The future of ROK-US alliance has not been discussed in detail by both governments since early 2000s. However, it is becoming more apparent that ROK-US alliance is facing various daunting challenges. The new administrations both in ROK and US might have different perspectives about the future of alliance. In the process of resolving outstanding North Korean nuclear issue, the alliance can face challenges to change its fundamental features such as halting joint military exercise. ROK-US governments also agreed to transfer wartime operational control as soon as possible. All those factors indicates the growing necessity to articulate the future of ROK-US alliance. ROK and US needs to facilitate to dialogue for future alliance with the possible scenarios of changing security environment such as maintaining status quo, reconciliation of North and South Korea, and entering the reunification stage. In each phase, ROK-US has to develop the goal for the alliance, military institution to implement the alliance, role of USFK, and etc. It is imperative to develop the road map for future ROK-US alliance at this stage to avoid unnecessary folly.
Purpose: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. Method: The subjects were 60'stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, $\chi^2-test$, and t-test using the SPSS/Win 10.0 computerized program. Result: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. Conclusion: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.
The aim of this study is to find ways to apply the strategic communications to the Republic of Korea Navy. It may be a little bit late for the ROK Navy to accommodate the SC in these days because the adoption and implementation of the SC by the Combined Forces Command has already been begun. It was in 2007 when the SC was in place in the CFC. ROK's Ministry of National Defense and Joint Chiefs of Staff have also mulled over the SC and begun to apply it in part in the annual exercises such as Key Resolve command post drills and Foal Eagle field training exercise, etc. For the ROK Navy, in addition to those exercises, it is faced with further areas like North Korean maritime provocations and other maritime incidents where its version of SC is needed. As noted, the SC is not intended to deter or defend directly those provocations and incidents, but aims to create conditions favorable to the achievement of the navy's strategic objectives. The ROK Navy has to establish a SC planning center and implementing organizations within the Headquarters to be consistent with its above organizations such as MND, JCS, and CFC that have already applied the SC in part or in entirety. SC center and other related organizations need to be under the control of VCNO and the center needs to be located and administered by the policy division in N-5 at the HQs. The vision of the navy's SC is the winning without combats and the least damages in time of war. In other for the navy to reach the vision, the strategies to be executed are early establishment of SC implementing organizations, forming consensus over the need for the SC within the navy, strengthening core competencies to apply the SC, acquiring the SC experts and making doctrines on the SC. The SC, in addition, in the navy has to be planned and implemented in not only peace time and crisis time but also war time.
The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.
Lee, Jae Jun;Park, Hyoung Joon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il
Archives of Plastic Surgery
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제40권4호
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pp.397-402
/
2013
Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. Methods We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. Results At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. Conclusions This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.
Purpose: To investigate the relationship between gross motor capacity and neuromuscular function in children with cerebral palsy (CP) through a short-term intensive intervention. Methods: Twenty-four children younger than 6 years of age (17 boys, 7 girls, mean $age{\pm}standard$ deviation, $42.71{\pm}14.43months$) who were diagnosed with CP underwent short-term intensive treatment for 8 weeks. An evaluation of gross motor function capacity using the gross motor function measure (GMFM-66 and GMFM-88) was performed to measure muscle strength, selective motor control (SMC), and spasticity, factors related to neuromusculoskeletal function. Changes in spasticity, strength, range of motion, selective motor function, and exercise intensity scores were evaluated in terms of the gross motor function classification system (GMFCS) and ages. Results: The GMFM-88 and GMFM-66 scores significantly increased, by $4.32{\pm}4.04$ and $2.41{\pm}1.51%$, respectively, following the 8-week intervention. The change in the GMFM-66 score did not reflect a statistically significant difference in the GMFCS level. However, there was a statistically significant difference in the GMFM-88 score change in individuals at GMFCS Level III, the strength and spasticity of subjects at GMFCS Levels I-II did not significantly differ (p<0.05). The changes in the GMFM-66 scores for strength, SMC, range of motion (ROM), and spasticity significantly differed according to age (p<0.05) in children aged 36 months and older. Overall, there was a statistically significant difference in strength, SMC, and spasticity (p<0.05) before and after intensive short-term treatment. Conclusion: The 8-week short-term intensive care intervention improved the motor function score of study participants, emphasizing the need for early intervention and additional research in this area.
Injury of the musculocutanous nerve can be associated with a proximal humeral fracture or shoulder dislocation, and injury of the brachial plexus. However, injury of this nerve associated with a humeral shaft fracture has rarely been reported. Diagnosis of the musculocutaneous nerve injury is difficult because its sensory loss is ill-defined, and examination of elbow flexion is difficult when it is associated with fractures. We report an unusual case of musculocutaneous nerve injury in a 27 years old woman who had multiple injuries including a humerus shaft fracture, an ipsilateral radius shaft fracture, and an associated radial nerve laceration. Diagnosis of the musculocutaneous nerve injury was delayed because combined fractures of the humerus and radius prevented proper examination of the elbow motion and nerve grafting of the radial nerve delayed early elbow motion exercise. Delayed exploration of the musculocutaneous nerve 6 months after trauma showed complete rupture of the nerve at its entry into the coracobrachialis muscle and the defect was successfully managed by sural nerve graft.
The purpose of this study is to suggest a proper tread of stairs using kinematic factors and moments of the lower-limb joints in the stair decent with the 3 different treads with boimechanical method in ergonomics. 9 subjects (body masses; $59.41{\pm}7.49$, $64.03{\pm}6.65$, $67.26:{\pm}7.58$, heights; $160.50{\pm}6.35$ ages; $31.22{\pm}2.99$; parity; $1.67{\pm}0.71$) participated in three experiments that were divided by physiological symptoms (the early (0-15 weeks), middle (16-27 weeks) and last (18-39 weeks). and they walked at self-selected pace on 4 staircases 3 trials. As extending the pregnancy period, cadence was shorter but cycle time were longer more and more. As extending treads of stair decent during pregnancy, speed, stride lengths and cycle time were increased. As extending the treads of stair decent, hip and ankle moments increased but knee moments decreased in sagittal plane. There were increasing or decreasing of moments by means of treads. These changes may account for relation between the treads of stair and moments in pregnant women. The main changes of pregnant women were joint moments and kinematic factors during pregnancy period because pregnancy makes them physical changes. It is possible that joints have connection with compensation each other to maximize stability and to control gait motion. In conclusion, we suggest that the tread of stair is longer than 26cm tread. and exercise programs to improve muscle activity were necessary where joint moments were small.
Bilgen, Fatma;Duman, Yakup;Bulut, Omer;Bekerecioglu, Mehmet
Archives of Plastic Surgery
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제45권4호
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pp.357-362
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2018
Background The most common complication after tendon repair is the development of adhesion, with subsequent rupture. Methods In this study, we present a new method in which the tendon healing contact surface is increased to reduce these complications. The tendons of chickens in groups 1, 3, and 5 were transversely cut and repaired with in the traditional fashion with double-modified Kessler method and 5/0 polypropylene. In the other groups, 3 mm of the tendon was removed from the proximal half of the upper end and from the distal half of the lower end of the tendon, and they were repaired with the modified Kessler method. The tendons of the chickens in groups 1 and 2 were evaluated immediatelly after surgery. Groups 3 and 4 were evaluated at 4 weeks after surgery. Groups 5 and 6 were evaluated at 6 weeks. Results Increases in transient inflammation and connective tissue formation were observed more clearly in the group treated with the new method in histopathological investigations at weeks 4 and 6. The stretching test showed statistically significant differences between groups 3 and 4 (P<0.05) and groups 5 and 6 (P<0.05). Conclusions When repairing tendons with the new method, the healing surface increases and the direction of collagen fibers at the surface changes. Because of these effects, the strength of the tendon healing line increases; we therefore expect that this technique will enable patients to safely engage in early active exercise after the operation, with less risk of tendon rupture.
Objectives: To grasp the traditional stream of cancer treatment inherited from the previous doctors. Methods: The author's research has been performed cancer treatment based on JIJU(積聚) taking the original text as a reference. Results & Conclusion: The general three outlines and five detailed rules of cancer treatment have been obtained as follows. The first outline of cancer treatment is that reinforced vital function makes cancer reduce naturally. the second is that Harmless cancer can coexist in human beings and aging with them. and the third is that Elimination and reinforcing therapies should be executed in appropriate era and those therapies should utilize appropriate methods. The first detailed rule of cancer treatment is when using reinforcing therapy, it must applicate mildly and when using elimination therapy, it must applicate calmly. The second detailed rule is that the methods of cancer treatment are different from each cancer stage. The concentration should be made on reinforcing therapy at early stage while reinforcing and elimination therapies must be conducted together at middle stage. At terminal stage reinforcing therapy is the sole method to be taken. The third detailed rule is that the basis property of cancer drug is warm nature and extremely biased property should be avoided and when complication arises (eg. inflamatory disease, cancer fever, etc), cold or cool nature can be applied. The fourth detailed rule is that Cancer drug must have the effect eliminating the blood stasis, phlegm and excessive fluid, all together. The fifth detailed rule is that Physicians have to control patient's stress or stress related symptom and teach patients about right way of taking care of themselves and patients should take hygienic rules with their free will by themselves (eg diet, exercise, stress, etc)
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