• 한국운동역학회지
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• 제18권2호
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• pp.75-83
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• 2008

본 연구의 목적은 보행 속도의 차이에 따른 최대 관절 모멘트와 최대 모멘트 발생 시점의 관절 각도 상관관계를 규명하는데 있다. 8명의 $20{\sim}30$대 남성을 대상으로 보행 속도의 3가지 단계(1.5m/s, 1.8m/s, 2.1m/s)를 나누어 속도에 따른 보행을 실시하여 얻어진 결론은 다음과 같다. 1. 보행 속도가 증가함에 따라 무릎 최대 신전 모멘트는 증가하였고, 굴곡, 외전 모멘트는 큰 영향을 받지 않았다. 2. 최대 신전 모멘트가 발생하는 시점의 무릎 관절 각도는 굴곡의 움직임이 커졌으나, 다른 무릎 관절 각도에는 변화가 없었다. 3. 힙 최대 신전, 굴곡, 외전 모멘트는 증가하였다. 4. 최대 굴곡과 신전 모멘트가 발생하는 시점의 힙 관절 각도의 신전과 굴곡의 증가 현상을 보였으나, 최대 외전 모멘트가 발생하는 시점의 무릎 관절 각도에는 변화가 없었다. 5. 무릎 최대 신전, 굴곡, 외전 모멘트와 무릎 관절 각도를 least square method를 이용하여 적합도 검사를 실시한 결과 R2값이 높게 나타나 상관관계의 설명력이 높았다. 이렇게 근사된 곡선의 근사식은 보행 속도에 따른 무릎 관절의 평가 자료로 이용될 것으로 기대된다.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.16-25
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• 2006

The aim of this study was to investigate the kinematics of young adults during descent ramp climbing at different inclinations. Twenty-three subjects descended four steps at four different inclinations (level, $-8^{\circ}$, $-16^{\circ}$, $-24^{\circ}$). The 3-D kinematics were measured by a camera-based Falcon System. The data were analyzed using one-way ANOVA and the Student-Newman-Keuls test. The kinematics of descent ramp walking could be clearly distinguished from the kinematics of level walking. On a sagittal plane, the ankle joint was more plantar flexed at initial contact with $-16^{\circ}/-24^{\circ}$ inclination, was decreased in the toe off position with all inclinations (p<.001),and was decreased at maximum plantar flexion during the swing phase (p<.001). The knee joint was more flexed at initial contact with the $-24^{\circ}$ inclination (p<.001), was more flexed in the toe off position with all inclinations (p<.001), and was more flexed at minimum flexion during stance phase and at maximum flexion during swing phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.001). The hip joint was more flexed in the toe off position with $-16^{\circ}$, $-24^{\circ}$ inclination and was deceased at maximum extension during stance phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.05). In the frontal plane, the ankle joint was more everted at maximum eversion during stance phase with $-16^{\circ}/-24^{\circ}$ inclination (p<.01) and was decreased at maximum inversion during swing phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.01). The knee joint was more increased at maximum varus during stance phase with $-16^{\circ}/-24^{\circ}$ inclination (p<.001). The hip joint was deceased at maximum adduction during stance phase with $-24^{\circ}$ inclination (p<.05). In a horizontal plane, only the knee joint was increased at maximum internal rotation during stance phase with $-24^{\circ}$ inclination (p<.05). In descent ramp walking, the different gait patterns occurred at an inclination of over $16^{\circ}$ on the descending ramp in the sagittal and frontal planes. These results suggest that there is a certain inclination angle or angular range where subjects do switch between level walking and descent ramp walking gait patterns.

• 대한골관절종양학회지
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• 제11권2호
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• pp.148-154
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• 2005

목적: 천추에 발생한 척색종에 대해 수술적 치료를 시행했던 환자들의 장기 추시 결과를 알아보고자 하였다. 대상 및 방법: 천추 척색종으로 수술을 시행받았던 4예를 대상으로 하였으며, 평균 추시 기간은 8.3년(3~11)이었다. 3예에서 후방 도달법을, 1예에서는 전후방 도달법을 통해 종양의 완전 절제를 시행하였으며, 1예에서 제 2천추 신경근 이상을, 3예에서 제 3천추 신경근 이상을 보존하였다. 술 후 배뇨, 배변 장애 유무를 포함한 하지의 운동, 감각 장애 유무를 평가하였고 수술 부위 감염 등의 합병증과 추시상 국소적인 재발 및 원거리 전이 유무를 조사하였다. 결과: 전 예에서 술 후 하지의 운동 장애는 없었으나 1예에서 우하지의 방사통이 심하였고, 1예에서 수술창의 감염이 있었다. 술 후 배뇨 기능은 2예에서 정상이었고 1예에서는 간헐적 요실금을, 1예에서는 지속적인 자가 도뇨를 시행하였다. 배변 기능은 1예에서 정상이었고, 2예에서는 변비를 보였다. 추시상 1예에서 재발 및 전이가 없었고, 1예에서 수술 부위의 재발이, 1예에서 원거리 전이 및 수술 부위의 재발이 있었다. 결론: 천추에 발생한 척색종에 대하여 수술적 절제 후 평균 8년 이상의 생존으로 만족할 만한 결과를 보였으며, 조기 발견을 통한 적극적인 수술적 치료가 상부 천추 신경근의 보존으로 기능 소실의 최소화와 함께 생존을 연장할 수 있는 방법으로 생각된다.

• 한국운동역학회지
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• 제13권3호
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• pp.327-340
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• 2003

The purpose of this study was to investigate the height of jump, angle of the ankle and knee, the angular velocity of the ankle and knee between two types of ballet shoes during a jump in the 1st position. The subjects were 5 female ballet majors of university in Busan the majors who have been dancing ballet for six years on the average. The conclusions are as follows: 1. The height of jump had no significant difference between two types of ballet shoes, and then the average of the height of jump with point shoes group ($20.24{\pm}4.62\;cm$) was a little higher than ballet shoes group ($17.50{\pm}4.05\;cm$). 2. The angle of the ankle had no significant difference for all events between two types of ballet shoes. The minimum angle of ankle joint was represented to $54.36_{\circ}$ at the E1 of the left ankle angle of the ballet shoes and the maximum value was showed $155.43_{\circ}$ at the E3 of the right ankle angle of the point shoes. 3. The angle of the knee had no significant difference for all events between two types of ballet shoes. The minimum angle of knee joint was represented to $99.54_{\circ}$ at the E1 of the left knee angle of the ballet shoes and the maximum value was showed $174.25_{\circ}$ at the E3 of the right knee angle of the point shoes. 4. The ankle velocity of the ankle had no significant difference for all events between two types of ballet shoes. The minimum angular velocity of the ankle was represented to 4.35 deg/s at the maximum height(E3) of the point shoes and the maximum value was showed 597.81 deg/s at the take-off(E2) of the right ankle angle of the point shoes. 5. The angular velocity of the knee had significant difference between two types of ballet shoes at the event 1(p<.05). The minimum angular velocity of the hee was represented to -1.68 deg/s at the maximum height(E3) of the point shoes and the maximum value was showed 360.25 deg/s at the take-off(E2) of the left knee angle of the ballet shoes. The other events had no significant difference between two types of ballet shoes.

• 대한골관절종양학회지
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• 제1권1호
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• pp.91-97
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• 1995

저자들은 1983년 1월부터 1992년 12월까지 신촌 세브란스병원 정형외과에서 활막육종 진단받고 치료를 받은 13명의 치료결과 및 생존율을 분석하여 다음과 같은 결과를 얻었다. 1. 평균 연령은 28세 2개월로 62%(8례)가 10세에서 40세 까지의 분포를 보였다. 2. 호발부위는 하지의 큰 관절 주위인 것으로 알려져 있으며 본 연구에서도 같은 결과를 보였다. 3. 13례중 46%(6례)에서 국소재발 또는 전이되었으며 원격전이는 폐가 주된 전이소였다. 4. 수술 및 보존적 치료를 시행한 활막육종 환자의 Kaplan-Meier법에 의한 5년 생존율은 68%였다. 5. 종양의 크기 5cm 미만인 경우가 5년 생존 예상율이 100%(6 of 6)로 5cm 이상의 38%(3 of 7)에 비해서 예후가 좋은 것으로 나타났다(p=0.0393). 6. 수술시 충분한 절제연을 가진 경우가 예후가 좋았다. 7. 따라서 활막육종의 치료는 종양의 크기가 5cm 미만인 조기에 발견하는 것이 가장 중요하며 수술시 충분한 절제연의 획득 및 술후 보조적 치료가 진행되어야 할 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제46권5호
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• pp.468-471
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• 2009

Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.39-45
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• 2009

목적: 중 고교 태권도 선수의 경기 중 발생한 골절 및 탈구의 발생 양상과 원인을 조사하여 그 예방법을 알아보고자 하였다. 대상 및 방법: 2005년부터 2007년 사이에 매년 열린 전국 중 고교 태권도 대회에서 발생한 골절 및 탈구 50례를 대상으로 조사하였다. 각 손상의 양상과 원인을 분석하고 32례에서 1년 후 설문조사로 추시 조사하였으며 적절한 치료와 예방을 위한 방법을 연구하였다. 결과: 족부 골절 26례(52%), 수부 골절15례(30%), 전완부 골절 9례(18%)가 발생하였다. 32례의 1년 후 설문 조사에서 치료만족이 9례(28%), 보통이 15례(47%), 불만족이 8례(25%)였으며 불만족의 원인으로 충분한 휴식 부족(7례), 과도한 훈련(5례), 무리한 경기 출전(6례) 등이 있었고, 21례(67%)에서 부상에서 완전 회복되기 전에 훈련에 복귀하였다. 결론: 중 고교 태권도 선수에서 발생하는 골절 및 탈구의 원인은 상, 하지의 타박 손상과 족부 무지가 지면에 접질리며 발생하는 고속 과굴곡 손상이었으며 이의 예방과 치료를 위해 보다 안전한 보호 장구의 개발과 경기장 시설 개선, 그리고 충분한 휴식과 교육이 필요할 것으로 사료된다.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.521-526
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• 2008

Purpose: Most burn scar contractures are curable with skin grafts, but free flaps may be needed in some cases. Due to the adjacent tissue scarring, local flap is rarely used, and thus we may consider free flap which gives us more options than local flap. However, inappropriate performance of free flap may lead to unsatisfactory results despite technical complexity and enormous amount of effort. The author will discuss the points we should consider when using free flaps in treating burn scar contractures Methods: We surveyed patients who underwent free flaps to correct burn scar contractures from 2000 to 2007. We divided patients into two groups. The first group was those in which free flaps were inevitable due to exposure of deep structures such as bones and tendons. The second group was those in which free flap was used to minimize scar contracture and to achieve aesthetic result. Results: We performed 44 free flap on 42 patients. All of the flaps were taken well except one case of partial necrosis and wound dehiscence. Forearm free flap was the most common with 21 cases. Most of the cases(28 cases) in which free flaps were inevitable were on the wrist and lower limbs. These were cases of soft tissue defect due to wide and extensive burns. Free flaps were done in 16 cases to minimize scar contracture and to obtain aesthetic outcome, recipient sites were mostly face and upper extremities. Conclusion: When using free flaps for correction of burn scar contractures, proper release and full resurfacing of the contracture should be carried out in advance. If inadequate free flap is performed, secondary correction is more challenging than in skin grafts. In order to optimize the result of reconstruction, flap thickness, size and scar of the recipient site should be considered, then we can achieve natural shape, and minimize additional correction.

• Journal of Chest Surgery
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• 제25권9호
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• pp.948-954
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• 1992

In spite of recent progress in anticancer chemotherapy, the survival of patients with metastases to the lung treated nonsurgically has been extremely poor. So we adopted more aggressive surgical approaches for the treatment of patients with pulmonary metastases since 1985. We experienced 22 operations of metastatic lung cancer in 19 patients in the department of Thoracic & Cardiovascular Surgery in Kosin Medical College since 1985, so we reviewed the results of treatment retrospectively. The results were as follows: 1. The primary organs of metastatic lung cancer were 4 cases in each of the breast, uterus, and extremities, 3 cases in the rectum, 2 cases in the kidney, 1 case in each of the pelvis and liver, and the pathological findings were 13 cases in carcinoma and 6 cases in sarcoma. 2. The treatments for primary lesions were 15 cases of the operations with anticancer chemotherapy or radiation therapy, 2 cases of choriocarcinoma with anticancer chemotherapy only, 1 cases of uterine cervical carcinoma with chemo-radiation therapy, and 1 case of pelvic synovia sarcoma with intra-arterial anticancer chemotherapy. 3. Disease free intrerval were as follows: 7 cases were in 2 years to 4 years, 4 cases were in 1 year to 2 years, and 5 cases were beyond one year, of them one case was discovered primary lesion and metastatic lung tumor concomittently. 3 cases were above 4 years, of them one case of breast cancer were above 13 years especially. 4. The sites of metastatic lung cancer was 15 lesions in the right lung, and 9 lesions in the left lung, And the lobar sites were 10 lesions in the upper lobe, 2 lesions in the middle lobe, and 12 lesions in the lower lobe. 5. The operative methods of metastatic lung cancer were 7 case of partial resection of lung, 12 cases of pulmonary lobectomy, 1 case of pneumonectomy and 1 case of dissection of mediastinal lymph node. 6. The postoperative complications were 1 case of mild respiratory insufficency, 1 cases of pyothorax, and 1 case of urethral stricture. 7. Postoperative adjuvant therapy were as follows: No adjuvant therapy were 4 cases, anti-cancer chemotherapy were 8 cases, radiation therapy was 1 case, and combined with chemo k radiation therapy were 8 cases. 8. The results of long term follow-up were as follows: The 5 patients were died at 2 months, 22 months, 24 months, 32 months, and 49 months postoperatively, so mean survival period was 32 months postoperatively excluding one patient who was died at 2 months postoperatively. And 14 patients are aliving, of them 3 patients are living in recurred state, and the other 11 patients are living without any evidence of recurrence.

• 대한간호학회지
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• 제13권2호
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• pp.44-57
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• 1983

The explosion of the aging population is changing the social environment of today's older people. Traditionally in Korea, a large percentage(over 90%) of elderly parents have lived with their married first son. But today, the number of elderly who live with their married sons has decreased(65.6%) The number of those who live in a different situation such as with their married daughter, unmarried offspring, with a spouse or alone has increased (34.4%) We can expect that the number of the elderly who have to live in institution will increase. The objective of this investigation was to determine differences in the number of health Complaints of older people according to their living situation with a view to planning more effective health care. The sample consisted of 231 persons over 65 years of age, 60 living in an Old Age Home ana 171 living in their own home in Kwangju. Data were gathered from July 9 to 26, 1983 by nursing students using a Questionnaire which was a modified form of the Cornell Medical Index. The data were categorized according to the subjects, living, sex, educational level, previous occupation, hobbies and sexual activity. The date were analyzed for statistical significant differences using F and X²tests. findings included the following: 1. There was a higher number of health complaints from persons who live in the institution than those living at home, but the difference was not significant. 2. The highest number of health Complaints were from persons who live alone, followed by those living with their daughters, and then by those living in the institution. Persons who live with their sons had the least Complaints. The difference in the number of Complaints accord-ing to with whom they were living was significant. 3. Women had signincantly more Complaints than men. Persons who were not living with their spouses had significantly more complaints than those living with their spouses.4. The higher eductional level the persons had, the less health Complaints they had. The number of Complaints accoraing to educational level was significantly different. 5. The highest number of health complaints were from persons who had involved in Commerce and industry, followed by those in Agriculture. Persons who were civil servant had the least 6. There were more complains from persons who had no hobby than those with hobbies. The complaints. The difference was significant. difference was significant. 7. Persons who said they were sexually inactive had significantly more complaints than those who said they were sexually active. As age increased, sexual activity significantly decreased. Those who lived with their spouse were significantly more sexually active. 8. The highest number of Somatic Complaints were eye fatigue, followed by nocturnal frequency, lumbago, cramps in extremities, vertigo, stiffness in Shoulder, tinnitus, common cold and constipation. The order of Psychic Complaints from higher to lower were anger. sensitivity, anxiety, depression and loneliness. 9. This group of Elderly persons said they valued Health the most, followed by Harmony, Religion, Money and Honor.