• Archives of Plastic Surgery
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• 제41권6호
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• pp.709-715
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• 2014

Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.27-32
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• 2017

Background: The purpose of this study was to compare the effects of IASTM and static stretching techniques on ankle joint range of motion (ROM), static foot pressure. Methods: Twenty four subjects with gastrocnemius shortness participated in this study. The subjects were assigned randomly to one of two groups: The soft tissue mobilization technique (IASTM) group received intervention using a IASTM instrument for two minutes, and the stactic stretching group performed self stretching for 30 seconds, four times. The ROM of the ankle joint was measured by active ankle dorsi-flexion test, and a TPScan was utilized to collect the plantar foot pressure. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}=.05$. Results: The results were as follows: 1) The ROM of the ankle joint and was significantly increased in both groups. 2) Plantar foot pressure was no significant in both groups. 3) There were no significant differences between the IASTM group and static stretching group for any variable. Conclusions: The results of this study suggest that static stretching is an effective and easy technique for restoring proper muscle length in subjects with gastrocnemius shortness. We recommend that static stretching technique be used for treat gastrocnemius shortness in clinical setting and home program.

• 한방재활의학과학회지
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• 제34권1호
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• pp.23-38
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• 2024

Objectives This study examined recent domestic and international clinical research trends in Gua sha therapy to suggest future direction for research. Methods We used six domestic and international databases (Research Information Sharing Service, Korean studies Information Service System, Oriental Medicine Advanced Searching Integrated System, PubMed, Embase, Cochrane Library) to select clinical studies with an original text in English or Korean published after 2018. Results Finally, 55 studies were selected. Randomized controlled trials accounted for the largest amount with 42 studies. Instrument assisted soft tissue mobilization was the most frequent term referring to Gua sha. Muscle shortening, limited range of motion, and plantar fasciitis were the most common symptoms, with six cases each. Additionally, there were two studies targeting symptoms other than the musculoskeletal system. Conclusions Additional research is needed on the effects of Gua sha therapy on the back of the lower extremities and hip joints, and research is needed on the possibility of their clinical use for diseases or symptoms other than those of the musculoskeletal system. And standards for the terminology of Gua sha and the types and methods of applied interventions are needed.

• 한국전산구조공학회논문집
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• 제32권6호
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• pp.425-434
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• 2019

연약지반이 두껍고 다양한 지층으로 구성된 지역에 건설되는 단일형 현장타설말뚝 교량은 다양한 지층을 통해서 단일형 말뚝으로 입력되는 지반운동에 대해서 내진안전성을 확보하는 것이 중요하다. 본 연구에서는 설계지반운동에 부합되는 다수의 인공합성지진을 생성하여 이를 암반의 입력지반으로 하여 지반해석을 수행하여 각 지층에서의 지반가속도이력을 산정하였다. 이 가속도이력을 이용하여 각 지층의 지반을 등가스프링으로 모델화하고, 각 지층에서의 가속도시간이력을 입력지반운동으로 하는 다지점 가진 지진해석을 수행하였다. 연약층의 비선형거동특성으로 입력지반운동의 세기는 크게 증폭되지 않아서 교량은 탄성영역 내에서 거동하였다. 한편, 특정 지층에서 산정된 가속도이력을 모든 지반스프링에 동시에 입력하면 응답이 감소하였다. 따라서, 다지점가진 해석을 수행하지 않으면 이러한 형식의 교량의 내진성능을 과대평가할 수 있다.

• Structural Engineering and Mechanics
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• 제85권3호
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• pp.381-391
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• 2023

The seismic performance of the tall building equipped with a tuned mass damper (TMD) considering soil-structure interaction (SSI) effects is well studied in the literature. However, these studies are performed on the nominal model of the seismic-excited structural system with SSI. Hence, the outcomes of the studies may not valid for the actual structural system. To address the study gap, the reliability theory as a useful and powerful method is utilized in the paper. The present study aims to carry out reliability analyses on tall buildings equipped with TMD under near-field pulse-like (NFPL) ground motions considering SSI effects using a subset simulation (SS) method. In the presence of uncertainties of the structural model, TMD device, foundation, soil, and near-field pulse-like ground motions, the numerical studies are performed on a benchmark 40-story building and the failure probabilities of the structures with and without TMD are evaluated. Three types of soils (dense, medium, and soft soils), different earthquake magnitudes (M_w = 7,0. 7,25. 7,5 ), different nearest fault distances (r = 5. 10 and 15 km), and three seismic performance levels of immediate occupancy (IO), life safety (LS), and collapse prevention (CP) are considered in this study. The results show that tall buildings built near faults and on soft soils are more affected by uncertainties of the structural and ground motion models. Hence, ignoring these uncertainties may result in an inaccurate estimation of the maximum seismic responses. Also, it is found the TMD is not able to reduce the failure probabilities of the structure in the IO seismic performance level, especially for high earthquake magnitudes and structures built near the fault. However, TMD is significantly effective in the reduction of failure probability for the LS and CP performance levels. For weak earthquakes and long fault distances, the failure probabilities of both structures with and without TMD are near zero, and the efficiency of the TMD in the reduction of failure probabilities is reduced by increasing earthquake magnitudes and the reduction of fault distance. As soil softness increases, the failure probability of structures both with and without TMD often increases, especially for severe near-fault earthquake motion.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.11-18
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• 2002

Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

• Computers and Concrete
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• 제9권3호
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• pp.195-213
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• 2012

This paper presents the investigation of the stochastic responses of seismically isolated bridges subjected to spatially varying earthquake ground motions including incoherence, wave-passage and site-response effects. The incoherence effect is examined by considering Harichandran and Vanmarcke coherency model. The effect of the wave-passage is dealt with various wave velocities in the response analysis. Homogeneous firm, medium and soft soil conditions are selected for considering the site-response effect where the bridge supports are constructed. The ground motion is described by filtered white noise and applied to each support points. For seismic isolation of the bridge, single and double concave friction pendulum bearings are used. Due to presence of friction on the concave surfaces of the isolation systems, the equation of motion of is non-linear. The non-linear equation of motion is solved by using equivalent linearization technique of non-linear stochastic analyses. Solutions obtained from the stochastic analyses of non-isolated and isolated bridges to spatially varying earthquake ground motions compared with each other for the special cases of the ground motion model. It is concluded that friction pendulum systems having single and double concave surfaces have important effects on the stochastic responses of bridges to spatially varying earthquake ground motions.

• 정보처리학회논문지B
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• 제14B권2호
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• pp.107-118
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• 2007

본 논문에서는 실제 수화자의 관점에서 기존 수화 아바타의 한계와 문제점을 지적한다. 이를 해결하기 위하여 손 모양, 손 방향, 손 운동을 비롯하여 입술 움직임, 얼굴 표정, 안색, 운동자 움직임, 몸동작 등을 통해 수화를 보다 자연스럽게 표현할 수 있는 수화 아바타를 개발하였다. 또한, 데이터베이스의 성능을 높이기 위해 손의 움직임과 함께 다른 신체 요소들의 움직임을 구조적으로 같이 기술할 수 있는 하이퍼 수화 문장을 제안한다. 개발된 시스템의 우수성을 보이기 위해 실제 청각 장애인을 대상으로 설문조사를 수행하여 시스템의 사용성을 평가하였다.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.159-164
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• 2012

Purpose: Soft tissue defect on posterior side of heel exposing Achilles tendon is vulnerable and require thin flap to improve aesthetic and functional results. Reverse superficial sural artery flap is simple and fast procedure, and it can preserves major arteries, supplies reliable constant blood, causes less donor site complication. Authors reviewed our cases and report the clinical results. Materials and Methods: Nine cases of soft tissue defects on the posterior side of heel exposing Achilles tendon were treated with distally based superficial sural artery flap. There were 6 male and 3 female and mean age was 48.4 years. The size of flap was from $4{\times}4cm$ to $10{\times}15cm$ and mean follow-up period was 23 months. Flap survival, postoperative complications were evaluated. Results: All flaps were survived completely without necrosis. There was one case of partial wound dehiscence that needed debridement and repair, and other one case had recurrent discharge that was healed after removal of calcaneal plate. All patient showed acceptable range of ankle motion. Conclusion: Authors suggest that the reverse superficial sural artery flap could be one of the useful treatment options for the soft tissue defect on posterior side of heel exposing Achilles tendon.

• 대한기계학회논문집B
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• 제35권11호
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• pp.1199-1204
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• 2011

본 연구에서는 원격촉진 시스템을 위한 양방향 원격조작 제어 전략개발의 일환으로, 작업환경의 실시간 파라미터 추정기법을 제안한다. 명시적 환경모델과 파라미터 추정은 원격제어에 있어 투명성의 개선과 작업환경의 경도정보를 제공할 수 있다. 본 연구는 기존의 환경모델이 갖는 문제점들을 개선하고 빠르고 안정된 알고리즘을 개발하기 위해, 연속체 역학 기반의 유한요소 모델과 확장 칼만필터를 이용한 추정 알고리즘을 포함하는 원격제어 기법을 제안한다. 이를 통해 사용자는 실시간으로 구현되는 환경 모델과 상호작용하며, 조작성의 향상 과 진단 및 분석을 위한 재료의 고유한 물성정보를 획득할 수 있다.