• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.245-248
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• 1997

Operative interventions for the management of osteonecrosis of the femoral head (ONFH) include core drilling, with or without vascularized fibular bone grafting. Nevertheless, their clinical results have not been consistently satisfactory. Recently, a new surgical procedure that incorporates cementation with polymethylmethacrylate (PMMA) after core drilling has been tried clinically. In this study, a biomechanical analysis using a finite element method(FEM) was undertaken to evaluate surgical methods and their underlying surgical parameter. Our finite element models included five types. They were (1) normal model (Type I), (2) necrotic model (Type II), (3) core decompressed model (Type III). (4) fibular bone grafted model (Type IV), and (5) cemented with PMMA model (Type V). The geometric dimensions of the femur were based on digitized CT-scan data of a normal person. Various physiological loading conditions and surgical penetration depths by the core were used as mechanical variables to study their biomechanical contributions in stress transfer within the femoral head region. In addition. the peak von Mises stress(PVMS) within the necrotic cancellous bone of the femoral head was obtained. The fibular bone grafted method and cementation method provided optimal stress transfer behaviors. Here. substantial increase in the low stress level was observed when the penetration depth was extended to 0mm and 5mm from the subchondral region. Moreover, significant decrease in PVMS due to surgery was observed in the fibular bone grafted method and the cementation method when the penetration depths were extended up to 0 and 5mm from the subchondral region. The drop in PVMS was greater during toe-off than during heel-strike (57% vs. 28% in Type IV and 49% vs. 22% in Type V). Both the vascularized fibular bone grafting method (Type IV) and the new PMMA technique (Type V) appear to be very effective in providing good stress transfer and reducing the peak Von-Mises stress within the necrotic region. Overall results show that fibular bone grafting and cementation methods are quite similar. In light of above results, the new cementation method appears to be a promising surgical alternative or the treatment of ONFH. The use of PMMA for the core can be less prone to surgical complication as opposed to preparation of fibular bone graft and can achieve more immediate fixation between the core and the surrounding region.

• 대한방사선기술학회지:방사선기술과학
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• 제29권4호
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• pp.225-228
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• 2006

목 적: 후족부의 병리학적 상태의 치료와 평가를 위해서는 관상면에서 종골과 경골이 연관된 배열상태의 정확한 평가가 필수적이다. 이전의 방사선학적 검사인 발과 발목의 전후방향, 측방향, 사방향 촬영과 종골 축방향 촬영 등의 X-선 촬영상은 관상면에서 종골과 경골이 연관된 배열상태를 증명하지 못했다. 이에 본 연구에서는 후족부 관상면 배열영상(hindfoot coronal alignment view)을 새롭게 소개하고자 한다. 검사방법 : 1) 양쪽 발을 지탱할 수 있는 방사선투과성의 스탠드형 보조기구를 제작한다. 2) 양측 발은 weight-bearing position이 되게 한다. 3) 각각의 발의 위치는 발의 종축이 보조기구 판과 수직이 되도록 자세를 유지한다. 4) silhouette tracing: 발뒷꿈치 outline과 둘째 발가락이 일직선상으로 지나도록 위치시킨다. 5) 중심 X-선: 발바닥 쪽을 향해 약 $15{\sim}20^{\circ}의 각도로 종골의 뒷쪽을 향해 입사한다. 결 과 : 1) 경골 축과 종골의 내측, 외측 결절의 영상이 함께 표출된다. 2) 종골이 회전되지 않아야 한다. 3) 거퇴관절강(talotibial joint space)이 함께 나타나야 한다. 결 론: CT나 MRI 영상에서도 관상면에서 후족부의 배열상태를 증명할 수 있지만, 환자의 체중이 주어지지 않기 때문에 발의 임상적인 증상을 보여주기에는 충분하지 못했다. 하지만 후족부 관상면 배열영상은 후족부의 inversion, eversion의 자세변화를 보여주고, 경골 원위부와 종골의 varus, valgus deformity의 치료를 위한 평가 자료로 좋은 검사방법이며, 비교적 자연스럽고 편안한 자세로 환자에게 큰 도움을 줄 것으로 사료된다.

• 한국전문물리치료학회지
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• 제15권1호
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• pp.38-45
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• 2008

This study investigated gait characteristics, kinematics, and kinetics in the lower extremities between two different shoe conditions (high heeled shoes (7 cm), and high heeled shoes with a total contact insert (TCI)) after lower extremity muscle fatigue. Although TCI shave been applied in high heeled shoes to increase comfort and to decrease foot pressure, no study has attempted to identify the effects of TCI in fatigue conditions. The purpose of this study was to determine the effects of walking in high heeled shoes with TCI after lower extremity muscle fatigue was induced. This study was carried out in a motion analysis laboratory at Hanseo University. A volunteer sample of 14 healthy female subjects participated. All in fatigue conditions, the subjects were divided into two groups. The muscle fatigue was induced by 40 voluntary dorsi- and plantar-flexion exercises and 40 heel-rise exercises of the dominant foot. Surface electromyography was used to confirm the localized muscle fatigue using power spectral analysis of three muscles (tibialis anterior, gastrocnemius medialis and lateralis). The results were as follows: (1) In muscle fatigue conditions, the use of TCI decreased the peak flexion angle of the hip joint significantly in the early stance phase (p<.05) and increased the peak hip flexion moment in the terminal stance phase (p<.05). (2) In muscle fatigue conditions, the application of TCI also increased peak hip power generation in the early stance phase and peak hip power absorption in the terminal stance phase (p<.05). (3) In muscle fatigue conditions, the use of TCI reduced the impact force significantly and increased the secondary peak vertical GRF. These findings suggest that the TCI may provide beneficial effects when muscle fatigue occurs for a high heeled shoe gait. Future research employing the patient population and various types of TCI materials are required to clarify the effects of TCI.

• 한국콘텐츠학회논문지
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• 제12권6호
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• pp.182-190
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• 2012

현대인의 생활은 굽이 높은 슬리퍼, 샌들, 하이 힐 등의 과다 사용에 따른 수축된 아킬레스건이 보행 또는 운동 중에 파열되는 사고로부터 예방의 필요성이 증가하고 있다. 또한 국민생활이 윤택해짐에 따라서 운동부족과 과잉섭취에 의한 국민비만은 심각한 상황이다. 본 연구는 아킬레스건의 신장과 이완된 종아리 근육을 풀어주거나 키워주는 역할의 기능성 샌들에 대한 외형 디자인에 대하여 현재 시제품에 대한 분류와 문제점들을 알아보고 어떠한 디자인 개발이 필요한 지 알아보는 데에 본 연구의 목적이다. 본 연구조사를 통하여 동일 제품군을 대상으로 현재 기능성 샌들 디자인 문제점과 경향으로 향후 개발되어질 기능성 샌들에 대하여 다음과 같은 결론을 얻을 수 있다. 첫째, 앞굽이 높고 바닥이 넓으며 지면과 맞닿는 부분이 많아야 한다. 둘째, 무채색 계열보다는 유채색 계열에 대하여 선호도가 높다. 셋째, 굽의 높이와 형태를 곡선 적으로 제작하고 신발의 균형에 대하여 디자인 고려해야 한다. 넷째, 기능성 샌달로써 형태가 너무 커 투박하거나 운동에 불편을 주지 않는 가운데 될수록 크게 보여 안정감을 주도록 한다. 다섯째, 형태를 디자인하는데 너무 복잡하게 디자인하지 않도록 한다. 연구는 기능성 샌들의 외형 디자인에 대해서 조사 분석한 것으로 실제 샌들의 사용 평가 등에 대해서 이루어지지 않았다. 향후 보다 구체적인 연구를 통해 건강을 위한 기능성 샌들 디자인의 다양화를 모색하고 우리나라의 산업과 디자인 경쟁력의 우위를 확보해 나아가야 할 것이다.

• 대한정형외과스포츠의학회지
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• 제1권2호
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• pp.138-142
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• 2002

목적: 스포츠와관련된급성아킬레스건파열의직접봉합및건외막피복술의결과및예후를평가하였다. 대상및방법: 1997년부터2001년까지수술후1년이상추시가능했던21예를대상으로하였다. 30대가$55\%$로가장많았으며축구후에생긴파열이5예로가장많았고, 양측이간격을두고파열된경우가2예로확인되었다. 수술은수상후1주이내에시행하였으며, 단단봉합술후주위건외막조직을충분히봉합하여혈액순환을최대한유지한상태로봉합부를피복하였다. 수술후슬관절을25도굴곡, 족관절은족저굴곡된상태로6주간장하지석고고정후2주간격으로단하지석고고정및족관절첨족을기능적위치로전환하여10주째90도족배굴곡상태로회복시켰다. 결과는Hooker의기준을이용하여수술후평균28개월에평가하였다. 결과: 환측이정상측에비해발뒤꿈치-지면거리가평균0.7cm 감소하였고, 20회체중부하족저굴곡후에는0.8 cm 감소하였으며, 하퇴둘레는0.3 cm 감소하였고, 능동적운동범위는족배굴곡과족저굴곡이각각3도와5도가감소하였다. 수술결과는1 6예에서우수, 5예에서양호를보였으며재파열이나상처부위괴사및감염의후유증은없었다. 결론: 아킬레스건파열의단단봉합술후주위건외막조직의충분한피복봉합은건의치유와수술후유착방지에, 그리고수술후주기적족관절족배교정은잔여첨족변형의예방에좋은치료방법이다

• 동서간호학연구지
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• 제10권1호
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• pp.75-85
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• 2004

The purpose of this study was to examine the effects of the stretching and recreation exercise including health education on physical flexibility and health behavior compliance of women in elderly. Subjects included 28 women elderly who were residents of H Dong, Dondae moon-Gu, Seoul. The treatment intervention was applied during total 8 weeks as 5 times/week for stretching exercise with 2 times/weeks for health education. Data collection were from February to April, 2004. SPSS Window program was used by aims of this study for data analysis. The results were as following: 1. 75 old age above (39.3%) was the most of age in subjects. None education (42.9%) was the most of subjects in this study. Perceived health state was the most as 71.4% in moderate and good health state. 2. Physical flexibility of both shoulder(right z=-4.301, p=,000)(left z=-4.306), both arm(right z=-3.623, p=.0001)(left z=4.111, p=.0001), heel on both ankle(right z=-3.472, p=.0001) (left z=956, p=.0001), both before food(right z=-4.205, p=.0001)left(z=4.191, p=.0001) and both knee(right z=-4.118, p=.0001)(left z=4.082, p=.0001) was increased after 8 weeks more than before stretching and recreation exercise including health education were done. 3. Health behavior compliance(z=-4.073, p=.0001) was significantly on the effect. Therefore, it is confirmed that stretching exercise included health education is an effective nursing intervention for physical, mental, and psychological health management in elderly. Accordingly, authors are proposing that variously effective health management exercise programs must be developed for elderly, at the same time, the application and following up on the programs will be more important in the future.

• 대한인간공학회지
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• 제28권3호
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• pp.95-102
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• 2009

Ten young females were participated in this study to investigate the effects of types of shoes (sneakers, high heels, kill heels), types of tasks (standing, walking floor, step up and down), and areas of foot (fore foot, middle foot, rear foot) on foot pressures as well as subjective discomfort ratings. Results showed that kill heels had the most discomfort shoes, followed by high heels and sneakers. Generally, as the heel was higher, the discomfort of foot increased. For the analyses of task types, generally discomfort ratings were highest for the step down and up, followed by walking floor and standing. Especially discomfort ratings of high heels and kill heels were more evident in case of step up and step down than standing and walking floor. Standing task was rated as the lowest levels of discomfort on users' foot. Peak and mean foot pressures were also evaluated in this study. The findings represented that there was no significant differences between types of shoes in both peak and mean foot pressures. The peak pressure (82.14kPa) and mean pressure (40.32kPa) for standing task were significantly lower than those of other tasks [walking floor (190.55kPa, 55.46kPa), step up (191.43kPa, 53.80kPa), and step down (200.66kPa, 52.62kPa)]. Generally discomfort ratings and peak/mean pressures associated with foot showed that fore foot had higher discomfort ratings as well as peak and mean pressures than middle and rear foots. In particularly, this trend was more obvious in case of high heels and kill heels. For the high heels and kill heels, the peak pressures of fore foot were 4.5~4.8 times and 2.3~2.5 times greater than that of middle foot and rear foot, respectively, whereas the peak pressures of fore foot were 2.9 times and 1.7 times greater than that of middle and rear foots, respectively, in case of sneakers.

• 한방안이비인후피부과학회지
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• 제8권1호
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• pp.131-132
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• 1995

After studing of viewpoint of surgical disease in seven medical books related with Ju Dan Gye(朱丹溪) among four eminent physicians in the Jin and Yuan dynasties(金元四大家) I get conclsion as following. 1. Studied surgical diseases are total 40 kinds. 2. In 40 kinds surgical diseaes, case of having theory are 20 kinds, cases of having no theory and having only treatement by medicine are 20 kinds. 3. In therapy, cases that mainly use a method to eliminate pathogenic factors are 27 kinds; Acute mastitis(乳癰), Deep-seated mammary abscess(내巖), Acute appendicitis(陽癰), Bone cellulitis(附骨疽), Carbuncle of the lower abdomen near external genitalia(便毒), Leprosy(癩風), Macule(斑), Rash(疹), Urticaria(은疹), Scrofula(나역), Stagnant plegm(結核), Goiter andtumer(영유), Erysipelas(丹), Furuncle(정瘡), Scabies(疥瘡), Chancre(下疳瘡), Syphilitic skin disease(樣梅瘡), Incised wound (金瘡), Dermatopathy of lower limb and heel(脚足部瘡), Pemphigus(天疱瘡), Itching eruption due to blood-heat or wind heat(血風瘡), Dermatopathy of head(頭面瘡), Scald and burn(湯火瘡), Tetanus(破傷風) , Ecthyma(염瘡), Fistula(久漏瘡), Tinea(癬瘡), Cases that mainly use external therapy are 5 kinds; Rhagades of hand and foot(手足군裂), Vulvar ulceration(婦人陰瘡), Chilblain(凍瘡), Rabies(풍狗咬), Tinea capitis(白禿瘡), Cases that mainly use a reinforcing method are 4 kinds; Internal deep-rooted carbuncle(內疽), Pruritus and dryness of skin(皮膚乾燥), Anul fistula(漏瘡), Macule Caused by disorder of internal organ(內傷發斑), Cases that mainly use eliminating first and then reinforcing are 2 kinds; Pyogenic infection and ulcerous disease of slin( 疽瘡상癰疽瘡瘍), Lung abscess(肺癰), Case that mainly uses reinforcement and elimination in combination is only Haemorroid(痔瘡). Case divided into two groups that are reinforcing method and a method to eliminate pathogenic factor is only Trauma(打撲). Case that have no treatment by medicine is only Abscess of the scrotum(囊癰). 4. In 40 kinds surgical diseases, we can know that except a few important surgical diseases, Ju Dan Gye haven't distinguished viewpoint in many surgical diseases, because there are many cases that have no theory and have only simple treatment of medicine, and that mainly use a method to eliminate pathogenic factors and external therapy. 5. Representative theory of Ju Dan Gye, nourishing Yin and extinguishing fire(滋陰降火), has little effect on therapy of surgical disease. We need to try statistical division of internal and external remedy in the future, and by studing of surgical disase in medical books related with four eminent physicians in the Jin and Yuan dynasties, I think we can see their viewpoint of surgical disease.

• 대한방사선치료학회지
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• 제10권1호
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• pp.60-68
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• 1998

Treatment of a large diseased area with electron often requires the use of two or more adjoining fields. In such cases, not only electron beam divergence and lateral scattering but also fields overlapping and separation may lead to significant dose inhomogeneities(${\pm}20\%$) at the field junction area. In this study, we made Acrylic Electron Wedges to improve dose homogeneities(${\pm}5\%$) in these junction areas and considered application it to clinical practices. All measurements were made using 6, 9, 12, 16, 20MeV Electron beams from a linear accelerator for a $10{\times}10cm$ field at 100cm SSD. Adding a 1 mm sheet of acryl gradually from 1 mm to 15 mm, We acquired central axis depth dose beam profile and isodose curves in water phantom. As a result, for all energies, the practical range was reduced by approximately the same distance as the thickness of the acryl insert, e.g. a 1 mm thick acryl insert reduce the practical range by approximately 1 mm. For every mm thickness of acryl inserted, the beam energy was reduced by approximately 0.2MeV. These effects were almost independent of beam energy and field size. The use of Acrylic Electron Wedges produced a small increase $(less\;than\;3\%)\;in\;the\;surface\;dose\;and\;a\;small\;Increase(less\;than\;1\%)$ in X-ray contamination. For acryl inserts, thickness of 3 mm or greater, the penumbra width increased nearly linear for all energies and isodose curves near the beam edge were nearly parallel with the incident beam direction, and penumbra width was $35\;mm{\sim}40\;mm$. We decide heel thickness and angle of the wedge at this point. These data provide the information necessary to design Acrylic Electron Wedge which can be use to improve dose uniformity at electron field junctions and it will be effectively applicated in clinical practices.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.421-426
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• 2011

Purpose: Although the sural nerve is the most commonly used donor for autologous nerve graft, its morbidity after harvesting is sparsely investigated. The sural nerve being a sensory nerve, complications such as sensory changes in its area and neuroma can be expected. This study was designed to evaluate the donor site morbidity after sural nerve harvesting. Methods: Among the 13 cases, who underwent sural nerve harvesting between January 2004 and August 2009, 11 patients with proper follow up were included in the study. The collected data included harvested graft length, actual length of the grafted nerve, anesthetic and paresthetic area, presence of Tinel sign and symptomatic neuroma, and scar quality. Results: In 7 patients, no anesthetic area could be detected. Of the patients with a follow up period of more than 2 years, all the patients showed no anesthetic area except two cases who had a very small area of sensory deficit ($225mm^2$) on the lateral heel area, and large deficit ($4,500mm^2$) on the lateral foot aspect. The patients with a short follow up period (1~2 m) demonstrated a large anesthetic skin area ($6.760mm^2$, $12,500mm^2$). Only one patient had a Tinel sign. This patient also showed a subcutaneous neuroma, which was visible, but did not complain of discomfort during daily activities. One patient had a hypertrophic scar in the retromalleolar area, whereas the two other scars on the calf were invisible. Conclusion: After a period of 2 years the size of anesthetic skin in the lateral retromalleolar area is nearly zero. It is hypothesized that the size of sensory skin deficit may be large immediately after the operation. This area decreases over time so that after 2 years the patient does not feel any discomfort from nerve harvesting.