• 대한관절경학회지
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• 제12권1호
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• pp.32-39
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• 2008

목적: 10시 방향 대퇴 터널의 전방십자인대 재건술 후 MRI 검사의 유용성을 알아보고자 하였다. 대상 및 방법: 자가 슬괵건을 이용한 전방 십자 인대 재건술 후 MRI 검사를 시행 받았던 29명의 소견을 분석하였다. 평균 술 후 MRI 검사까지의 기간은 18.9개월($7{\sim}40$개월)이었다. 이식건의 신호강도, 형태, 연속성, 대퇴터널 시작점, 대퇴터널 위치, 과간 절흔 충돌, 교차 핀 손상 및 위치에 대해 조사하였으며 KT-2000 검사, Lysholm 점수, 축회전 검사 등과 비교하였다. 결과: 이식건의 신호강도와 술후 MRI 검사까지의 기간은 유의한 상관관계가 없었다. 이식건의 형태와 연속성은 straight, well-preserved 가 대부분이었다. 대퇴 터널의 시작점은 zone 4가 13례, zone 3가 16례였으며 과간 절흔 충돌은 관찰되지 않았다. 교차 핀의 손상은 10례였고 이중 대퇴 후방 피질골 밖으로 빠진 경우가 5례였고, 방향이 후방을 향하는 경우가 9례였다. 교차 핀의 손상 여부와 임상 결과와의 상관 관계는 통계적으로 유의하지 않았다. 결론: 전방 십자 인대 재건술 후 MRI 검사는 이식건의 상태와 위치, 교차 핀의 위치 등을 파악하는데 유용하였다. 10시 방향 대퇴터널의 전방십자인대 재건술에서는 특이 교차 핀의 위치가 중요하므로 수술 시 교차 핀의 손상을 피하기 위한 세심한 주의를 요한다.

• 대한족부족관절학회지
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• 제12권2호
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• pp.197-202
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• 2008

Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.84-92
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• 2016

Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at $60^{\circ}$ abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni's post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.

• 대한족부족관절학회지
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• 제17권2호
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• pp.100-105
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• 2013

Purpose: To present radiographic characteristics and report the clinical results of the operative treatment of M$\ddot{u}$ller-Weiss disease. Materials and Methods: This is a retrospective study including 13 patients, 14 feet who had been operated for M$\ddot{u}$ller-Weiss disease between April 2006 and December 2011. Osteoarthritis of the peri-navicular joints were radiographically evaluated. Various range of peri-navicular fusion and joint-preserving surgeries according to patients' symptoms and radiographic findings were done. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). Results: On radiographs, osteoarthritic changes were presented at talonavicular joint in 11 cases, calcaneocuboid joint in 7 cases, subtalar joint in 6 cases, naviculo-cuneiform joint in 1 case. The mean anteroposterior talocalcaneal angle was 16.6 degrees. On hindfoot alignment view, 6 cases were varus, 5 cases were neutral and 3 cases were valgus alignment. Fusion comprised 6 cases in triple fusion, 1 case in talonavicular-cuneiform fusion, 2 cases in talonavicualr fusion and 1 case in talonavicular & calcaneocuboid fusion. Joint-preserving surgeries were bony fragment excision of the lateral part of navicular & medial displacement calcaneal osteotomy in 1 case, bony spur excision of talonavicular joint in 1 case and medial displacement calcaneal osteotomy in 2 cases. The postoperative AOFAS and VAS score were improved significantly (p=0.000, p=0.000). Conclusion: In cases of M$\ddot{u}$ller-Weiss disease without osteoarthritic changes at peri-navicular joints, fragment excision of navicular, bony spur excision with or without medial displacement calcaneal osteotomy were effective operative treatments.

• 대한기계학회논문집B
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• 제25권12호
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• pp.1702-1710
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• 2001

Supersonic coaxial jets are investigated numerically by using the axisymmetric, Wavier-Stokes equations which are solved using a fully implicit finite volume method. Three different kinds of coaxial nozzles are employed to understand the flow physics involved in the supersonic coaxial jets. Two convergent-divergent supersonic nozzles are designed to have the same Mach number 2.0, and used to compare the coaxial jet flows with those discharging from one constant-area nozzle. The impingement angle of the annular jets are varied. The primary pressure ratio is changed in the range from 2.0 to 10.0 and the assistant jet ratio from 1.0 to 3.0. The results obtained show that the fluctuations of the total pressure and Mach number along the jet axis are much higher in the constant-area nozzle than those in the convergent-divergent nozzles, and the constant-area nozzle lead to higher total pressure losses, compared with the convergent-divergent nozzles. The assistant jets from the annular nozzle affect the coaxial jet flows within the distance less than about ten times the nozzle throat diameter, but beyond it the coaxial jet is conical with self-similar velocity profiles. Increasing both the primary jet pressure ratio and the assistant jet pressure ratio produces a longer coaxial jet core.

• 한국항공우주학회지
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• 제34권8호
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• pp.95-103
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• 2006

알루미늄 분말이 약 20% 포함된 2종류의 고체 추진제에 대해 원료성분, 연소실에서의 연소가스 물성치 및 산화알루미늄의 입자 크기를 비교 분석하였다. 산화제(AP/HNIW) 분말이 200과 5 ${\mu}m$로 이분양상이고 47% 부피분율을 지닌 알루미늄을 함유한 PCP계 추진제는 산화제(AP) 분말이 400, 200 및 6 ${\mu}m$로 삼분양상이고 64% 부피분율을 지닌 알루미늄을 함유한 HTPB계 추진제 보다 알루미늄들이 응집될 가능성이 크다는 것을 축소부 내열재에서 채취한 산화알루미늄 입자의 SEM 사진을 통해 확인할 수 있었다. PCP계 추진제를 적용한 고체 추진기관의 노즐 축소부 내열재에서는 큰 산화알루미늄 입자의 충돌로 인해 그레인 슬랏과 일치하는 4개 원주방향 부위에서 삭마가 크게 되었지만 HTPB계 추진제를 적용한 경우에는 원주방향으로 균일하게 삭마되었다.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.95-104
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• 2016

Purpose: To evaluate the knee joint after double-bundle anterior cruciate ligament (ACL) reconstruction with three-dimensional (3D) isotropic magnetic resonance (MR) image, and to directly compare the ACL graft findings on 3D MR with the clinical results. Materials and Methods: From January 2009 to December 2014, we retrospectively reviewed MRIs of 39 patients who had reconstructed ACL with double bundle technique. The subjects were examined using 3D isotropic proton-density sequence and routine two-dimensional (2D) sequence on 3.0T scanner. The MR images were qualitatively evaluated for the intraarticular curvature, graft tear, bony impingement, intraosseous tunnel cyst, and synovitis of anteromedial and posterolateral bundles (AMB, PLB). In addition anterior tibial translation, PCL angle, PCL ratio were quantitatively measured. KT arthrometric values were reviewed for anterior tibial translation as positive or negative. The second look arthroscopy results including tear and laxity were reviewed. Results: Significant correlations were found between an AMB tear on 3D-isotropic proton density MR images and arthroscopic proven AMB tear or laxity (P < 0.05). Also, a significant correlation was observed between increased PCL ratio on 3D isotropic MRI and the arthroscopic findings such as tear, laxities of grafts (P < 0.05). KT arthrometric results were found to be significantly correlated with AMB tears (P < 0.05) and tibial tunnel cysts (P < 0.05). Conclusion: An AMB tear on 3D-isotropic MRI was correlated with arthroscopic results qualitatively and quantitatively. 3D isotropic MRI findings can aid the evaluation of ACL grafts after double bundle reconstruction.

• 대한의용생체공학회:의공학회지
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• 제43권4호
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.202-208
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• 2010

목적: 상완골 근위부 골절에 대하여 최소 침습적 금속판 술식을 시행하고, 임상 결과를 분석하여 유용성을 알아보고자 하였다. 대상 및 방법: 상완골 근위부 골절에 대하여 최소 침습적 금속판 술식을 시행한 27명을 대상으로 하였다. 골절 분류는 2분 골절 16예, 3분 골절 10예였으며, 4분 골절 1예가 포함되었다. 임상적 평가는 UCLA 점수와 KSS 점수 및 운동 범위 회복 정도와 합병증 발생 여부를 조사하였으며, 방사선학적으로는 골유합 기간과 경간각 회복 정도를 평가하였다. 평균 추시 기간은 19개월이었다. 결과: 최종 추시에서 UCLA 점수는 우수가 15예, 양호가 12예였으며 KSS 점수는 평균 91.4점이었다. 또한 최종 견관절 운동 범위는 전방 거상이 평균 $167.2^{\circ}$로 측정되었다. 모든 환자에서 수술 후 평균 14.1주에 골유합을 얻었으며, 경간각 회복 정도는 우수가 24예였으며 보통이 3예였다. 액와 신경 마비나 심부 감염, 금속판의 충돌 증후군 등의 합병증은 발생하지 않았다. 결론: 상완골 근위부 골절에 대한 최소 침습적 금속판 술식은 충분한 해부학적 지식을 숙지하고 시행하면 주변 연부 조직 박리를 최소화하여 합병증 발생을 감소시키고 조기 관절 운동을 가능하게 하므로 상완골 근위부 골절 치료의 효과적인 수술 방법의 하나로 사료된다.

• 대한정형외과학회지
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• 제56권1호
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• pp.68-75
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• 2021

목적: 견관절의 운동 기능에 대한 평가는 견관절 질환의 진단 및 경과를 파악하는 데 있어 중요하다. 본 연구는 정상군 및 견관절질환을 가진 환자군에 대해 깊이 센서 기반 동작 분석 시스템을 통한 관절 운동을 동적으로 분석하여 문헌 고찰과 함께 보고하는 바이다. 대상 및 방법: 70명의 피험자가 연구에 참여하였으며 정상군 30명과 견관절 질환을 가진 환자 40명으로 분류하였다. 견관절 질환을 가진 환자 40명은 4가지 질환(회전근개 파열, 유착성 활액막염, 충돌 증후군, 회전근개 관절병증)으로 세분화하였다. 총 3회 반복된 외전 및 내전 운동 시 시간에 따른 각도를 깊이 센서 기반 동작 분석 시스템으로 측정하였으며, 최대 외전 각도, 최대 외전 각 속도, 최대 내전 각속도, 외전/내전 시간 비를 계산하였다. 상기 매개 변수들에 대해 정상군 30명과 환자군 40명을 비교하는 한편, 정상군 30명과 4가지 질환군별 10명, 총 5개 군을 비교하였다. 결과: 견관절 질환을 가진 환자군에서는 정상군에 비해 감소된 최대 외전 각도(θ_max), 최대 외전 각속도(ω_max), 최대 내전 각속도(ω_min)를 보였으며, 증가된 외전/내전 시간 비(t_abd/t_add)를 보였다. 세분화된 질환군별 비교에서는 최대 외전 각도(θ_max)와 최대 외전각속도(ω_max)가 정상군에 비해 유착성 활액막염 환자군 및 회전근개 관절병증 환자군에서 감소되었고, 외전/내전 시간 비(t_abd/t_add)가 정상군에 비해 유착성 활액막염 환자군, 회전근개 파열 환자군 및 회전근개 관절병증 환자군에서 증가되었다. 결론: 깊이 센서 기반 동작 분석 시스템을 사용한 견관절의 운동 분석을 통해 관절 운동 범위뿐 아니라 각속도 등의 동적 운동 변수를 측정할 수 있었으며, 이를 통해 견관절의 더 정확한 기능 평가 및 심도 있는 질환의 이해가 가능할 것이다.