• Archives of Reconstructive Microsurgery
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• v.23 no.2
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• pp.70-75
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• 2014

Purpose: Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics. Materials and Methods: Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from $4{\times}5cm$ to $17{\times}11cm$. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery. Results: There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13. Conclusion: In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.

• Journal of the Korean Society for Railway
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• v.15 no.2
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• pp.205-215
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• 2012

The purpose of this research is to identify the factors affecting the intention to adopt a transcontinental railway in Korea. We develop an empirically testable model that demonstrates the effects of factors including cost, service, and efficiency of railway transportation, on modal shift intention to railway, attitude of a Railway, and intention to adopt a Transcontinental Railway (KTAR) as a railway transportation mode in the end. A survey method enables us to analyze the model with a structural equation modeling. The empirical analysis reveals that two most influential factors-the modal shift to railway transportation and the attitude of a Railway-play roles in determining intention to adopt the Transcontinental Railway (KTAR). Of the factors of transportation mode, transportation cost has a greater impact than transportation service and transportation efficiency on the intention to adopt a Transcontinental Railway (KTAR).

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.51-60
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• 2019

Objectives Osteoarthritis is hard to manage with both conventional and Korean medicine treatment. The core outcome set (COS) to demonstrate the effectiveness of Korean medicine treatment has not been established yet. We aimed to present preliminary data of COS by performing a literature review on the evaluation indices used in existing clinical research. Methods We examined the literature from 2000 to 2017 in two Korean electronic databases (Korea citation index and oriental medicine advanced searching integrated system) by searching for the following 3 terms 'total knee replacement (Korean)', 'total knee replacement,' and 'knee surgery.' We found 333 articles; among them, 50 duplicates were removed. Finally, we selected 160 articles after complete screening. We then extracted measured indices and clinical outcomes from the selected articles and categorized the relevant criteria. Results According to this study, the hospital for special surgery and knee society, range of movement angle, cross leg, Berg balance scale and balance ability, muscle strength, 6 minutes walking test, visual analogue scale, self-efficacy, the 12-item and 36-item short form survey and self-rated health status are the most commonly used outcomes of knee. Conclusions This study found that the several categories after total knee replacement (TKR) are being evaluated in the literature, and we were able to verify the most frequently used evaluation indices in these categories. The results of this study will be used to establish evaluation indices for the treatment of TKR in the future using Korean medicine.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.16-23
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• 2022

Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.102-106
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• 2013

■ Objectives The purpose of the this study was to investigate organization change(pennation angle) of lower extremity muscle in elderly with knee osteoarthritis through ultrasonic image. Also, we examined organizational change of muscle was by influenced after total knee replacement(TKR). ■ Methods Rectus femoris image was taken at 50% of the distance between the anterior superior iliac spine and the superior border of the patella. Vastus medialis image was taken at the most distal insertion level of vastus medialis on the medial border of the patella. measurements included the most distal insertion level of the vastus medialis on the medial border of the patella. ■ Results Change of pennation angle in rectus femoris showed decrease from 5.11° in preoperation to 4.29° in 1 week after operation. Change of pennation angle in vastus medialis showed decrease from 6.94° in preoperation to 5.76° in 1 week after operation. ■ Conclusion We consider decrease of pennation angle after total knee replacement in this study was casued by organizational change of muscle and this pennation angle was influenced force created by muscle. Therefore, we thinks that this pennation angle through ultrasonic image will be available to plane individual muscle exercise program and to confirm muscle mass by muscle strength training.

• Journal of Life Science
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• v.14 no.3
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• pp.484-489
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• 2004

Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.

• Proceedings of the KSME Conference
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• 2004.11a
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• pp.372-376
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• 2004

In this paper, the standard test methods at low temperature of rubber suspension components of railway vehicle are investigated and reviewed. In order to connect the TKR(Trans-Korean Railway)-TSR(Trans-Siberian Railway), it is necessary to evaluate the performance of rubber suspenion components of railway vehicle. In the current Korean Standard, the test method at low temperature of railway vehilce components and the test method of rubber bellows of air spring are specified. But, the specified test temperature is higher than the the operating temperature of TSR railway. So, the in-depth research for the test method and performance evaluation technique of rubber suspension component at low temperature is necessary and current KS code should be adjusted.

• Proceedings of the KSME Conference
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• 2007.05a
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• pp.189-194
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• 2007

To reduce the cost and time of transport in Eurasian railroad networks such as TKR, TCR and TSR owing to the problem of different track gauges(narrow/standard/broad gauge), it is important to develop the gauge - adjustable wheelset system to adapt easily to these gauges. Moreover, freight trains having the gauge - adjustable wheelset will be run various curved tracks in railroad networks. Therefore, to assure the safety of the gauge-adjustment wheelset system, it is necessary to evaluate integrity of locking parts in the system using stress analysis. In this study, it was performed to contact stress analysis of locking parts by using FEA(finite element analysis) simulator during the gauge changeover operation and freight trains' service in the curved track, respectively.

• Proceedings of the KSR Conference
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• 2004.06a
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• pp.562-569
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• 2004

To operate a border station between South and North Korea is one of the most important tasks for the future inter-Korean railway transportation. Currently, North Korea and China are operating three border stations each. Among them, a Dandong-Sinuiju route handles the most amount of transport volume and can be a model for the operation of South-North Korean border station. This Study is to suggest an efficient way of operating the planned South-North Korean border station and international railway transportation via the station. To that end, operation system at the border station between Chinese Dandong and North Korean Sinuiju was analyzed and the Train Operation Agreement made by the two Koreas was studied.

• Proceedings of the KSR Conference
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• 2007.11a
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• pp.1012-1017
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• 2007

To reduce the cost and the time of transport in Eurasian railroad networks such as TKR(Trans-Korea Railway), TCR(Trans-China Railway) and TSR(Trans-Siberia Railway) owing to the problem of different track gauges (narrow/standard/broad gauge), it is important to develop the gauge - adjustable wheelset system to adapt easily to these gauges. Moreover, this system accomplishes periodically a conversion operation from the gauge variable segment between different gauge. Gauge adjustable compression coil spring during conversion process accomplishes repetitively a central role for operation mechanism between flange and locking part. Therefore, to assure the safety of the gauge-adjustment wheelset system, it is necessary to stress analysis of the optimized spring in the system. In this study, it was performed to optimal design of the spring for stress analysis by using the genetic algorithm.