• 한국안전학회지
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• 제20권4호
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• pp.148-153
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• 2005

Computer dominated jobs and industrial automation have rapidly created work-related musculoskeletal disorders(WMSDs) and WMSDS are expanding to employee of other general industry. Specific risk factors associated with WMSDs include repetitive motion, heavy lifting, forceful exertion, contact stress, vibration awkward posture and rapid hand and wrist movement. The purpose of this paper is to analyze the effects of the neck muscle workload according to posture(joint angle) and load weight. Seven male students participated in this study. To analyze neck muscle workload was studied on electromyographic(EMG) activity for sternocleidomastoid and trapezius, was subjectively rated using a Borg's CR-10 scale. ANOVA showed that the CR-10 ratings and most EMG root-mean-square (RMS) value were statistically significant improvement according to posture(joint angle) and load weight. The results of this study indicate the joint angle and weight of neck muscle workload to provide safe working conditions. To reduce the large number and severity of WMSDs employees have been experiencing, we need to redesign the job in workplace to identify and control hazards that are reasonably likely to be causing or contributing to the WMSDs.

• Archives of Reconstructive Microsurgery
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• 제14권2호
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• pp.144-151
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• 2005

Purpose: Disaster as traffic accident, industrial disaster, high voltage electrical bum and flame burn of extremity have a destructive effect because of the involvement of deep structure. Generally, such injury may result in decreased function or loss of limb. In this study the successful use of the combined scapular/parascapular flap as microsurgical transfer to cover extensive defect of electrical and flame bum is reported. Material and Method: Between January 2000 and June 2001, the combined scapular and parascapular flap was used for the coverage of soft tissue defect for 7 patients were admitted to our department with high voltage electrical bum and flame burn. The recipient site were the wrist joint in 2 cases, the forearm in 1 case, the ankle joint in 1 case, the foot dorsum in 1 case, the heel in 1 case. Result: Flap survival was complete in all patients. The result of flap coverage for these deep wound was successful. Conclusion: The advantages of scapular/parascapular combined flap were coverage of the large defect, easy shaping of the flap to fit the required three dimensional configuration around the joint, non hair bearing skin of uniform thickness, minimal donor site morbidity.

• 한국의학물리학회지:의학물리
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• 제2권2호
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• pp.161-173
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• 1991

앉은 자세에서 동적 작업을 수행하는 6명의 실험대상자에 작용하는 관절 모멘트에 대해 통계학적인 해석을 수행하였다. 본 연구에서는 곧게 앉은 자세에서 1kg의 물체를 오른손에 들고 가슴 앞쪽에서 어깨 높이로 물체를 왕복으로 움직이는 작업에 대하여 미시간대학 생체역학 실험실에서 얻은 실험자료를 사용하였다. 각 실험대상자에게 동일한 작업을 3 번씩 수행하게 하여 얻은 자료를 기초로 3 차원 생체역학 모델을 사용하여 손목, 팔꿈치, 어깨관절, 세번째 요추관절, 고관절, 무릎 및 발목과 같은 주요 관절에 작용하는 모멘트를 계산하였다. 관절 모멘트의 실험대상자 사이의 차이와 수행 사이의 차이를 고찰하기 위하여 선형상관계수와 이원분산분석을 적용하였다. 세번째 요추관절에서 가장 큰 크기의 모멘트가 작용하였고 가장 큰 변화량을 나타내었으며, 모멘트와 본 연구에서 시도한 모멘트의 차원을 갖는 량 사이에 선형적인 상관관계를 찾을 수 없었으며, 각 관절에 작용하는 모멘트의 최대값과 변화량은 3번의 수행 사이에서 통계학적으로 동일하지만 6 명의 실험대상자 사이에는 통계학적으로 동일하지 않다는 결과를 얻었다.

• 한국운동역학회지
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• 제20권4호
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• pp.381-386
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• 2010

This study examined the changes in the walking pattern during level walking under low illumination conditions. Fourteen male subjects ($22.1{\pm}2.21$ years, $174{\pm}3.74\;cm$, $68.86{\pm}10.81\;kg$) with normal vision and no disabilities were enrolled in this study. All experiments were performed on a level walkway with three conditions: normal walking (preferred & low speed) and walking with low illumination. 3D motion capturing system was used for acquisition and analysis of the walking motion data with a sampling frequency of 120Hz. The walking speed, normalized jerk(NJ) at the center of mass(COM), wrist and heel, knee and elbow joint angle, ratio of the knee joint angle to elbow joint angle and the toe clearance on stance phase were used to compare the differences in walking pattern between the two illumination conditions, The results showed that the walking speed and joint angles decreased in low illumination, whereas the NJ and toe minimum clearance increased. In low illumination, most variables were similar to effects of low speed walking, but toe clearance was different from the effects of low speed. These results can be used as primary data for examining the changes in the level walking pattern of young adults under low illumination. Further study will be needed to compare these results in young adults with those in the elderly.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.14-23
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• 2004

Introduction: The hand and wrist are particularly susceptible to electrical burn. Skin defect with damage or exposure of underlying vital structure requires coverage by skin flap especially in case of the need for late reconstruction. We are reporting 4 cases of electrical burned hand treated by posterior tibial arterial free flap. The commonly used skin flaps such as scapular flap or groin flap are too bulky so that they are not satisfactory in function and cosmetic appearance. So we tried to cover them with a more thin skin flap. Materials and Method: From January 2002 to June 2003, four cases of hand and wrist electrical burn were covered using posterior tibial arterial free flap. All the cases were due to high voltage electrical burn. Age ranged from 31 years to 38 years old and all the cases were male patients. Recipient sites were 2 wrist, one thenar area and one knuckle of 2.3rd MP joint. Additional procedures were flexor tenolysis (simultaneous), FPL tenolysis and digital nerve graft (later) and extensor tendon reconstruction (later). Result: All the flap have survived totally without any complication including circulatory concern about the donar foot. Posterior tibail arterial free flap was so thin that debulking procedure was not required. Conclusion: For skin coverage of the hand & wrist region, posterior tibial arterial free flap have many advantages such as reliable anatomy, easy dissection and easy anastmosis with radial or ulnar artery and possibility of sensory flap. The most helpful advantage for hand coverage is its thinness. So we think this flap is one of the very useful armamentarium for reconstructive hand surgery.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.1-13
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• 2005

Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

• 대한의용생체공학회:의공학회지
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• 제37권1호
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• pp.15-20
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• 2016

Essential tremor is a neurological disorder with a tremor of the arms and hands. It is well known that essential tremor is characterized by the postural tremor and the action tremor. There has been no report on the quantitative difference in the characteristics of two tremor types. The purpose of this study was to investigate the possible difference in tremor characteristics of postural and action tremors. Seventeen patients with essential tremor ($68.9{\pm}7.9years$, 7 men, 10 women) participated in this study. Patients performed the tasks of postural maintenance (arms outstretched) and daily actions (spiral drawing). Three-axes (pitch, roll and yaw) gyro sensors were attached on index finger, back of hand and forearm, from which the segment and the joint angular velocities were calculated. Outcome measure was the tremor amplitude defined as the root-mean-square mean of the vector-sum angular velocity at segments and joints. Two-way ANOVA showed that task and joint had main factor on the tremor amplitude (p < 0.05). Post-hoc analysis revealed that tremor amplitude at the metacarpo-phalangeal joint was not affected by task (p > 0.05). However, tremor amplitude at the wrist joint differed among the tasks (p < 0.05), and it was greater in the action tasks than in postural task. Tremor was greater at finger segments than at hand and forearm and it increased in action tasks. The results of this study would be helpful for the understanding and task-specific treatments of the essential tremor.

• 대한골관절종양학회지
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• 제13권1호
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• pp.55-59
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• 2007

활액막 연골종은 관절의 활액막에서 결체조직의 화생에 의해 연골 조직이 형성되는 질환이며 드물게 건초, 활액낭에 발생하는 경우도 있다. 정확한 발생 기전은 아직 밝혀지지 않았으나 외상, 감염 등이 원인으로 제시되고 있으며 관절 연골을 구성하던 연골의 일부가 떨어져 나와 활액막내로 흡수되어 연골성 화생을 일으킨다는 가설이 유력하다. 주로 슬관절에 발생하며 그 외 견관절, 주관절, 고관절 등에서 발생하는 것으로 알려져 있다. 65세 남자가 약 6개월 간의 우측 주관절 동통, 주관절 구축 및 우측 제1수지와 완관절의 신전 장애 및 감각 저하를 주소로 내원 하였다. 단순 방사선 검사상 주관절의 관절 간격이 좁아져 있었고 관절면의 가장 자리에 골극이 형성되어 있었으며 연골하골은 경화소견이 관찰되었다. 자기 공명 영상 검사상 요골두 직하방 전외측에 약 $16{\times}12$ mm 크기의 원형의 종양이 관찰되었으며, T1 강조 영상에서 균질의 저신호 강도, T2 강조 영상에서 고신호 강도와 저신호 강도가 혼재되어 있었다. 종양 절제술을 시행하였으며 수술소견상 종양에 의해 요골신경이 압박되어있는 소견이 관찰되었다. 절제한 종양은 조직소견상 활액막 연골종으로 진단되었다.

• 근관절건강학회지
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• 제9권2호
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• pp.144-153
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• 2002

This study was designed to explore use of unconventional treatments and identify related variables of patients with rheumatic disease. One hundred fifty rheumatic patients were recruited from two university based rheumatic centers according to selection criteria. Collected data were analyzed using SAS program through with a structured questionnaire. T-test, ANOVA, and Scheffe's test were adopted. The results were as follows: 1. 77.7% of the subjects were over forties and mean age was 48.5 years. 74.0% were women and 73.2% were living with their spouse. 82.0% of them was good or moderate or good economic status, 38.3% was university graduates. 2. 58.0% of the subjects had rheumatoid arthritis, and mean duration of suffering rheumatic disease was 6.5 years. 89.3% of them had joint pain and their mean pain score was 4.07. Most painful joints were hip(58.0%), finger(42.0%), wrist(42.0%), and the number of painful joint was 5.4. 70% of the subjects using unconventional treatments, the most common treatments using them was herb medicine(42.7%) and acupuncture(36.7%). 3. Level of pain was different according to subject's age, educational background, diagnosis, number of painful joints, and using unconventional treatments or not. It is recommended that use of a larger sample to understand more about unconventional treatments and pain of patients with rheumatic disease. More research is needed to consider developing individual nursing interventions for their well-being and quality of life.

• 대한의용생체공학회:의공학회지
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• 제20권3호
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• pp.315-321
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• 1999

본 논문에서는 근전도의 신호만으로 동적 운동시 근육에 발생하는 근력 예측을 위한 수학적 모델의 개발에 목표를 두고 있다. 이를 위하여 인체의 관절 운동중에 발생하는 근력과 근전도의 상관관계를 규명하는 것이 필요하기 때문에 동역학적 관절모델로서 수근관절을 포함한 주관절이 고려되었으며, 기구학 및 동역학 해석을 위하여 2개의 자유도를 갖는 Flexible Goniometer 로 관절의 각변위, 각속도, 가가속도등의 데이터를 실시간 측정하였다. 근전도 측정을 위해서는 비교적 신호가 뚜렷한 이두박근이 선정되었으며, 운동시 발생하는 이두박근의 근전도 신호는 표면전극을 이용한 다태널 Noraxon EMG 장치로 측정하였다. 결과로서, 근력과 근전도의 측정 시간에 따른 적분값의 비교는 1차 함수의 형태로 비례하는 상관관계로 표현됨을 알 수 있었으며, 동적인 운동시 발생하는 근수축을 동심 수축 구간( Concentric Contraction Period)과 편심 수축 구간(Eccentric Contraction Period)으로 양분하여 분석하였을 때도 근력과 근전도의 측정 시간에 따른 적분값의 비교는 1차 함수의 형태로 비례함을 알 수 있었다. 이 상관관계식을 이용하여 근전도 신호 측정을 통하여 관절에 작용하는 근육의 근력 예측이 가능함을 알 수 있었으며, 각기 다른 신체 부위의 관절에도 적용할 수 있는 가능성을 보여주고 있다.