• Title/Summary/Keyword: Wagner grade

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Intralesional Injection of Autologous Platelet-Rich Plasma as an Effective Regeneration Therapy: A Case Report of Chronic Wagner Grade 2 Diabetic Foot Ulcer (증례 보고: 병변 내 자가 혈소판풍부혈장 주사로 효과적으로 재생된 만성화된 Wagner Grade 2 당뇨발 궤양 1예)

  • Moon Hee, Kim
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.187-191
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    • 2022
  • The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

The Current Status of Bacterial Identification by Wound Culture for Diabetic Foot Lesions in a Single Tertiary Hospital in South Korea (단일 3차 의료기관에 내원한 당뇨병성 족부병변 환자의 창상 배양검사를 통한 세균 검출 현황)

  • Jung, Sung Yoon;Lee, Myoung Jin;Lee, Seung Yup;Lee, Sang Yoon
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.2
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    • pp.100-107
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    • 2021
  • Purpose: The present study aimed to develop guidelines regarding initial choice of antibiotics for diabetic foot ulcers (DFU) by investigating bacterial isolates. Materials and Methods: This study included 223 DFU patients that visited a single tertiary hospital and underwent bacterial culture between January 2016 and February 2020. The study was conducted in two parts: 1) to compare bacterial isolates and wound healing according to comorbidities such as chronic kidney disease (CKD) and peripheral artery disease (PAD), and 2) to compare bacterial isolates according to wound depth using the Wagner classification. Results: Of the 223 patients, 43 had CKD (group A), 56 had PAD (group B), 30 had CKD and PAD (group C), and 94 had none of these comorbidities (group D). The isolation rate for multidrug-resistant gram-negative bacteria (MRGNB) and gram-negative to gram-positive bacteria ratio were highest in group C (p=0.018, p=0.038), and the proportion that achieved wound healing was lowest in group C (p<0.001). In the second part of the study, subjects were classified into 5 grades by wound depth using the Wagner classification; 13 grade I, 62 grade II, 60 grade III, 70 grade IV, and 17 grade V. No significant difference was observed between these grades in terms of isolation rates or gram-negative to gram-positive bacteria ratios. Conclusion: This study suggests antibiotics that cover gram-negative bacteria including MRGNB produces better results in the presence of CKD and PAD and that initial antibiotic choice should be based on the presence of CKD and PAD rather than wound depth.

THE EFFECT OF HYPERBARIC OXYGEN THERAPY IN TREATMENT OF DIABETIC FOOT ULCER (당뇨병성 족부 병변에 있어 고압 산소 치료의 효과)

  • Park, Tae-Woo;Cho, Sung-Do;Cho, Young-Sun;Kim, Bum-Soo;Lew, Sog-U;Kim, Moon-Chan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.35-39
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    • 2002
  • Purpose: The purpose of this study was to evaluate the effect of hyperbaric oxygen therapy(HBOT) and the resultant amputation rate in the treatment of diabetic foot ulcer. Material and methods: From 2000 Jan. to 2002 April, thirty two diabetic foot patients were admitted for treatment of foot ulcers and infection. Of the thirty two cases, thirteen patients received HBOT and nineteen did not. The results were analyzed by amputation rate and healing time. All were classified according to the Wagner classification. Results: Of the HBOT treated group, three(23%) patients underwent amputation: two below knee and one metatarsophalangeal disarticulations. Of the non-treated group, eleven(58%) patients underwent amputation, : four below knee and seven metatarsophalangeal disarticulations. The healing times, based on hospital days were average 16, 38, 43 days in the HBOT treated group and average 20, 50, 35 days in the non treated group respectively in Wagner grade II, III, IV. Conclusions: HBOT might be effective in decreasing amputation rate and hospital stay in diabetic patients with severe foot ulcers.

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Stainless Steel Foil Substrates; Robust, Low-Cost, Flexible Active-Matrix Backplane Technology

  • Hong, Yong-Taek;Heiler, Gregory;Cheng, I-Chun;Kattamis, Alex;Wagner, Sigurd
    • 한국정보디스플레이학회:학술대회논문집
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    • 2005.07b
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    • pp.892-896
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    • 2005
  • In this paper, key issues of stainless steel foil substrates for display applications have been described. We studied and analyzed technical issues on substrate passivation/planarization to control surface roughness and capacitive coupling from conductive substrates. A thick (either multiple or single) passivation/planarization layer needs to be applied on the nonelectronic-grade stainless steel substrate to provide a smooth surface and electrical insulation from the conductive substrate. Especially for large size, high-resolution display applications, low k and thick passivation/planarization layers should be used for appropriate capacitive coupling. Based on our initial study, a unit area capacitance of less than $2nF/cm^2$ of passivation/planarization layers is needed for 32" HD TV OLED displays.

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Preparation, Characterization and Low Frequency a.c. Conduction of Polypyrrole-Lead Titanate Composites

  • Basavaraja, C.;Choi, Young-Min;Park, Hyun-Tae;Huh, Do-Sung;Lee, Jae-Wook;Revanasiddappa, M.;Raghavendra, S.C.;Khasim, S.;Vishnuvardhan, T.K.
    • Bulletin of the Korean Chemical Society
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    • v.28 no.7
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    • pp.1104-1108
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    • 2007
  • Conducting Polypyrrole-lead titanate (PPy/PbTiO3) composites have been prepared by in situ deposition technique by placing different wt.% of fine grade powder of PbTiO3 (10, 20, 30, 40, and 50%) during polymerization of pyrrole. The composites formed were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), and thermogravimetric analysis (TGA), and these data indicate that PbTiO3 particles are dominating with an increase in crystallinity as well as thermal stability of the composites. The results on the low frequency dielectric studies which are obtained in the form of pressed pellet state are interpreted in terms of Maxwell Wagner polarization, which are responsible for the dielectric relaxation mechanism and frequency dependence of conductivity.

Clinical Analysis of Intractable Diabetic Foot Ulcers: Accessing Risk Factors (난치성 당뇨 족부 궤양에 대한 임상적 고찰: 치료에 영향을 미치는 인자 분석)

  • Park, Se-Jin;Lee, Seung-Hee;Park, Hun-Yong;Kim, Jang-Hwan;Shin, Hun-Kyu;Kim, Eu-Gene;Choi, Jae-Yeol
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.232-239
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    • 2011
  • Purpose: Diabetic foot ulcer is one of the most important diabetic complications because it increases the risk of amputations. Moreover, it lowers the quality of patients' life and increases the social medical expenses. Authors analyzed risk factors of intractable diabetic foot ulcer using retrospective study. Materials and Methods: From January 2007 to December 2010, 40 patients who could not achieve complete healing despite more than 12 weeks of proper management among who had been diagnosed and treated as diabetic foot ulcer at our hospital were included and evaluated retrospectively. We compared the risk factors between two groups who were finally treated by amputation and non-amputation. Results: The sample was composed of 31 male patients (77.5%) and 9 female patients (22.5%). Comorbidity including hypertension and hyperlipidemia were 77.5% and 80% each. By Wagner classification, 30 patients (80%) had ulcerative lesion over the grade 3. From bacteriology results, 29 patients (72.5%) had polybacteria infection. 35 patients (87.5%) had neuropathy and 26 patients (65%) had vascular stenosis at least one level. The mean initial ankle-brachial index and toe-brachial index were 0.982 and 0.439. In comparison between amputation group and non-amputation group, ulcer severity, number of stenotic vessel and initial ankle-brachial index/toe-brachial index had statistical significance. Conclusion: The most commonly risk factor of intractable diabetic foot ulcer was peripheral neuropathy reaching 87.5% of cases. In comparison with non-amputation group, ulcer severity according to Wagner classification, number of stenotic vessel and initial ankle-brachial index/toe-brachial index were demonstrated as a risk factor of amputation in intractable diabetic foot ulcer.

The Usefulness of Infrapopliteal Percutaneous Transluminal Angioplasty in the Treatment of Diabetic Gangrene (당뇨병성 족부 괴저의 치료에서 무릎 밑 경피적 경혈관 혈관성형술의 유용성)

  • Choi, Jae-Yeol;Shin, Hun-Kyu;Kim, Eu-Gene;Kim, Jong-Min;Lee, Yong-Taek;Kim, Seung-Kwon;Kim, Jong-Min
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.216-220
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    • 2007
  • Purpose: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) below the knee as a treatment in diabetic foot gangrene. Materials and Methods: Between May 2003 and May 2006, angiography was performed in 35 diabetic foot gangrene classified as either Wagner grade IV or V. Infrapopliteal PTA was performed in 10 patients among them. Clinical success was defined as prevention of major amputation. Results: Among 25 patients who did not receive infrapopliteal PTA, the major amputation rate is 22% (in one arterial occlusion cases), 50% (in two arterial occlusion cases), 63% (in three arterial occlusion cases), respectively. Infrapopliteal PTA was successfully performed in 8 among 10 patients. Two patients were failed and undergone below-knee amputation. Toe amputation were performed in 2 patients with one arterial occlusion. Out of 6 patients with three arterial occlusions, toe amputations were performed in 4 patients and the other 2 patients were healed through debridement. Conclusion: As a first choice revascularization procedure for limb salvage in diabetic foot gangrene, infrapopliteal PTA can be one of treatment options.

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A comparison of supplemental calcium soap of palm fatty acids versus tallow in a corn-based finishing diet for feedlot steers

  • Warner, Crystal M.;Hahm, Sahng-Wook;Archibeque, Shawn L.;Wagner, John J.;Engle, Terry E.;Roman-Muniz, Ivette N.;Woerner, Dale;Sponsler, Mark;Han, Hyungchul
    • Journal of Animal Science and Technology
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    • v.57 no.6
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    • pp.25.1-25.7
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    • 2015
  • Rumen bypass fat is commonly added to increase energy intake in dairy cattle. The objective of this study is to examine the addition of rumen bypass fat during finishing period on performance and carcass characteristics in grain fed steers. This study was conducted as a completely randomized block design with 126 cross-bred steer calves (initial BW $471.5{\pm}7.5kg$) randomly assigned to pens with 9 steers/pen (n = 7 pens/treatment). Each pen was randomly assigned to one of two treatment groups; rumen bypass fat treatment (CCS, calcium soap of palm fatty acids) and control diet (CT, tallow). The diets were formulated to be isonitrogenous and isocaloric. Animals were fed twice daily at 110 % of the previous daily ad libitum intake. Blood from each sample was taken from the jugular vein. Muscle and adipose samples were collected from the longissimus dorsi regions. Feedlot performance and carcass characteristics were assessed. To examine adipogenic gene expression, quantitative real-time PCR was completed. Steers fed the CT had a greater level of performance for most of the parameters measured. The CT group had greater DMI (P < 0.05) and tended to have greater ADG (P < 0.10). Marbling score (P < 0.05) and quality grade (P < 0.05) were greater for steers fed the CT diet than those fed CCS. The longissimus muscle area tended to be greater (P < 0.10) in steers fed CT ($87.60cm^2$) than those fed CCS (84.88 cm2). The leptin mRNA expression was down-regulated (P < 0.05) in adipose tissue of steers fed a CCS when compared to those fed CT. These data suggest that calcium soap of palm fatty acids can be added to finishing diets without significant reduction in final body weight, although there may be modest reductions in marbling and quality scores.