OBJECTIVE: To determine whether ankle plantar flexors stretching exercise affects functional reach in elderly men. METHOD: Twenty elderly men with an average age of 78.2 years were selected for this study. A active range of motion of ankle dorsiflexion and a functional reach (FR) distance were measured before and after ankle stretching exercise. The ankle dorsiflexion was measured by goniometer in knee extended position. The FR distance was measured in standing position. Ankle plantar flexors stretching exercises were carried out by physical therapist 4 times per week for 4 weeks. At 4 weeks after the stretching exercise, we retested the active range of motion of ankle dorsiflexion and the FR distance using the same method. RESULTS: At 4 weeks after the stretching exercise, the active range of motion of right ankle dorsiflexion was increased from 2.81 +/- 3.26degrees to 5.98 +/- 4.34degrees, and the left ankle dorsiflexion was increased from 3.15 +/- 3.77degrees to 6.35 +/- 2.45degrees. The FR distance was increased form 12.22 +/- 7.54 cm to 19.69 +/- 8.59 cm after the stretching exercise. CONCLUSION: The FR distance was significantly increased after the ankle plantar flexors stretching exercise (p<0.01). This results suggest that the ankle plantar flexors stretching excercise may be capable of increasing the FR distance in elderly.
Aged* ; Ankle Joint ; Ankle* ; Exercise ; Humans ; Knee ; Male ; Physical Therapists ; Range of Motion, Articular

Purpose: Single-incision laparoscopic surgery is a recently developed minimally invasive surgical technique. We aimed to compare the feasibility and safety of single-incision plus one port laparoscopic low anterior resection (S+1-LAR) with those of multi-port laparoscopic low anterior resection (M-LAR) for mid-to-low rectal cancer. Methods: We retrospectively reviewed patient characteristics and surgical outcomes by assessing data collected from the medical records of patients who underwent elective laparoscopic low anterior resection for mid-to-low rectal cancer at the Gangneung Asan Hospital. Results: From April 2015 to April 2019, 52 patients underwent S+1-LAR (n=28) or M-LAR (n=24) for midto-low rectal cancer at Gangneung Asan Hospital. There were no significant between-group differences in clinical characteristics. The mean postoperative 1-day pain score was significantly lower in the S+1-LAR group. Surgical outcomes and postoperative complications did not differ significantly between the two groups. Conclusion S+1-LAR is a feasible and safe technique and is comparable with M-LAR in terms of surgical outcomes of patients with mid-to-low rectal cancer.

The thyroid cartilage, which is the biggest cartilage in laryngeal cartilages, undergoes the osseous changes with advancing age and the process is ordinary endochondral ossification. With respect to the spread pattern of ossification, there are several reports but study about the Korean is negligible. The purpose of this study is to estimate the age based on radiographic analysis of the Korean thyroid cartilage. Dedicated mammography was carried out on 124 specimens of the thyroid cartilage including 76 males and 48 females. We measured 14 qualitative measurements. The results were as followed ; The Ratio of radio-opacity exhibited increasing value with advancing age on both sexes. The ossification began at the posterior border and involved orderly the inferior border, the anterior angle (anterior border) and notch as advancing age in male subjects. We could propose the pattern of ossification for age-estimation in Korean male subjects. Concerning the female subjects, we could not propose the relation between age and the pattern of ossification. In conclusion, we can estimate the age for male subjects by radiographic quantitative analysis of the Korean thyroid cartilage.
Cartilage ; Female ; Humans ; Laryngeal Cartilages ; Male ; Mammography ; Thyroid Cartilage* ; Thyroid Gland*

No abstract available.
Female ; Humans ; Low Back Pain*

OBJECTIVE: Poor head and neck support during sleep can exacerbate the neck pain. Based on the ideal sleep posture and pillow suggested by Cyriax, we designed a new cervical pillow and compared the degree of pain reduction, quality of sleep and pillow satisfaction with a low hospital pillow and a high pillow. METHOD: The newly designed pillow has a built-in pressure-adjustable air bag in the cervical area and provides normal cervical lordotic curve in supine position and maintains cervical and thoracic vertebrae to form a horizontal line in side-lying position. Thiry-four patients with cervical pain used low hospital pillows for the first week of 3-week randomized crossover design study. They were subsequently randomly assigned to use each of the other two pillows for 1-week period. Outcomes were measured using visual analog scale, sleep questionnaire and a pillow satisfaction scale. RESULT: Compared with the other 2 types of pillows, subjects using the newly designed pillow showed much reduced pain intensity, increased duration of sleep and sleep quality and better pillow satisfaction. CONCLUSION: We designed a cervical pillow with built-in pressure adjustable air bag and it can significantly reduce pain intensity and improve quality of sleep in patients with cervical pain.
Air Bags ; Cross-Over Studies ; Head ; Humans ; Neck ; Neck Pain ; Posture ; Surveys and Questionnaires ; Supine Position ; Thoracic Vertebrae ; Visual Analog Scale

This study analyzed the outcome of 26 cases of cesarean hysterectomy performed at Wonju Christian Hospital, College of medicine, Yonsei university during 15 years from January, 1982 to May, 1996. There were 27,602 deliveries during this period. Cesarean hysterectomy was performed in 11 of 10,373 cesarean section(0.11 %) and in 15 of 17,229 vaginal deliveries(0.09 %). The age of patients varied from 20 to 48. Indications for emergency cesarean hysterectomy were uterine atony (46.2 %), uterine rupture(26.9 %), and placenta accreta(19.2 %). The relative risk of emergency hysterectomy was 1.22(95 % confidence interval 0.56 to 2.65) for cesarean deliveries, 1.91(95 % confidence interval 0.73 to 4.98) for prior cesarean deliveries and 20.56(95 % confidence interval 10.85 to 38.95) for placenta previa. The patients who had cesarean hysterectomy received from 750 ml to 11,500 ml of blood transfusion with a mean of 3,500 ml. No significant differences in length of operating time, amount of blood loss and postoperative complications were found between total abdominal hysterectomy and subtotal abdominal hysterectomy. In about 1/2 of total patients (46.2 %), there were no operative complications. Maternal death was found in 1 case. Hemorrhage still remains main cause of maternal mortality, the decision of hysterectomy must be conjunction with maternal life saving and free from various dangerous sequalae. So in this study, clinical evaluation for cesarean hysterectomy and an attempt to identify risk factor that might pridict those patients likely to require emergency hysterectomy was made.
Blood Transfusion ; Emergencies ; Gangwon-do ; Hemorrhage ; Humans ; Hysterectomy* ; Maternal Death ; Maternal Mortality ; Placenta ; Placenta Previa ; Postoperative Complications ; Risk Factors ; Uterine Inertia

Anorectal cancer is traditionally treated via abdominoperineal resection and/or chemoradiation. Currently, endoscopic submucosal dissection (ESD) is widely used to treat early gastrointestinal epithelial neoplasias. However, the use of ESD to treat lesions of the anal canal raises concerns that do not arise when treating lesions of the stomach and colorectum. Therefore, particular care is needed when treating lesions in the anal area. We recently treated a 75-year-old woman who was scheduled for surgical resection to treat anorectal cancer. The lesion was successfully removed using ESD. This is the first report of the use of ESD to treat anorectal cancer in Korea. Here, we present our case report and review the relevant literature.
Aged ; Anal Canal ; Female ; Humans ; Korea ; Stomach

Recently a huge benign tumor of the ovary (greater than 25 pounds) is rare because of early detection and operation. Although infrequently seen, many serious problems associated with the removal of such tumors have been described, including cardiovascular and respiratory complications. For successful management and good prognosis, it certainly requires slow decompression. We have experienced one case of huge benign tumor of the ovary, and report this case with brief review of literatures.
Decompression ; Female ; Ovary* ; Prognosis

Small bowel diverticulosis is a rare finding within all bowel diverticuloses and jejunal diverticulosis is even rarer. Their relative clinical rarity and varied presentation may make diagnosis both delayed and difficult. We experienced a case of jejunal diverticulosis, which was diagnosed intraoperatively. A 55-year-old woman was admitted to Emergency Department with pneumoperitoneum on plain chest and abdominal film from a local clinic. She was hemodynamically stable with minimal tenderness on the left upper quadrant of the abdomen but no rebound tenderness. At surgery, small bowel torsion and jejunal diverticulosis were confirmed. Over 30 variable sized small bowel diverticula were noted on the mesenteric side of the proximal jejunum. The affected segment of the jejunum was about 180 cm. On exploration, we could not find any perforation site. No postoperative complications were observed, and the patient made a full recovery. Jejunal diverticulosis is rare, but it should not be regarded as insignificant.
Abdomen ; Diagnosis ; Diverticulum* ; Emergency Service, Hospital ; Female ; Humans ; Jejunum ; Middle Aged ; Pneumoperitoneum* ; Postoperative Complications ; Thorax

BACKGROUND: Results of recent studies have suggested that the extent and severity of coronary artery disease and the degree of left ventricular dysfunction are two major factors influencing survival in patients with acute myocardial infarction. Although non-invasive modalities including exercise stress electrocardiography, echocardiography and nuclear cardiologic techniques can predict the prognosis of patients with acute myocardial infarction to an extent, coronary angiography is still the best modality for exact evaluation of the severity and the extent of coronary artery disease. METHODS: A review was done from January, 1985, to August, 1993, on 631 patients with acute myocardial infarction who underwent coronary angiography with or without left ventricular angiography within 30 days after onset of acute myocardial infarction at Yonsei University Severance Hospital. RESULTS: 1) The mean age of the 631 patients was 55.2 years(23-82 years). Five hundred thirty three(84.5%) were males and 98(15.5%) were females. The prevalences of coronary artery disease were high in the 5th decade in males and in the 6th decade in females. 2) The major risk factors were cigarette smoking(69.6%), hypertension(34.9%), diabetes mellitus(18.9%), and hypercholesterolemia(12.3%). Cigarette smoking was statistically more frequent in males and hypertension was more frequent in female. 3) Of the 631 patients studied, 570 patients(90.3%) had Q wave myocardial infarction and 61 patients(9.7%) had a non-Q wave myocardial infarction. 33 patients(5.2%) had a history of previous myocardial infarction. 4) The coronary angiogram showed 25 patients(4.0%) had normal coronary anatomy and 29 patients(4.6%) had minimal coronary vessel lesions. Lesions greater than 50% were confined to one major artery in 309 patients(49.0%), whereas two-and three-vessel disease were found in 179(28.3%) and 83(13.1%) patients respectively. 5) The normal or minimal lesion coronary anatomy and one-vessel disease were significantly frequent in patients under 40 years of age. However, multi-vessel disease was significantly more frequent in patients over 40 years of age. 6) The patients who had a history of cigarette smoking often had more normal or minimal lesion coronary anatomy, one vessel disease and less multi-vessel disease, compared with those without a history of cigarette smoking. The patients with hypertension had more multi-vessel disease and less normal or minimal lesion coronary anatomy, one vessel disease. The patients with diabetes mellitus had less one vessel disease and more multi-vessel disease. 7) According to the site of infarction, anterior myocardial infarction was associated with more prevalence in normal or minimal lesion coronary anatomy, one vessel disease, inferior myocardial infarction was associated with more prevalence in multi-vessel disease. 8) The infarct related artery was the left anterior descending artery in 5.3.7%, the right coronary artery in 35.9%, the left circumflex artery in 10.3%. Additionally, there was one case of anterior myocardial infarction associated with the left main coronary artery occlusion. 9) With the passage of time, there was a decrease of total occlusion in all cases whether thrombolytic therapy was administered or not. The patients with thrombolytic therapy had a lower total occlusion rate of infarct related artery compared with those without thrombolytic therapy. 10) The left ventricular ejection fraction was higher in the patients with non-Q wave infarction than in those with Q wave infarction. The left ventricular ejection fraction was higher in the patients with thrombolytic therapy in comparison with those who did not receive thrombolytic therapy. CONCLUSION: The coronary angiographic findings of patients with acute myocardial infarction showed higher prevalence of one vessel disease, and more frequent onset of myocardial infarct under 40 years of age with normal or minimal lesion coronary anatomy. Thrombolytic therapy administered to patients with acute myocardial infarction resulted in the beneficial effects of decreased total occlusion rate of the infarct related artery and improved left ventricular function.
Angiography ; Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diabetes Mellitus ; Echocardiography ; Electrocardiography ; Female ; Humans ; Hypertension ; Infarction ; Inferior Wall Myocardial Infarction ; Male ; Myocardial Infarction* ; Prevalence ; Prognosis ; Risk Factors ; Smoking ; Stroke Volume ; Thrombolytic Therapy ; Tobacco Products ; Ventricular Dysfunction, Left ; Ventricular Function, Left