• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.157-163
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• 2019

Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.129-136
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• 2010

Purpose: Anatomically, the foot is provided with insufficient blood supply and is relatively vulnerable to venous congestion compared to other parts of the body. Soft tissue defects are more difficult to manage and palliative treatments can cause hyperkeratosis or ulcer formation, which subsequently requires repeated surgeries. For weight bearing area such as the heel, not only is it important to provide wound coverage but also to restore the protective senses. In these cases, application of flaps for hind foot reconstruction is widely recognized as an effective treatment. In this study, we report the cases of soft tissue reconstruction for which various types of flaps were used to produce good results in both functional and cosmetic aspects. Methods: Data from 37 cases of hind foot operation utilizing flaps performed between from June 2000 to June 2008 were analyzed. Results: Burn related factors were the most common cause of defects, accounting for 19 cases. In addition, chronic ulceration was responsible for 8 cases and so forth. Types of flaps used for the operations, listed in descending order are radial forearm free flap (18), medial plantar island flap (6), rotation flap (5), sural island flap (3), anterolateral thigh free flap (2), lattisimus dorsi muscular flap (2), and contra lateral medial plantar free flap (1). 37 cases were successful, but 8 cases required skin graft due to partial necrosis in small areas. Conclusion : Hind foot reconstruction surgeries that utilize flaps are advantageous in protecting the internal structure, restoring functions, and achieving proper contour aesthetically. Generally, medial plantar skin is preferred because of the anatomical characteristics of the foot (e.g. fibrous septa, soft tissue for cushion). However alternative methods must be applied for defects larger than medial plantar skin and cases in which injuries exist in the flap donor / recipient site (scars in the vicinity of the wound, combined vascular injury). We used various types of flaps including radial forearm neurosensory free flap in order to reconstruct hind foot defects, and report good results in both functional and cosmetic aspects.

• The Journal of the Korea Contents Association
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• v.16 no.1
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• pp.734-742
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• 2016

Purpose : The present study was aimed at investigating the plantar pressure on dynamic balance of subjects with functional ankle instability following fatigue of lower leg. Methods : The subjects(30 university students) were divided into 2 groups ; functional ankle instability group(7males and 7females) and ankle stable group(9males & 7females) who could evaluate questionnaire. All the participants were evaluated muscle fatigue of lower leg by Biodex system III and distribution of plantar pressure by Zebris FDM-S system, The dynamic balance was tested by single-leg jump landing. This study were to measure of plantar pressure on dynamic balance with the difference between FAIG and control group following muscle fatigue. Results : In functional ankle instability group(FAIG), the post-fatigue was significantly higher than pre-fatigue in forefoot(p2,p3,p4) of plantar pressure on dynamic balance(p<0.05). The FAIG was significantly higher than the ASG in forefoot(p2, p3, p4) & lat midfoot(p6) of plantar pressure after fatigue in dynamic balance(p<0.05). The FAIG was significantly longer than the ASG in anteroposterior(AP) & mediolateral(ML) distance on center of pressure(CoP) after fatigue in dynamic balance(p<0.05). Conclusion : This study showed that FAIG were effected plantar pressure and center of pressure(CoP) by dynamic balance following muscle fatigue. Further study is needed to measure various age & work with ankle instability for clinical application.

• Journal of Life Science
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• v.24 no.12
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• pp.1291-1300
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• 2014

Peroxiredoxins (Prxs) are a ubiquitous family of antioxidant enzymes that participate in a variety of biological processes, including $H_2O_2$-mediated signal transduction, molecular chaperoning, and mitochondrial function. In this study, we isolated and characterized a Prx 2 cDNA from abalone (Haliotis discus hannai). The abalone Prx 2 cDNA encoded a 199-amino acid polypeptide that belongs to a class of typical 2-Cys Prxs that contain peroxidatic and resolving cysteines. The deduced abalone Prx 2 protein showed strong homology (64-99%) with Prx 2 proteins from other species, including mollusk, fish, amphibians, and mammals, and it was most closely related to disk abalone (H. discus discus) Prx 2. Abalone Prx 2 mRNA was ubiquitously detected in tested tissues, and its expression was comparatively high in the mantle, gills, liver, foot, and digestive duct. The expression level of abalone Prx 2 mRNA was 106.7-fold, 51.9-fold, and 437.8-fold higher, respectively, in the gills, digestive duct, and liver than in the muscles. The expression level of abalone Prx 2 mRNA in the liver peaked at 6 hr postinfection with Vibrio parahemolyticus and decreased at 12 hr postinfection. The expression level of abalone Prx 2 mRNA in hemocytes was drastically increased at 1 hr postinfection with V. parahemolyticus. These results suggest that abalone Prx 2 is conserved through evolution and that it may play a role similar to that of its mammalian counterpart.

• PNF and Movement
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• v.4 no.1
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• pp.45-50
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• 2006

Purpose : This study shows the movements of the ankle and the foot in walking stages, and helps to diagnose and treat the problems of the ankle and the foot. The foot in human is a mean of the transportation, body support, and shock absorber. However, the slightest changes in the anatomical position can cause a significant increase of the stress and force in the ankle and the foot. The regular compressive force in the ankle of the normal person is generated by the contraction of the gastrocnemius and popliteus muscles, and transmitted to the achilles tendon. The plantar flexion about 10 degrees occurs immediately after the heel strike, getting ready for the weight acceptance. The shear force about 80 % of the body weight is generated immediately after the heel off of the mid stance phase. In those who have a problem in the ankle, the compression force at the ankle decreased to 1/3 of the body weight, and the shear force decreased, and the compressive force was reached at their maximum level earlier than the normal people. Conclusion : Analysis of the movements at the ankle and the foot in walking phase can make the effort to diagnose and treat the ankle and foot with the problems. However, the further study is necessary.

• Journal of Korean Foot and Ankle Society
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• v.1 no.2
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• pp.102-111
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• 1997

The tibial Pilon fracture, which is defined as a comminuted intraarticular fracture of the distal tibia, is difficult to manage because high axial compression and rotational forces to the ankle joint result in impaction, severe comminution, metaphyseal disruption and soft tissue damage. There are variable methods of treatment such as manipulation and cast, calcaneal traction and cast, external fixation, pin and plaster, limited open reduction and external fixation, and open reduction and rigid internal fixation. Though most of authors reported better result after a surgical treatment. than that of conservative treatment, many complications such as posttraumatic arthritis and soft tissue problem still remain troublesome. We have reviewed 19 cases of the tibial Pilon fractures in 18 patients which were treated with limited open reduction and internal fixation from September 1993 to May 1996. The results were as follows: 1. The fractures were classified into five types according to the system of Ovadia and Beals, and the most frequent type was type 3 (53%). The most common cause of injury was traffic accident (47%). 2. All of the cases of type 1 and 2, in which the injury of the ankle joint was less severe, revealed good or excellent clinical results. But in type 4 and 5, because the injury is much severe and accurate reduction is difficult, the clinical results were unsatisfaetory. 3. The most frequent complication was posttraumatic osteoarthritis, and which developed in second frequent complication, was developed m the three cases of type 3 in which the radiographic results were less than fair, but there were no correlation with the clinical results. 4. We could markedly reduce the complications related to the soft tissue problem of Pilon fracture by treatment with limited open reduction and internal fixation, and consider that this is a good method of treatment of Pilon fracture when the injury is less severe and accurate reduction is possible.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.64-71
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• 2004

Background: Video-assisted sympathicotomy is a safe and effective method for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side-effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the relationship between temperature change measured by DITI (digital infrared thermographic imaging) and clinical results according to the level and extent of sympathicotomy in essential hyperhidrosis. we tried to obtain a more precisely and objectively, the distribution and degree of compensatory sweating by DITI and also for ascertaining the clinical usefulness. Material and Method: From January 2000 to June 2002, the thoracoscopic sympathicotomy was performed in 28 patients suffering from essential hyperhidrosis in Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into four groups, Group I: patients having undergone T2 sympathicotomy, Group II: patients having undergone T3 sympathicotomy, Group III: patients having undergone T3,4 sympathicotomy, and Group IV: patients having undergone T2,3,4 sympathicotomy. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory and plantar sweating, and temperature changes of entire body measured by DITI Result: There was no difference in age and follow-up period among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However, the rate of long-term satisfaction were 85.8%, 85.8%, 42.9%, and 28.6% in group I, II, III, and IV (p<0.05). More than embarrassing compensatory sweating was present in 14.2%, 14.2%, 57.1%, 71.4% in group I, II, III, and IV (p<0.05) In regard to plantar sweating, decrease in sweating was expressed in each of four groups, but was not significant between groups. An apparent increase of temperature measured by DITI indicated sufficient denervation and predicted long-lasting relief of essential hyperhidrosis and also decrease in temperature of trunk and lower extremity by DITI had correlated well with postoperative satisfaction, and also postoperative compensatory sweating. Conclusion: We suggested that the incidence and degree of compensatory sweating was closely related to the site and the extent of thoracic sympathicotomy. Resection of the lower interganglionic neural fiber of the second thoracic sympathetic ganglion on the third rib is the most practical and minimally invasive treatment than other surgical methods. We were also to anticipated the distribution and degree of compensatory sweating by DITI precisely and objectively and for ascertaining the clinical usefulness.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.130-138
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• 1996

Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

• The Journal of the Korea Contents Association
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• v.10 no.8
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• pp.257-265
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• 2010

The purpose of this study was to investigate the effect of different ramp inclination on the maximum plantar foot pressure and pathway of the center of pressure. Fifteen healthy adults who had no musculoskeletal disorders were participated with this study and descended the ramp with different inclination(level, $-5^{\circ}$, $-10^{\circ}$, $-15^{\circ}$). Plantar foot pressures were recorded by the Matscan system(Tekscan, Boston, USA) during level and descending ramp with barefoot. Plantar foot surface was defined as seven regions for pressure measurement; two toe regions, three forefoot regions, one midfoot region, one heel region. Repeated ANOVA was used to compare each region data of foot according to different ramp inclination. As descending ramp inclination became increased, the pressure of hallux region was significantly increased at $-15^{\circ}$ inclination and the pressure of 2-3 metatasal head region were significantly decreased at $-5^{\circ}$, $-10^{\circ}$, $-15^{\circ}$ inclination. The pathway of COP had a tendency to be shifted inside in forefoot and prolonged to great toe as the descending ramp inclination increased. The results indicated that plantar foot pressure could be changed at hallux and forefoot regions with $-5^{\circ}$ ramp inclination and these findings demonstrated that ramp inclination could affect the structure and function of foot.

• Journal of the Korean Applied Science and Technology
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• v.35 no.3
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• pp.948-955
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• 2018

The purpose of this study was to compare plantar pressure and COP parameters in three types of arch support insole during stair descent in elderly with flatfoot. A total of 14 women elderly were recruited for this study. Pedar-X was used to obtain plantar pressure(peak pressure, mean pressure, and contact area) and COP(distance, displacement, excursion) parameters. One-way ANOVAs were used to compare peak pressure, mean pressure, and contact area, distance of COP, displacement of COP, and excursion of COP. Among the plantar pressure parameters, significant(p<0.05) differences were observed in M3 for the peak pressure, M2, M3, and M4 for the mean pressure, and M2, M3, and M6 for the contact area. Among the COP parameters, distances of COP both in the mediolateral and anteroposterior axes revealed significant(p<0.05) differences. The larger peak pressure values of type A and B insoles were observed as compared to normal insole. The larger peak pressure and shorter COP distance values of type A and B insoles were observed as compared to normal insole.