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Current Trends in the Treatment of Hallux Valgus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (무지외반증 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Jaeho;Cho, Byung-Ki;Park, Hyun-Woo;Sung, Ki-Sun;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.157-164
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    • 2021
  • Purpose: This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents. Conclusion: This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.

Environmental Evaluation through Low-carbon Ecotourism Index -Focusing on 6 Ecotourism Areas in Changwon City- (저탄소 생태관광지표를 통한 환경 평가 -창원시 생태관광지역 6곳을 중심으로-)

  • Jang, Yu Mi;Lee, Sung Jun
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.5
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    • pp.677-684
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    • 2022
  • This study is a basic study to evaluate the ecological environment of Changwon City. The study site was 6 ecotourism districts in Changwon-si, and the ecotourism index was evaluated through direct visits and interviews with the person in charge through preliminary research and various literature data from June to July 2021. There are six ecotourism indicators: climate crisis, air quality improvement, water conservation, natural coexistence, citizen participation, and tourism resource management. When looking at the scores for the six ecotourism areas in Changwon, it received the highest score in the areas of natural coexistence and air quality improvement. However, the ecoregion received the lowest score in the water resource conservation category, indicating that the water resource conservation as a whole was weak. Next, tourism resource management, climate crisis, and citizen participation are at the same level in all regions. As a result of the evaluation through the low-carbon ecotourism index, the Changwon City low-carbon ecotourism certification system should first be operated as a measure to revitalize the ecotourism region. It is necessary to prepare a low-carbon ecotourism level for Changwon City. Second, it is very important to guide and promote ecotourism areas to revitalize ecotourism areas. Lastly, to operate a sustainable eco-environment area, it is necessary to operate using local governance above all else.

Current Trends in the Treatment of Ankle Ligament Injuries: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 인대 손상 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Lee, Myoungjin;Lee, Jun Young;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.22-29
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    • 2022
  • Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

A case study for prediction of the natural ventilation force in a local long vehicle tunnel (장대도로터널의 자연환기력 예측 사례연구)

  • Lee, Chang-Woo;Kim, Sang-Hyun;Gil, Se-Won;Cho, Woo-Chul
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.11 no.4
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    • pp.395-401
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    • 2009
  • One of the key design factors for the ventilation and safety system at extra long tunnel is the airflow velocity induced by the natural ventilation force. Despite of the importance, it has not been widely studied due to the complicated influencing variables and the relationship among them is difficult to quantify. At this moment none of the countries in the world defines its specific value on verified ground. It is also the case in Korea. The recent worldwide disasters by tunnel fires and demands for better air quality inside tunnel by users require the optimization of the tunnel ventilation system. This indicates why the natural ventilation force is necessary to be thoroughly studied. This paper aims at predicting the natural ventilation force at a 11 km-long tunnel which is in the stage of detailed design and will be the longest vehicle tunnel in Korea. The concept of barometric barrier which can provide the maximum possible natural ventilation force generated by the topographic effect on the external wind is applied to estimate the effect of wind pressure and the chimney effect caused by the in and outside temperature difference is also analyzed.

Reports on bionomical characteristics of Mellicta ambigua (여름어리표범나비(Mellicta ambigua (Menetries))의 생태적 특성에 관한 보고)

  • Kim, Se-Gwon;Nam, Gyoung-Pil;Kim, Nam-Ee;Bae, Kyoung-Sin;Choi, Young-Cheol;Lee, Sang-Hyun
    • Journal of Sericultural and Entomological Science
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    • v.52 no.2
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    • pp.110-116
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    • 2014
  • Recently the number of the butterflies, Mellicta ambigua, had been decreasing rapidly, and already disappeared at many habitat. In this studies, we investigated ecological environment of Mellicta ambigua for preparing of primary research data recovering habitat, and studied on bionomical characteristics. Two different habitat, Jindo and Inje, were selected for investigation of ecological environment. We investigated four times during 3-month, from June to August in 2012. In Jindo, we observed more than 100 butterflies and a lot of host plants, Melampyrum roseum var. japonicum. But only 5 butterflies and only a few host plants, Veronicastrum sibiricum were observed in Inje. We could not observe the eggs, the larva and pupa on the host plants at all. For finding of bionomical characteritics, we reared butterflies at natural conditions. Collected 3-female butterflies from Jindo laid 465 eggs on the leaves of 3-host plants, Veronicastrum sibiricum. 120 ~ 186 eggs per each female were laid in the shape of cluster. An egg was globular shape, 0.6 mm diameter and 0.7 mm height. The egg periods were $9.96{\pm}0.4days$ after ovipositioning, and the hatchability was 95.% at natural condition. The larval periods were $4.1{\pm}0.6days$ (1st instar), $2.1{\pm}1.0days$ (2nd), $8.1{\pm}0.7days$ (3rd), $239.2{\pm}10.9days$ (4th), $12.3{\pm}1.3days$ (5th), $17.1{\pm}1.1days$ (6th), $10.5{\pm}1.0days$ (7th) each other. The larva of 4th instar overwintered in the nest that had been made into the leaf of host plant with secreted thread as a group until early March next year. In the early March next year, overwintered larva went around their nest in search of host plants, and went to other host plants, Veronica persica and Plantago asiatica, sometimes. The overwintered larva of Mellicta ambigua could grow up on two other host plants normally. In the following experiment, the butterflies of Mellicta ambigua laid eggs on the leaves of Plantago asiatica, but the 1st instar larva from eggs died all. The headwidth of each developmental larval stage were $0.28{\pm}0.02mm$ (1st), $0.45{\pm}0.02mm$ (2nd), $0.58{\pm}0.02mm$ (3rd), $0.75{\pm}0.03mm$ (4th), $0.89{\pm}0.05mm$ (5th), $1.23{\pm}0.06mm$ (6th), $2.13{\pm}0.11mm$ (7th). The pupal ratio was 92.0%. The pupal period were $9.1{\pm}1.6days$, and the emergence rate was 88.6%. As a result we determined that Mellicta ambigua can rear at natural conditions. But indoor-rearing is considered to be difficult and not useful industrially, because they have long term larval stage and only one life cycle per an year.

Hwaunsi(和韻詩) on the Poems of Tu Fu(杜甫) and Su Shi(蘇軾) Written by Simjae(深齋) Cho Geung-seop(曺兢燮) in the Turning Point of Modern Era (근대 전환기 심재 조긍섭의 두(杜)·소시(蘇詩) 화운시)

  • Kim, Bo-kyeong
    • (The)Study of the Eastern Classic
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    • no.56
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    • pp.35-73
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    • 2014
  • This paper examined the poem world of Simjae(深齋) Cho Geung-seop(曺兢燮: 1873-1933) in the turning point of the modern era, focused on his Hwaunsi (和韻詩: Poems written by using the rhymes of other poets' poems). In his poems, there are lots of Hwaunsi on the poems of Tu Fu(杜甫) and Su Shi(蘇軾), especially. This makes him regarded as a medieval poet, engaged in Chinese poem creation in the most traditional method in the turbulent period. Looking at the Hawunsi(和韻詩) alone, Simjae's creative life became the starting point of turnaround at around 40 years old. Before the age of 40, the poets in the Tang Dynasty and Song Dynasty and Ming Dynasty and Qing Dynasty and Korean figures like Lee Hwang(李滉), as well as Tu Fu and Su Shi were the subjects of his Hwanunsi. After the age of 40, some examples of writing poems using the rhymes of other poets' poems, especially Korean figures related to regions, are often found, reducing Hwaunsi on Tu Fu and Su Shi. Simjae called Tu Fu the integration of poets, talking about the integrity of poetic talent and his being highly proficient in mood and view. As reflecting such an awareness, the themes and moods and views are demonstrated diversely in Simjae's Hwaunsi. Although, he did not reveal his thinking about the poems of Su Shi, he seemed to love Su Shi's poems to some degree. The closeness to the original poems, the poems of Tu Fu are relatively higher than those of Su Shi. Roughly speaking, Simjae tried to find his own individuality, intending to follow Tu Fu, but, he seemed to attempt to reveal his intention using Su Shi's poems, rather than trying to imitate. To carefully examine, Simjae wrote Hwaunsi, but he did not just imitate, but revealed the aesthetics of comparison and difference. In many cases, he made new meanings by implanting his intentions in the poems, while sharing the opportunity of creation, rather than bringing the theme and mood and view as they are. The Hwaunsi on Su Shi's poems reveal the closeness to the original poems relatively less. This can be the trace of an effort to make his own theme and individuality, not being dominated by the Hwaun(和韻: using the rhymes of other poets' poems) entirely, as he used the creative method having many restrictions. However, it is noted that the Hwaunsi on Tu Fu's poems was not written much, after the age of 40. Is this the reason why he realized literary reality that he could not cope with anymore with only his effort within the Hwaunsi? For example, he wrote four poems by borrowing Su Shi's Okjungsi(獄中詩: poem written in jail) rhymes and also wrote Gujung Japje(拘中雜題), in 1919, while he was detained. In these poems, his complex contemplation and emotion, not restricted by any poet's rhymes, are revealed diversely. Simjae's Hwaunsi testifies the reality, in which Chinese poetry's habitus existed and the impressive existence mode at the turning point of the modern era. Although, the creation of Hwaunsi reflects his disposition of liking the old things, it is judged that his psychology, resisting modern characters' change, affected to some degree in the hidden side. In this regard, Simaje's Hwaunsi encounters limitation on its own, however, it has significance in that some hidden facts were revealed in the modern Chinese poetry history, which was captured with attention under the name of novelty, eccentricity and modernity.

A Methodology of Multimodal Public Transportation Network Building and Path Searching Using Transportation Card Data (교통카드 기반자료를 활용한 복합대중교통망 구축 및 경로탐색 방안 연구)

  • Cheon, Seung-Hoon;Shin, Seong-Il;Lee, Young-Ihn;Lee, Chang-Ju
    • Journal of Korean Society of Transportation
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    • v.26 no.3
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    • pp.233-243
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    • 2008
  • Recognition for the importance and roles of public transportation is increasing because of traffic problems in many cities. In spite of this paradigm change, previous researches related with public transportation trip assignment have limits in some aspects. Especially, in case of multimodal public transportation networks, many characters should be considered such as transfers. operational time schedules, waiting time and travel cost. After metropolitan integrated transfer discount system was carried out, transfer trips are increasing among traffic modes and this takes the variation of users' route choices. Moreover, the advent of high-technology public transportation card called smart card, public transportation users' travel information can be recorded automatically and this gives many researchers new analytical methodology for multimodal public transportation networks. In this paper, it is suggested that the methodology for establishment of brand new multimodal public transportation networks based on computer programming methods using transportation card data. First, we propose the building method of integrated transportation networks based on bus and urban railroad stations in order to make full use of travel information from transportation card data. Second, it is offered how to connect the broken transfer links by computer-based programming techniques. This is very helpful to solve the transfer problems that existing transportation networks have. Lastly, we give the methodology for users' paths finding and network establishment among multi-modes in multimodal public transportation networks. By using proposed methodology in this research, it becomes easy to build multimodal public transportation networks with existing bus and urban railroad station coordinates. Also, without extra works including transfer links connection, it is possible to make large-scaled multimodal public transportation networks. In the end, this study can contribute to solve users' paths finding problem among multi-modes which is regarded as an unsolved issue in existing transportation networks.

Concurrent Weekly Cisplatin and Radiation Therapy for High risk group of Uterine Cervical Cancer (국소적으로 진행된 자궁경부암에 대한 방사선 치료와 Cisplatin의 동시 병행요법의 치료 결과)

  • Suh Hyun Suk;Kang Seung Hee;Kim Ju Ree;Lee Eung Soo;Kim Yong Bong;Park Sung Kwan
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.213-217
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    • 1992
  • Locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate despite the advances in modern radiation therapy techniques. Combination of chemotherapy and radiation therapy demonstrated benefit in improving local control and possibly the overall survival. Twelve patients with advanced stages (Figo stage III, IV) or 11b with bulky tumors (>5 cm in diameter) were treated with combination of radiation therapy and concurrent weekly cisplatin between May of 1988 and September of 1991 at Inje University Paik Hospital. Cisplatin was administered in bolus injections of 50 mg at weekly intervals during the courses of radiation therapy. Median follow-up period was 34 months with ranges from 3 to 53 months. Eleven patients were evaluable for the estimation of response. Response was noted in all the 11 patients: complete response (CR) in 7 ($64\%$), partial response (PR) in 4 ($36\%$). Of the 7 patients with CR, all maintained local control, whereas only 1 of 4 with PR showed local control. Six of 7 with CR are alive disease free on the completion of follow-up. Eight of 11 patients ($73\%$) maintained local control in the pelvis. The median survival for CR patient is 27 months and 9 months for the PR patients. Analysis of survival by stage shows 11 b 4/5, III 2/3 and IV 1/3. Overall survival rate was $61\%$. Three patients recurred: 1 at local, 1 in distant site and 1 with local and distant site. Toxicity for the combination therapy was not excessive. These results are preliminary, but definitely encouraging in view of markedly improved response rate compared with the results of historical control group.

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Clinical Experiences of Open Heart Surgery (개심술(開心術) 2,000례의 임상적 고찰)

  • 김하늘루;박경택;곽기오;한일용;소영환;최강주;이양행;조광현
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1183-1194
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    • 1998
  • Background: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery(OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. Material and Method: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease(CHD) and 468 cases were acquired heart disease(AHD). The age distribution was 9 days(4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. Result: The CHD cases consisted of 940 ventricular septal defects(61.4%), 324 atrial septal defects(21.1%), 112 tetralogy of Fallot(7.3%), 46 pulmonary stenosis(3%), 38 endocardial cushion defects(2.5%), 15 valsalva sinus ruptures(1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles(0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements(36 aortic valve replacements(AVR), 188 mitral valve replacements(MVR), and 2 tricuspid valve replacements(TVR), among these were 71 cases of double valve replacements(AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty(TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery(CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. Conclusion: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6%(72/2,000).

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Geochemistry and Petrogenesis of the Granitic Rocks in the Vicinity of the Mt. Sorak (설악산 부근의 화강암류에 대한 지구화학 및 성인)

  • Kyoung-Won Min;Sung-Bum Kim
    • The Journal of the Petrological Society of Korea
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    • v.5 no.1
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    • pp.35-51
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    • 1996
  • The granitic rocks in the vicinity of the Mt. Sorak, the northeastern part of the NE-SW elongated Mesozoic granitic batholith in the Kyeonggi massif, consist of granodiorite, biotite granite, two-mica granite and alkali feldspar granite. Variations In major and most trace elemental abundances show a typical differentiation trend in a granitic magma. Granitic rocks all display a calc-alkaline trend in the AFM diagram. Also, In the ACF diagram discriminating between I- and S-type granitic rocks, granodiorite and most biotite granite in the southeastern area represent I-type and magnetite-series characteristics, while most biotire granite and two-mica granite in the northwestern area exhibit S-type and ilmenite-series ones.According to recent studies of the granitle rocks In the Inje-Hongcheon district. all ihe granitic rocks distributed in the northeastern part of the Kyeonggi massif have been classified as late Triassic to early Jurassic Daebo granite. With reference of the formerly published ages, an age oi $125.6{\pm}4.4$ Ma calculated by the slope in the plot of $^{87}Rb/^{86}Sr-^{87}Sr/^{86}Sr$ for the biotite granite samples from the southeastern area is inferred as an emplacement age for the granitic rocks in the vicinity of the Mt. Sorak. On the basis of elemental variations and Sr isotope compositions, an possible evolutional process for the granitic magmas in this area is suggested. The primary magma of I-type and magnetite-series generated about 125 Ma by partial melting of igneous originated crustal materials, might be emplaced and evolved through fractional crystallization, convection and assimilation of the surrounding Precambrian metasediments to become S-type and ilmenlte-serles in the outer area, and then solidified to granodiorite, biotite granite and two-mica granite.At the latest stage, the evolved hydrothermal solution altered the formerly solidified biotite granite to alkali feldspar granite and probably later local igneous activities affected the alkali feldspar granite again.

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