• 대한통합의학회지
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• 제9권4호
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• pp.299-309
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• 2021

Purpose : The purpose of this study was to compare the ankle pronation squat with the general squat and investigate the effect on the geun varum and the muscles around the knee. Methods : Subjects were chosen as the target for squat exercise with the distance between the knees more than 5 cm. The selected 30 students were randomly divided into 15 pronation squat group and 15 general squat group, and performed five sets movements 20 times. Global postural system (GPS) and digital goniometer were used to check the distance between the knees and the Q angle, and muscle activity was measured with EMG during squat exercise. Results: The result is as follows. First, as a result of analyzing the change in the distance between the knees, the distance between the knees decreased and the Q angle increased in the pronation squat group after exercise. Second, as a result of analyzing the change in muscle activity of the peroneus longus, the muscle activity increased in the pronation squat group after exercise, and it was more effective than the general squat group. Third, as a result of analyzing the change in the VMO (vastus medialis oblique) and VL (vastus lateralis) muscle activity ratio, the activity ratio of the pronation squat group increased after exercise, and the imbalance in the VMO/VL muscle activity was decreased. Conclusion: The pronation squat exercise applied to the ankle will greatly affect what is made into a balanced leg as decreased of the distance between knees, increased of Q angle, increased of the muscle activity of the peroneus longus and the ratio of VMO/VL.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.18-22
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• 2001

Purpose : The purpose of this study was to evaluate stress fracture of vascularized fibular grafts(VFG) by analyzing factors associated with stress fracture and the treatment results. Materials and Methods : From June 1985 to May 1998, 7 patients with stress fractures in the 38 patients with long bone defect who had vascularized fibular graft were evaluated with clinical and radiologic methods including grafted fibular length and hypertrophic index of de Boer. The average age of the patients was 35 years(range, $14{\sim}60$ years). The mean follow-up period was 20 months(range, $16{\sim}32$ months). Results: 7(18.4%) stress fractures occurred in 38 patients. Characteristics of the fractures were (1) all occurred at lower extremity of male patients treated with VFG for long bone defected caused by infected nonunion; (2) all occurred 10 months at the average(range, $4{\sim}17$ months) after VFG; and (3) the length and hypertrophic index of grafted fibula had no influence on the incidence of stress fracture. Union was obtained in 3 patients by conservative treatment. 4 patients obtained union by internal fixation; one at immediately onset of fracture; and three after failure of conservative treatment who had fracture around the knee joint. Conclusion : Stress fracture may occur during the first one year after vascularized fibular graft and more attention must be paid for prevention of it, especially in the cases of infected nonunion. Stress fracture around the knee joint was expected to lead to a good result of early union by operative treatment.

• Journal of Chest Surgery
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• 제56권6호
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• pp.387-393
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• 2023

Background: The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins. Methods: This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery. Results: The study included 179 limbs from 120 patients (47 men and 73 women). The mean patient age was 56.5 years (range, 20-78 years), and the distribution of preoperative Clinical-Etiology-Anatomy-Pathophysiology clinical classes was 8% C0-C1, 88% C2, and 4% C3-C6. The preoperative diameter of the saphenofemoral confluence averaged 6.9 mm (range, 2.7-15.8 mm). After a mean postoperative follow-up period of 24 months, evidence of neovascularization around the stump of the saphenofemoral junction (SFJ) was observed in 2 limbs (1.1%). Additionally, varicose vein recurrence was found in 1 limb (0.6%) and was associated with an incompetent thigh perforator. At postoperative follow-up, both VCSS and AVVQ scores were significantly lower than the preoperative scores. Conclusion: Modified surgical treatment of GSV incompetence, involving preservation of the SEV and stripping of a short segment up to the knee, demonstrated favorable clinical results in terms of postoperative complication rate, neovascularization rate around the SFJ stump, varicose vein recurrence rate, and improvement in lower extremity symptoms.

• 대한의용생체공학회:의공학회지
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• 제26권2호
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• pp.111-116
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• 2005

This study was designed to apply the stimulation system developed in our laboratory to investigate how the stimulation conditions affect the muscle contractile characteristics in the isometric condition as well as during the FES standing/walking. Four paraplegic and ten healthy subjects participated in this study, and their knee extensors were voluntary contracted or electrically stimulated to measure the muscle force and the fatigue index for different waveforms of the pulse train. We also investigated different combinations of the electrode positions during standing/walking. It was confirmed that continuous and high-frequency stimulation causes faster fatigue than intermittent and low-frequency stimulation. Fatigue resistance was higher around the optimal muscle length than at a stretched position in healthy subjects, whereas the opposite was observed in paralyzed subjects. The paired t-test results with the level of significance at 0.01 indicated that the sinusoidal waveform generated the largest torque among the four typical waveforms. Although statistically not very significant, the sinusoidal waveform also generated, in general, the highest fatigue resistance at an intensity level below the supramaximal stimulation. One of the paraplegic subject who participated in the standing/walking program can now stand up for 1 minute and 50 seconds with the knee extensors, and walk for about 5 minutes at the speed of 12m/sec.

• Steel and Composite Structures
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• 제31권5호
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• pp.453-467
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• 2019

Portal frame structures, made up of cold-formed steel trusses, are increasingly being used for lightweight building construction. A novel pin-jointed moment connector, called the Howick Rivet Connector (HRC), was developed and tested previously in T-joints and truss assemblage to determine its reliable strength, stiffness and moment resisting capacity. This paper presents an experimental study on the HRC, in moment resisting cold-formed steel trusses. The connection method is devised where intersecting truss members are confined by a gusset connected by HRCs to create a rigid moment connection. In total, three large scale experiments were conducted to determine the elastic capacity and cyclic behaviour of the gusseted truss moment connection comprising HRC connectors. Theoretical failure loads were also calculated and compared against the experimental failure loads. Results show that the HRCs work effectively at carrying high shear loads between the members of the truss, enabling rigid behaviour to be developed and giving elastic behaviour without tilting up to a defined yield point. An extended gusset connection has been proposed to maximize the moment carrying capacity in a truss knee connection using the HRCs, in which they are aligned around the perimeter of the gusset to maximize the moment capacity and to increase the stability of the truss knee joint.

• 한국운동역학회지
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• 제25권1호
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• pp.49-56
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• 2015

Objectives : The purpose of this study was to present quantitative data and basic references to decrease the accident risk of soccer instructors. Methods : To obtain data, we conducted an investigation on how H/Q ratio affects the dynamic stability of the lower extremity at the time of drop landing. The study targeted 13 soccer players from C University who have not had any injuries or wounds in the lower extremity joints and in any other parts of their bodies over the last 6 months. By using CMIS (USA), the players were divided into two groups according to H/Q ratios higher and lower than 69%, respectively. The subjects in each group were instructed to perform a drop landing. Results : The H/Q ratio did not affect the maximal flexion angle of the knee joints at the time of drop landing. In addition the dominant group with a relatively high H/Q ratio was observed to have increased time to reduce shock and to efficiently absorb the ground reaction force during drop landing. Also, the dominant group with a relatively high H/Q ratio utilized the strong performances of the antagonistic muscles around the hamstrings and the controlled rotatory powers of the thighs that were applied to the tibias supported by the ground. Finally, H/Q ratio, load factors, and mean and maximum EMG were significantly negatively related, whereas GRFx showed a positive relationship. In fact, these factors all affected the impact of the load from the H/Q ratio to the knee joints. Conclusion : From these findings it can be concluded that unbalanced H/Q ratio can be considered as a predictor of knee joint injury at the time of drop landing.

• 대한의용생체공학회:의공학회지
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• 제29권6호
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• pp.451-456
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• 2008

Total knee arthroplasty(TKA) using computer-assisted navigation has been increased in order to improve the accuracy of femoral and tibial components implantation. Recently, a few clinical studies have reported on the femoral stress fracture after TKA using computer-assisted navigation. The purpose of this study is to investigate the stress concentration around the femoral pin-hole for different pin-hole diameter, the modes of pin penetration by finite element analysis to understand the effects of pin-hole parameters on femoral stress fracture risk. A three-dimensional finite element model of a male femur was reconstructed from 1 mm thick computed tomography(CT) images. The bone was rigidly fixed to a 25 mm above the distal end and 1500 N of axial compressive force and 12 Nm of axial torsion were applied at the femoral head. For all cases, transcortical pin penetration mode showed the highest stress fracture risk and unicortical pin penetration mode showed the lowest stress concentration. Pin-hole diameter increased the stress concentration, but pin number did not increase the stress dramatically. The results of this study provided a biomechanical guideline for pin-hole fracture risk of the computer navigated TKA.

• 방송공학회논문지
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• 제18권3호
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• pp.401-408
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• 2013

본 논문에서는 영상 내의 문맥 특징(context feature)과 외형 특징(appearance feature)을 함께 학습함으로써 의료영상 내의 비슷한 외형 특징을 가지는 장기들을 자동으로 검출하는 기법을 제안한다. 기존 검출 기법들은 외형 특징 정보만을 학습하여 분류기(classifier)를 생성하였기 때문에 의료영상 내에 외형이 비슷한 장기들이 다수 포함되어 있는 경우 검출 오류가 발생하였다. 제안하는 기법은 외형 특징을 이용하여 학습된 분류기를 통해 얻은 확률 값들을 바탕으로 관심 복셀(voxel) 주변의 확률 분포 특징을 반복적으로 학습함으로써 문맥 정보를 포함하는 분류기를 생성한다. 또한, 실험 단계(test stage)에서 '지역 기반 투표 방식'(region based voting scheme)을 도입함으로써 효율성과 정확성을 향상시킨다. 제안하는 기법의 성능 평가를 위해 SKI10 무릎 관절 데이터 셋 내에서 외형 특징이 비슷한 대퇴골(femur)과 경골(tibia)을 검출하는 실험을 진행하였다. 실험 결과를 통해 제안하는 기법이 외형 특징만을 이용했던 검출 기법에 비해 개선된 검출 성능을 보이고 있음을 확인할 수 있었다.

• 한국운동역학회지
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• 제26권2호
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• pp.167-174
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• 2016

Objective: The purpose of this study was to determine the interrelationship between ranges of motion of the knee and ankle joints on the sagittal plane and the attenuation magnitude of impact shock at high frequency (9~20 Hz) in the support phase during downhill running. Method: Fifteen male heel-toe runners with no history of lower extremity injuries were recruited for this study (age, $25.07{\pm}5.35years$; height, $175.4{\pm}4.6cm$; mass, $75.8{\pm}.70kg$). Two uniaxial accelerometers were mounted to the tuberosity of tibia and sacrum, respectively, to measure acceleration signals. The participants were asked to run at their preferred running speed on a treadmill set at $0^{\circ}$, $7^{\circ}$, and $15^{\circ}$ downhill. Six optical cameras were placed around the treadmill to capture the coordinates of the joints of the lower extremities. The power spectrum densities of the two acceleration signals were analyzed and used in the transfer function describing the gain and attenuation of impact shock between the tibia and the sacrum. Angles of the knee and ankle joints on the sagittal plane and their angle ranges were calculated. The Pearson correlation coefficient was used to test the relationship between two variables, the magnitude of impact shock, and the range of joint angle under three downhill conditions. The alpha level was set at .05. Results: Close correlations were observed between the knee joint range of motion and the attenuation magnitude of impact shock regardless of running slopes (p<.05), and positive correlations were found between the ranges of motion of the knee and ankle joints and the attenuation magnitude of impact shock in $15^{\circ}$ downhill running (p<.05). Conclusion: In conclusion, increased knee flexion might be required to attenuate impact shock during downhill and level running through change in stride or cadence while maintaining stability, and strong and flexible ankle joints are also needed in steeper downhill running.

• 대한정형외과스포츠의학회지
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• 제9권1호
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• pp.7-15
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• 2010

전방 슬관절 동통 증후군은 여러 가지 형태의 다양한 원인으로 서서히 양측 슬개-대퇴 관절 내 또는 주위에 동통을 야기하는 증상이다. 원인으로는 하지의 부적절한 생역학, 전체적인 신전 기전의 병변, 슬개-대퇴 관절 병변, 슬개골 자체의 병변 또는 부정정렬, 단단한 연부조직, 약화된 근육 등이며, 전방 슬관절 동통 증후군을 평가하기 위해서는 슬개골 정열의 측정이 필요하고 현재 이학적 검사 및 방사선 검사 등 다양한 방법이 사용되어 진단 및 치료 정도를 평가하는데 사용되고 있다. 치료는 슬관절 전방 통증의 원인에 따라 결정되며, 주로 수술적 치료보다는 약물 치료나 대퇴사두근 근력 강화 운동, 함스트링 스트레칭운동 등이 보편적으로 사용되고 있다. 경부목 또는 내측 경골 스트레스 증후군은 전내측 경골 원위 2/3 부위에서 발생되는 통증을 의미하며, 반복적이고 조화되지 않는 충격이 하퇴부에 가해지는 스포츠를 하는 체육인에게 흔히 발생된다. 문제의 원인을 정확히 파악하여 진단하는 것이 치료에 매우 중요하며, 따라서 원인, 치료, 재활 및 예방까지 여러 이론이 보고되었다. 치료는 통증이 심할 경우 휴식과 함께 얼음찜질을 실시하며, 진통제를 복용하여 통증을 완화시켜 주는 것이 좋으며, 또한 다리 근육을 강화시켜 줄 수 있는 운동을 하며, 적절한 재활과 예방적 처치가 추후 재발을 방지하는 데 도움이 된다.