Case report
- Medical Informatics
- Development of an automated foot contact area measurement program for podoscopes using ChatGPT-4: a case report
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Min Cheol Chang
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J Yeungnam Med Sci. 2025;42:13. Published online December 3, 2024
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DOI: https://doi.org/10.12701/jyms.2024.01326
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3,897
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- Accurate measurement of the foot contact area is crucial for diagnosing pes planus (flatfoot) and pes cavus (high arch), which significantly affect pressure distribution across the plantar surface. This study aimed to develop a program using ChatGPT-4 to automate foot contact area measurements using a podoscope, thereby enhancing diagnostic precision. A 53-year-old female volunteer stood on a podoscope to capture images of her feet, which were processed to isolate the foot contours and measure the contact areas. A program developed utilizing ChatCPT-4 was designed to outline the feet, detect contact areas, and calculate their sizes and ratios. The results demonstrated clear visualization of foot contours with automated calculation of the contact area and its ratio to the total foot area. The entire foot area measured 1,091,381.00 pixels, with a contact area of 604,252.50 pixels. The ratio of the ground contact area to the entire foot area was calculated as 55.37%. This method, which employs advanced image-processing techniques powered by ChatGPT-4, demonstrates the potential for integrating artificial intelligence into clinical applications. This approach could improve diagnostic precision and patient outcomes through personalized treatment strategies.
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- Emerging technologies in the field of medicine presented at the Consumer Electronics Show 2025
Jong-Ryul Yang, Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 42: 31. CrossRef - What should researchers do in the era of artificial intelligence?
Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 43: 2. CrossRef
Focused Review articles
- Orthopedics and Sports Medicine
- State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review
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Inha Woo
, Seung Jae Cho
, Chul Hyun Park
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J Yeungnam Med Sci. 2023;40(4):321-327. Published online October 12, 2023
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DOI: https://doi.org/10.12701/jyms.2023.00976
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- Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using “diabetic foot [MeSH]” and “osteomyelitis [MeSH]” or “diagnosis” was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.
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- Evaluasi Temuan Radiologi Foto Polos Pedis dextra pada Pasien dengan Osteomielitis di Instalasi Radiologi Rumah Sakit Siloam Sriwijaya Palembang
Danda Wibowo, Harry Wahyudhy, Zanariah
JURNAL LENTERA ILMIAH KESEHATAN.2026; 4(1): 8. CrossRef - Deep learning-enhanced MRI for diabetic foot tarsal bone lesions and insulin injection behavior analysis
Haidong Ye, Fang Yao
Journal of Radiation Research and Applied Sciences.2025; 18(2): 101493. CrossRef - Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef
- Orthopedics and Sports Medicine
- The pathophysiology of diabetic foot: a narrative review
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Jiyoun Kim
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J Yeungnam Med Sci. 2023;40(4):328-334. Published online October 5, 2023
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DOI: https://doi.org/10.12701/jyms.2023.00731
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- An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.
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Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef
- Orthopedics and Sports Medicine
- Management of diabetic foot ulcers: a narrative review
-
Jahyung Kim
, Otgonsaikhan Nomkhondorj
, Chi Young An
, Ye Chan Choi
, Jaeho Cho
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J Yeungnam Med Sci. 2023;40(4):335-342. Published online September 22, 2023
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DOI: https://doi.org/10.12701/jyms.2023.00682
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- Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.
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- Clinical Efficacy of Type I Collagen Skin Substitutes Versus Human Amnion/Chorion in Treating Diabetic Foot Ulcers Using 55 Patient Randomized Controlled Independent Two Trials, One in India and the Other in the USA
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Ji Min Kim, Chong Hwa Kim, Seon Mee Kang, Jung Hwa Jung, Ki Chun Kim, Sanghyun Ahn, Tae Sun Park, Ie Byung Park
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Levent Demir, Mustafa Avcı, Murat Kahraman, Selahattin Kılıç
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Idris Ajibola Omotosho, Noorasyikin Shamsuddin, Hasniza Zaman Huri, Wei Lim Chong, Inayat Ur Rehman
International Journal of Molecular Sciences.2025; 26(14): 6909. CrossRef - Mango ginger-derived exosome-like nanovesicles promotes diabetic wound healing via inducing the promigratory protein, follistatin-like 1.
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Dhayalan Kalavathy GokulRaj, Ravichandran Jayasuriya, Kunka Mohanram Ramkumar
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Bethany L. Patenall, Kristyn A. Carter, Matthew R. Ramsey
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Ying Li, Li Zhang, Meifang He, Yuebin Zhao
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Sara Memarpour
American Journal of Stem Cells.2024; 13(2): 87. CrossRef - Etiopathophysiology, Novel and Advanced Therapy Options, Management and Care Plan to Prevent Lower Limb Amputations for Diabetic Foot Ulcer
Richa Dayaramani, Nipa Gandhi, Areeg Anwar Ali Shamsher, Nour Aymn Ahmad
Research Journal of Pharmacy and Technology.2024; : 5141. CrossRef - Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef
- Endocrinology, Diabetes, and Metabolism
- Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review
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Chi Young An
, Seung Lim Baek
, Dong-Il Chun
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J Yeungnam Med Sci. 2023;40(4):343-351. Published online September 19, 2023
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DOI: https://doi.org/10.12701/jyms.2023.00717
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- Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient’s general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.
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- Therapeutic options and prognostic risk factors in diabetic foot osteomyelitis: a narrative review
Zi-Xian Liu, Mou-Zhang Huang, Ming-Cong Ding, Xin-Ping Ma, Nan Jiang
International Journal of Surgery.2026; 112(2): 4799. CrossRef - Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef
Resident fellow section: Teaching images
- Musculoskeletal Disorders
- A 40-year-old man with neuropathic pain in the entire left foot
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Jae Hwa Bae
, Mathieu Boudier-Revéret
, Min Cheol Chang
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J Yeungnam Med Sci. 2023;40(2):223-224. Published online August 30, 2022
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DOI: https://doi.org/10.12701/jyms.2022.00486
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Original article
- Endocrinology, Diabetes, and Metabolism
- Risk factors affecting amputation in diabetic foot
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Jun Ho Lee
, Ji Sung Yoon
, Hyoung Woo Lee
, Kyu Chang Won
, Jun Sung Moon
, Seung Min Chung
, Yin Young Lee
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Yeungnam Univ J Med. 2020;37(4):314-320. Published online May 6, 2020
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DOI: https://doi.org/10.12701/yujm.2020.00129
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11,470
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- Background
A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU).
Methods
The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery.
Results
Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561−10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087−5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981−0.999), ulcer size (HR, 1.247; 95% CI, 1.107−1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224−0.73) were associated with risk of amputation.
Conclusion
Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.
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Review article
- Orthopedics and Sports Medicine
- Forefoot disorders and conservative treatment
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Chul Hyun Park
, Min Cheol Chang
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Yeungnam Univ J Med. 2019;36(2):92-98. Published online May 14, 2019
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DOI: https://doi.org/10.12701/yujm.2019.00185
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Abstract
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- Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.
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