• 대한족부족관절학회지
• /
• 제27권2호
• /
• pp.75-78
• /
• 2023

During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixation when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2004년도 추계학술대회 논문집
• /
• pp.865-870
• /
• 2004

This paper describes the generation of chordal surface for various shell structures, such as automobile bodies, plastic injection mold components and shell metal parts. After one-layered tetrahedral mesh is generated by an advancing front algorithm, the chordal surface is generated by cutting a tetrahedral element. It is generated one or two elements at a tetrahedral element and the chordal surface is composed with triangular or quadrilateral elements. This algorithm has been tested on several models with rib structure.

• 한국전문물리치료학회지
• /
• 제18권2호
• /
• pp.60-66
• /
• 2011

Foot posture is important in the development of the musculoskeletal structure in the lower limbs because it can change the mechanical alignment. Although foot orthotics are widely used for the correction of malalignments in the lower extremities, the biomechanical effects of wedges have not yet been cleared. The aim of this study was to investigate whether medial wedges affect the electromyographic (EMG) activity of the knee and hip joints in healthy adults that are performing one leg standing. Seventeen healthy volunteers performed the one leg standing under two foot conditions: A level surface, and a $15^{\circ}$ medial wedge. The subjects' EMG data for the gluteus maximus (Gmax), gluteus medius (Gmed), tensor fasciae latae (TFL), biceps femoris (BF), vastus lateralis (VL), and vastus medialis oblique (VMO) were recorded, along with the surface EMG, and all were analyzed. The EMG activity of the Gmed and TFL had significantly decreased under the medial wedge condition during one leg standing. Further study is needed in order to investigate whether medial wedges influence the EMG activity and kinematic data of the knee and hip joints as well as the ankle joints in adults with flexible flatfoot, while they are performing one leg standing.

• 대한관절경학회지
• /
• 제10권2호
• /
• pp.214-218
• /
• 2006

목적: 급성 또는 재발성 슬개골 탈구의 치료에 있어서 내측 슬개-대퇴 인대의 해부학적 위치를 고려하여 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술을 새롭게 고안하였기에 소개하고자 한다. 수술 술기: 관절경하에서 내측 슬개-대퇴 인대가 위치하는 부위의 내측 관절막에 봉합사를 관절 밖에서 안으로 통과시킨다. 슬개골에 유도강선으로 3개의 터널을 뚫는데, 그 관절내 입구가 슬개골의 내측 변연 상부 1/2에 위치하도록 한다. 관절 내로 들어와 있는 봉합사를 슬개골의 터널을 통해 관절 밖으로 빼내고, 봉합사에 긴장을 준 상태에서 적절한 정도로 외측 지대 유리술을 시행한 후 봉합사를 결찰한다. 결론: 본 술기는 최근 중요시되고 있는 내측 슬개-대퇴 인대를 봉합함으로써 내측 관절막 중첩술의 효과를 극대화시키고 슬개골의 아탈구 및 경사를 교정할 수 있으며, 최소 침습적이고 비교적 쉽고 간단하여 급성 또는 재발성 슬개골 탈구의 치료에 있어서 효과적인 술식으로 생각된다.

• 대한관절경학회지
• /
• 제5권1호
• /
• pp.45-48
• /
• 2001

내측 반월상연골의 전각부는 경골의 전면에 부착되어 있으며 횡인대에 의하여 외측 반월상연골 전각부와 연결되어 있다. 후각부는 후방 십자 인대 경골부착부 바로 전방에 견고하게 부착되어 있다. 관절경 검사상 반월상연골의 후각부가 경골의 정상적인 부위에 부착되어 종지되지 않고 전각부 하방까지 부착부위가 연장되는 반월상연골이 관찰되어 저자들은 이와같은 비정상적인 내측 반월상연골 1례 를 문헌고찰과 함께 보고하는 바이다.

• 국제물리치료학회지
• /
• 제10권2호
• /
• pp.1756-1762
• /
• 2019

Background: Functional ankle instability (FAI) indicating a decrease in muscle strength, proprioception, neuromuscular control, balance and postural control function. Objective: To investigate the effect of jumping exercise on the supporting surface on the ankle muscle thickness, proprioceptive sensation, and balance in adults with FAI. Design: Randomized Controlled Trial. Methods: Twenty young people with FAI were randomly assigned to the unstable supporting surface jump group (N=10) and the stable supporting surface jump group (N=10). The intervention was conducted three times a week for eight weeks, and for 30 minutes per session. Trampoline was used as an unstable support surface and the stable support surface was carried out on a regular floor. The thickness of the tibialis anterior muscle and medial gastrocnemius muscle was measured by ultrasonography, and the proprioception of dorsiflexion and plantarflexion was measured using an electrogoniometer. The dynamic balance was also measured with a balance meter. Results: The the muscle thickness of the medial gastrocnemius muscle was significantly higher in the stable supporting surface jump group than in the unstable supporting surface jump group (p<.05). Furthermore, the plantar flexion proprioception and dynamic balance were significantly improved in the unstable supporting surface jump group than in the stable supporting surface jump group in the intergroup comparison (p<.05). Conclusions: The conclusion has been reached in this study that the jumping exercise on the unstable supporting surface could be a more effective in improving FAI than the regular surface.

• Applied Microscopy
• /
• 제16권2호
• /
• pp.61-74
• /
• 1986

The anatomy of the renal papilla and pelvis of the bat(Pipistrellus abramus abramus Temminck) and their ultrastructure of the epithelium has been studied by means of light, scanning and transmission electron microscopy. The bats were captured at Ondal cave located in Yangchun-Myun, Tanyang-Kun, Chungchongpuk-Do, Korea in the active(July) and hibernating(January) phases. A conical renal papilla with several papillary foramina at the apex was curved toward the ureter. At the margin of the funnel-shaped renal pelvis, the fornix extended deeply into the kidney parenchyme was formed between the outer zone of the medulla and the cortex. The epithelium of the papilla covered the inner zone of the medulla. The epithelium of the fornix medially overlayed the outer zone of the medulla, and laterally the cortex. The surface epithelium of the papilla was simple columnar in shape with the scanty organelles and the short microvilli on their luminal surface. The fornix was Jined with $1{\sim}2$ cell layered squamous epithelium. On the medial surface of the fornix, two types of the superficial epithelial cells were identified; one had numerous short microvilli and the other had the microplicae and plaques on their luminal surface. The lateral surface of the fornix lined with the epithelial cells showed microridges and plaques on the luminal surface. The epithelial cells on the medial and lateral surfaces of the fornix were similar to their internal ultrastructures. The pelvic epithelium was a typical transitional type, which was composed of a layer of basal cells, one or two layers of intermediate cells, and a layer of superficial(facet) cells. The fusiform vesicles were observed in the cytoplasm of the intermediate and facet cells. There were no noticeable morphological changes in the epithelium of the papilla, fornix and pelvis except the medial epithelium of the fornix in the hibernating cycle. The microvillar cells were more numerous in the hibernating phase than in the active phase. The morphology, of the renal papilla and fornix of bats, indicates that a functional relationship may exist between the pelvic urine and the renal parenchyme.

• Macromolecular Research
• /
• 제16권5호
• /
• pp.473-480
• /
• 2008

In this study we investigated bacterial and cell adhesion to poly(propylene carbonate) (PPC) films, that had been synthesized by the copolymerization of carbon dioxide (a global warming chemical) with propylene oxide. We also assessed the biocompatibility and biodegradability of the films in vivo, and their oxidative degradation in vitro. The bacteria adhered to the smooth, hydrophobic PPC surface after 4 h incubation. Pseudomonas aeruginosa and Enterococcus faecalis had the highest levels of adhesion, Escherichia coli and Staphylococcus aureus had the lowest levels, and Staphylococcus epidermidis was intermediate. In contrast, there was no adhesion of human cells (cell line HEp-2) to the PPC films, due to the hydrophobicity and dimensional instability of the surface. On the other hand, the PPC films exhibited good biocompatibility in the mouse subcutaneous environment. Moreover, contrary to expectation the PPC films degraded in the mouse subcutaneous environment. This is the first experimental confirmation that PPC can undergo surface erosion biodegradation in vivo. The observed biodegradability of PPC may have resulted from enzymatic hydrolysis and oxidative degradation processes. In contrast, the PPC films showed resistance to oxidative degradation in vitro. Overall, PPC revealed high affinity to bioorganisms and also good bio-degradability.

• Archives of Reconstructive Microsurgery
• /
• 제11권2호
• /
• pp.153-161
• /
• 2002

Purpose : Plantar surfaces, calcaneal area, and region of Achilles insertion, which are extremely related with weight-bearing area and shoes application, must be reconstructed with glabrous and strong fibrous skin. Numerous methods of reconstructing defects of these regions have been advocated, but the transfer of similar local tissue as a cutaneous flap with preservation of sensory potential would best serve the functional needs of the weight-bearing and non-weight-bearing surfaces of this region. Therefore it is recommended to use the limited skin of medial surface of foot that is similar to plantar region and non-weight-bearing area. In this paper we performed the medial plantar flap transfered as a fasciocutaneous island as one alterative for moderate-sized defects of the plantar forefoot, plantar heel, and area around the ankle in 25 cases and report the result, availability and problem of medial plantar flap. Materials and methods : We performed proximally based medial plantar flap in 22 cases and reverse flow island flap in 3 cases. Average age was $36.5(4{\sim}70)$ years and female was 3 cases. The causes of soft tissue defect were crushing injury on foot 4 cases, small bony exposure at lower leg 1 case, posterior heel defect with exposure of calcaneus 8 cases, severe sore at heel 2 cases, skin necrosis after trauma on posterior foot 4 cases, and defect on insertion area of Achilles tendon 6cases. Average follow up duration was 1.8(7 months-9.5 years) years. Results: Medial plantar flaps was successful in 22 patients. 18 patients preserved cutaneous branches of medial plantar nerve had sensation on transfered flap but diminished sensation or dysesthesia. At the follow up, we found there were no skin ulceration, recurrence of defect or skin breakdown in all 18 patients. But there was one case which occurred skin ulceration postoperatively among another 4 cases not contained medial plantar nerve. At the last follow up, all patients complained diminished sensation and paresthesia at medial plantar area distally to donor site, expecially with 4 patients having severe pain and discomfort during long-time walking. Conclusion : Medial plantar island flap based on medial plantar neurovascualr pedicle have low failure rate with strong fibrous skin and preserve sensibility of flap, so that it is useful method to reconstruct the skin and soft tissue defect of foot. But it should be emphasized that there are some complications such like pain and paresthesia by neuropraxia or injury of medial plantar nerve at more distal area than donor site. We may consider that medial plantar flap have limited flap size and small arc of rotation, and require skin graft closure of the donor defect and must chose this flap deliberately.

• Archives of Plastic Surgery
• /
• 제37권2호
• /
• pp.137-142
• /
• 2010

Purpose: Tumor ablation and traumatic intractable ulceration of the plantar surface of the foot results in skin and soft tissue defects of the weight-bearing sole. Simple skin grafting is not sufficient for reconstruction of the weight-bearing areas. Instead, the island medial plantar flap (instep flap) and distally-based island medial plantar flap was used for proper reconstruction of the weight bearing area. However, there are some disadvantages. In particular, an island medial plantar flap has a short pedicle limiting the mobility of the flap and the distally-based island medial plantar flap is based on a very small vessel. We investigated whether good results could be obtained using a reverse island medial plantar flap based on the lateral plantar vessel as a solution to the above limitations. Methods: Three patients with malignant melanoma were cared for in our tertiary hospital. The tumors involved the lateral forefoot, the postero-lateral heel, and the medial forefoot area. We designed and harvested the flap from the medial plantar area, dissected the lateral and medial plantar artery and vena comitans, and clamped and cut the vessel 1 cm proximal to the branch from the posterior tibial artery and vena comitans. The medial plantar nerve fascicles of these flaps anastomosed to the sural nerve, the 5th interdigital nerve, and the 1st interdigital nerve of each lesion. The donor sites were covered with skin grafting. Results: The mean age of the 3 subjects was 64.7 years (range, 57 - 70 years). Histologically, all cases were lentiginous malignant melanomas. The average size of the lesion was $5.3\;cm^2$. The average size of the flap was $33.1\;cm^2$. The flap color and circulation were intact during the early postoperative period. There was no evidence of flap necrosis, hematomas or infection. All patients had a normal gait after the surgery. Sensory return progressively improved. Conclusion: Use of an island medial plantar flap based on the lateral plantar vessel to the variable weight-bearing sole is a simple but useful procedure for the reconstruction of any difficult lesion of the weight-bearing sole.