• Annals of Rehabilitation Medicine
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• 제39권6호
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• pp.897-904
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• 2015

Objective To investigate differences in plantar pressure distribution between a normal gait and unpredictable slip events to predict the initiation of the slipping process. Methods Eleven male participants were enrolled. Subjects walked onto a wooden tile, and two layers of oily vinyl sheet were placed on the expected spot of the 4th step to induce a slip. An insole pressure-measuring system was used to monitor plantar pressure distribution. This system measured plantar pressure in four regions (the toes, metatarsal head, arch, and heel) for three events: the step during normal gait; the recovered step, when the subject recovered from a slip; and the uncorrected, harmful slipped step. Four variables were analyzed: peak pressure (PP), contact time (CT), the pressure-time integral (PTI), and the instant of peak pressure (IPP). Results The plantar pressure pattern in the heel was unique, as compared with other parts of the sole. In the heel, PP, CT, and PTI values were high in slipped and recovered steps compared with normal steps. The IPP differed markedly among the three steps. The IPPs in the heel for the three events were, in descending order (from latest to earliest), slipped, recovered, and normal steps, whereas in the other regions the order was normal, recovered, and slipped steps. Finally, the metatarsal head-to-heel IPP ratios for the normal, recovered, and slipped steps were $6.1{\pm}2.9$, $3.1{\pm}3.0$, and $2.2{\pm}2.5$, respectively. Conclusion A distinctive plantar pressure pattern in the heel might be useful for early detection of a slip event to prevent slip-related injuries.

• 대한조선학회논문집
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• 제54권4호
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• pp.335-343
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• 2017

The Newman-Raju formula and contour integral-based finite element analyses(FEAs) have been widely used to assess crack growth rates and residual lives at crack locations in ships or offshore structures, but the Newman-Raju formula is known to be less accurate for the complicated weld details and the conventional FEA-based contour integral approach needs concentrated efforts to construct FEA models. Recently, an extended finite element method(XFEM) has been proposed to reduce those modeling efforts with reliable accuracy. Stress intensity factors(SIFs) from the approaches such as the Newman-Raju formula, conventional FEA-based J-integral, and XFEM-based J-integral were compared for an infinitely long plate with a propagating elliptic crack. It was concluded that the XFEM approach was far reliable in terms of prediction ability of SIFs. Assuming a 25 year-aged coast guard patrol ship had the prescribed cracks at the bracket toes attached to longitudinal stiffeners in way of deck and bottom, SIFs were derived based on the three approaches. To obtain axial tension loads acting on the longitudinal stiffeners, long term hull girder bending moments were assumed to obey Weibull distribution of which two parameters were decided from a reference (DNV, 2014). For the complicated weld details, it was concluded that the XFEM approach could cost-effectively and accurately estimate the crack growth rates and residual lives of ship structures.

• 대한족부족관절학회지
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• 제23권2호
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• pp.52-57
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• 2019

Purpose: An ingrown nail is common in military trainees who are exposed to highly demanding activities. Although the matrixectomy procedure has been the main treatment modality, several drawbacks may follow after the procedure, such as infection, periostitis, and continued pain that causes a delayed return to duty. This study examined the outcomes of a simple partial nail extraction with the hypothesis that this procedure may bring an earlier return to duty, lower the perioperative complications, and produce a comparable recurrence rate. Materials and Methods: The medical records of patients who had surgical treatment for an ingrown nail in the authors' institution between April 2016 and December 2017 were reviewed retrospectively. Under the inclusion and exclusion criteria, 28 patients with a simple partial nail extraction (group A) and 29 patients with a partial nail extraction with matrixectomy (group B) were investigated. As the clinical outcome, the visual analogue scale (VAS) and satisfaction score, time to return to duty, complications, and recurrence rate were checked and compared between the groups. Results: The VAS scores of group B were significantly higher during the first (p<0.001) and second (p=0.026) follow-up week than group A. The time to return to duty was shorter in group A (7.8 days) than group B (10.1 days), and this difference was significant (p<0.001). Group B had five patients with complications, whereas group A had none (p=0.028). No differences in the recurrence rate (p=0.197) and patient satisfaction (p=0.764) were found between the groups. Conclusion: In this study, simple partial nail extraction in military trainees resulted in lower postoperative pain, lower complication rates, and earlier return to duty than the procedure with matrixectomy. Military trainees are temporarily exposed to highly demanding activities. Thus, a satisfactory outcome would be expected with simple partial nail extraction without performing a radical procedure, such as a matrixectomy.

• 대한족부족관절학회지
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• 제22권3호
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• pp.111-115
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• 2018

Purpose: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. Materials and Methods: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. Results: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. Conclusion: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.91-97
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• 2021

Background In postaxial polysyndactyly of the foot, the choice of which toe to excise is controversial. It is often treated by resection of the fifth toe to save the lateral neurovascular bundles of the sixth toe. However, the sixth toe is often short and laterally deviated, which may require wedge osteotomy, potentially shortening the phalanx and compromising circulation. This study outlines an individualized method to spare the length and axis of the fifth toe in polysyndactyly with a short and deviated sixth toe. Methods We retrospectively analyzed 38 patients who underwent surgery between 2006 and 2019. The fifth toe was spared in 18 cases, and the sixth toe in 20 cases. The ratios of the forefoot width, angle difference, and toe length were compared between the affected and unaffected sides postoperatively. Complications and subjective judgments on cosmetic results were recorded and compared. Results No significant between-group differences were observed for sex, age at surgery, or the follow-up period. The forefoot width ratio did not significantly differ between the groups. However, the angle difference and toe length ratios showed significantly better results in the fifth toe-spared group than in the sixth toe-spared group (P<0.05 and P<0.01, respectively). There were no cases of impaired circulation, and subjective evaluations revealed satisfactory results in the fifth toe-spared group. Conclusions In cases with short and deviated sixth toes, sparing the fifth toe is an effective method of cosmetic treatment. The surgical results were satisfactory, with an improved appearance and no residual deformities.

• International Journal of Naval Architecture and Ocean Engineering
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• 제13권1호
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• pp.379-395
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• 2021

For the complicated structural details in ships and offshore structures, the traditional hotspot stress approaches are known to be sensitive to the element variables of element topologies, sizes, and integration schemes. This motivated to develop a new approach for predicting reasonable hotspot stresses, which is less sensitive to the element variables and easy to be implemented the real marine structures. The three-point bending tests were conducted for the longitudinal attachments with the round and rectangular weld toes. The tests were reproduced in the numerical simulations using the solid and shell element models, and the simulation technique was validated by comparing the experimental stresses with the simulated ones. This paper considered three hotspot stress approaches: the ESM method based on surface stress extrapolation, the Dong's method based on nodal forces along a weld toe, and the proposed method based on nodal forces perpendicular to an imaginary vertical plane at a weld toe. In order to study the element sensitivities of each method, 16 solid element models and 8 shell element models were generated under the bending and tension loads, respectively. The element sensitivity was analyzed in terms of Stress Concentration Factors (SCFs) in viewpoints of two statistical quantities of mean and bias with respect to the reference SCFs. The average SCFs predicted by the proposed method were remarkably in good agreement with the reference SCFs based on the experiments and the ship rules. Negligibly small Coefficients of Variation (CVs) of the SCFs, which is measure of statistical bias, were drawn by the proposed method.

• 중환자간호학회지
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• 제16권1호
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• pp.1-14
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• 2023

Purpose : This study aimed to compare peripheral pulse oxygen saturation (SpO₂) values, measured at different monitoring sites, and arterial oxygen saturation (SaO₂) of neurocritical patients. Methods : The study included 110 patients admitted to the neurosurgical intensive care unit of a university hospital. The patients' SpO₂ values were measured in their index fingers, both second toes, both earlobes, and foreheads, using the patient monitoring system. These values were compared with the standard value of SaO₂ measured using a blood gas analyzer. Data were analyzed using descriptive values, Pearson's correlation coefficients, Lin's concordance correlation coefficients (CCC), and Bland-Altman plots. Result : Regardless of the measuring site, SpO₂ was correlated with the paired measurements of SaO₂ (r=.40~.60, p<.001, CCC range=.40~.58). No significant bias in paired measurements of SpO₂ and SaO₂ was observed at all sites (-0.06~0.19%, p>.05). SpO₂ values at the left finger and right earlobe had the narrowest range, with a 95% limits of agreement (LOA) (left finger -3.04~2.93% and right earlobe -3.18~2.79%). SpO₂ at the index finger, on the side without an arterial catheter, had a narrower range of 95% LOA than that of the opposing finger (-3.00~2.97% vs. -3.73~3.26%). Conclusion : SpO₂ at the finger without an arterial catheter had the highest level of precision. This study suggests using the index finger, on the side without an arterial catheter, for pulse oximetry in neurocritical patients.

• 한국의류산업학회지
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• 제25권1호
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• pp.52-61
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• 2023

This study aimed to present data for the development of a shoe which is suitable for plus-size men (BMI 25kg/m² or higher) and to analyze the characteristics of each type of foot. The results of the study are as follows. To assess foot shape in relation to weight gain, participants were categorized into normal weight, overweight, and obese weight groups, according to their BMI indexes. Those in the normal weight group exhibited a smaller value than the overweight or obese weight group in all items. As a result of the cluster analysis, by type of foot, of the obese men category, men were classified into four BMI index groups: members of the type 1 group had a BMI index of 157 (18.4% of total sample), while for type 2 the figure was 213 (25.0% of sample), for type 3 it was 259 (30.4%), and for type 4 it stood at 224 (26.3% of total sample). Those from the type 1 group had thin ankles with narrow toes and flattened sides. Type 2 group members had thick ankles with well-developed outer feet and thick sides. Those within the type 3 group had medium-thick ankles with narrow feet but wide inner feet. Finally, those in the type 4 group had feet with a slanted side, as well as thick ankles, wide feet, and flat sides. Among these categories, the type 3 group members indicated the highest distribution.

• 한국응급구조학회지
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• 제28권1호
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• pp.35-46
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• 2024

Purpose: This study aimed to compare the oxygen saturation measured at fingertips with unpolished and self-artificial nails (sticker, tip) using a portable pulse oximeter. Methods: The sample comprised 27 women who had used nail care services. Using a pulse oximeter, oxygen saturation was measured at fingertips with unpolished nails in a stable state. Self-fabricated sticker and tip nails were attached to the right and left hands, respectively, using five nail colors (black, blue, green, purple, and brown). Oxygen saturation was measured at fingertips with self-fabricated nails first in the usual manner and then measured again by rotating the oximeter by 90°. Values of oxygen saturation were compared and analyzed using the Friedman test and Wilcoxon signed-rank test with Bonferroni correction using IBM SPSS 26.0. Results: Oxygen saturation values were significantly different among colors for both sticker nails (p=.036) and tip nails (p=.000), with black self-artificial nails tending to demonstrate lower oxygen saturation. Moreover, oxygen saturation values obtained by measuring the usual way on unpolished nails was significantly different than those obtained by rotating the oximeter by 90° on thumb with sticker (p=.001) and tip nails (p=.001). Conclusion: The findings of this study suggest that oxygen saturation should be measured on other fingers except for thumb instead of removing the self-artificial nails in emergency situations. For patients with black self-artificial nails, is the findings recommend measuring oxygen saturation at other body parts such as toes, earlobes, forehead, etc.

• 대한골관절종양학회지
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• 제10권2호
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• pp.107-112
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• 2004

목적: 저자들은 족부에 발생한 조갑하 외골증에서 병변부위 및 크기에 따라 다른 수술방법을 시도하여 좋은 결과를 얻었기에 이에 대한 경험을 보고하고자 한다. 대상 및 방법: 1995년 10월부터 2003년 5월까지 1년 이상 추시가 가능하였던 12례를 대상으로 하였다. 여자가 9례, 남자가 3례였다. 수술 당시 평균나이는 13.4세였으며, 증상 발현기간은 평균 20.3개월 이었다. 무지에 발생한 경우가 9례였으며, 제 2, 3, 5족지에 발생한 경우가 각각 1례였다. 무지에 발생한 9례 중 8례가 원위지골의 배내측에 위치하였으며, 1례에서 배외측에 발생하였다. 제 2, 3, 5족지의 경우 모두 중앙부에 발생하였다. 무지에 발생한 경우 조갑을 절제하지 않고 보존하는 방법으로 외골증에 대한 수술적 접근을 시도하였고, 다른 족지에 생긴경우 조갑의 완전절제를 시도하였으나 가능한 조상은 보존하도록 노력하였다. 술후 판정은 조갑의 모양이 거의 정상이고, 임상적 및 방사선적으로 재발이 없는 경우 우수, 재발은 없으나 조갑의 융기와 같은 약간의 변형이 있는 경우 양호, 확실한 조갑의 변형 또는 방사선적으로만 발견되는 무증상의 경미한 재발이 있는 경우 보통, 임상적 및 방사선적으로 확실한 증상이 있는 재발의 경우 불량으로 하였다. 결과: 무지의 경우 6례에서 우수, 2례에서 양호, 1례에서 재발하여 불량으로 판정되었으며 기타 족지에 발생한 경우 3례 모두에서 양호 소견을 보였다. 결론: 족부에 발생한 조갑하 외골증에서 병변의 부위와 크기에 따라 다른 수술방법으로 치료하여 만족할 만한 결과를 얻었기에 저자들의 수술법은 권장할 만한 치료법으로 생각된다.