformed into normal distribution. The significant physiological factor affecting the amplitude of nerve conduction is age, whereas height and temperature play no role. Conclusions : In multiple regression analysis, height is widespread variable for the nerve conduction velocities and temperature is important variable for lower extremities. The parametric statistical analysis cannot be applied to the amplitude of the compound muscle or nerve action potentials because of marked left shift in distribution. Sqareroot transformation of the CMAP and CNAP may be useful in normalizing the distribution. The most significant physiological factor affection the amplitude is age. Sex differences are not seen in nerve conduction study.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.51-57
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• 2004

Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.