신경손상시 신경속 봉합을 위한 전기적 신경속 감별법

박운교,양경무,박병화 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.4

Epineural suture has been the traditional method of repairing peripheral nerves since 1800S. However, after a nerve has been repaired by epineural suture, the motor and sensory functions are sometimes less than satisfactory because of the inability to identify the various fascicles and the inevitable non-functioning union of sensory fibers to motor fibers. For optimal results in a mixed nerve, there must be a good apposition of the various sensory and motor parts of the nerve bundles of each body region. Fascicular repair would be a more specific repair technique than epineural suture. It is possible to differentiate motor from sensory bundles in the proximal and distal cut end by electrical stimulation of the individual fascicle. Authors experienced 7 cases of fascicular repair with electrical fascicle identification method under the general anesthesia wake-up technique. By 12 months after the operation, motor and sensory functions of the patients with fascicular suture had recovered to an excellent degree with rapid reinnervation.

칸트『유작』(Opus postumum)의 시발점(Ansatzpunkt)

김재호(Kim, Jae-Ho) 서울대학교 철학사상연구소 2010 철학사상 Vol.37 No.-

『판단력비판』의 출간으로 한때 비판적 과업의 완성을 믿었던 칸트는 도대체 어떤 이유로 자신의 철학적 체계를 다시 세우는 마지막 저서를 준비하게 된 것일까? 다시 말해,『유작』에서의 칸트의 문제의식은 도대체 어디로부터 생겨난 것이며, 구체적으로는 그의 어떤 이전 작품의 문제들과 연관된 것일까? 칸트 『유작』의 시발점 문제는 바로 이 질문들에 관한 논의이다. 그런데 이 시발점 문제는 이미 현존하는 『유작』 편집의 역사속에 이미 반영되어 나타나고 있다. 그 대표적 예는『유작』의 가장 오래된 문서들로 알려진 합본 IV의 23개 낱장문서들의 편집문제이다. 본 논문에서는 이들 23개 낱장문서 중 5개만을『유작』에 포함시킨 아디케스 연구의 문제점을 살펴보고 이를 통해 『유작』에서 칸트의 문제의식의 출발점을 추론해 보고자 한다. 또한『유작』의 시발점을 『판단력비판』에서 찾았던 레만(Lehmann)의 입장을 비판적으로 검토함으로써『유작』 해석의 바람직한 방향을 제시하고자 한다. In 1790, in the preface to his Critique of Judgement, Kant had written: “With this then, I bring my entire critical undertaking to a close.” Yet, later, Kant mentioned ‘a gap in the critical philosophy’, which now stands open will be filled. Why has Kant, then, tried to reconstruct his system of critical philosophy? Why has Kant decided to engage in another major work, especially the ‘Transition-Project’ in his opus postumum? In other words, where is the opus postumum located in the context of Kant"s other writings? The issue of the ‘starting-point’ in Kant"s opus postumum is concerned with these questions. However, this issue of the ‘starting-point’ in Kant"s opus postumum was already applied to the history of editions of Kant"s original manuscripts. A typical example is the early 23 leaves of the IVth fascicle. In this paper I have tried to investigate the problem of Adickes" research, which excluded 18 leaves of the IVth fascicle from "Vorarbeiten" to the opus postumum, and from this I tried to infer the "starting-point" of the opus postumum. Besides, I have tried to discuss Lehmann"s opinion, according to which the origin of Kant"s plan for a "Transition" in the opus postumum is not from Metaphysical Foundations of Natural Science, but from Critique of Judgement; and finally, on the basis of these discussions, I have tried to present an appropriate interpretation of Kant’s opus postumum.

외측광근의 근속 길이가 유소년 축구선수의 등속성 근력 및 동적 균형에 미치는 영향

진정두,이호성 한국운동생리학회 2019 운동과학 Vol.28 No.4

PURPOSE: The purpose of this study was to determine the effect of vastus lateralis muscle fascicle length on isokinetic muscle strength and dynamic balance in youth soccer players. METHODS: Fourteen youth soccer players were divided into long fascicle length group (LFG, n=7) and short fascicle length group (SFG, n=7) by fascicle length of vastus lateralis muscle using ultrasound imaging. And measurements of muscle thickness, fascicle pennation angle, and physiological cross-sectional area were taken at the same location. Additionally, maximal isokinetic strength of knee extensors was assessed at 60°/sec and 120°/sec and a Y-balance test was completed. RESULTS: Fascicle length and ratio of fascicle length/lower limb length were significantly greater in LFG than that in SFG (p<.001). Fascicle pennation angle (p<.01) and physiological cross-sectional area (p<.05) were significantly greater in SFG than that in LFG. The isokinetic maximal strength of knee extensors at 120°/sec was significantly greater in SFG than that in LFG (p<.05). The composite score of Y-balance was significantly greater in SFG than that in LFG (p<.05). CONCLUSIONS: Our results show differences in architectural characteristics of the vastus lateralis. Further, the maximal isokinetic strength of knee extensors at 120°/sec and the ability of dynamic balance were greater in short vastus lateralis fascicle length of youth soccer players.

한국인 시신을 대상으로 한 앞아래정강종아리인대 아래다발의 형태학적 특성 연구

권형욱,조재호,김디귿,최유진,박광락,박사범,최윤일,이민주,이영일,박정현 대한체질인류학회 2024 해부·생물인류학 (Anat Biol Anthropol) Vol.37 No.1

: 본 연구에서는 한국인 시신을 대상으로 발목의 앞아래정강종아리인대 아래다발의 형태를 분류하고 위치를 계측하여 발목의 충돌증후군의 원인이 되는 앞아래정강종아리인대 아래다발의 역할에 대한 해부학적 근거를 마련하 고자 하였다. 본 연구를 위하여 포르말린으로 고정된 한국인 시신(평균나이 76.86±11.97세)을 사용하여 79쪽의 발을 해부하였다. 남자가 50쪽, 여자가 29쪽이었으며, 오른발이 40쪽, 왼발이 39쪽이었다. 앞아래정강종아리인대 아래 다발의 유형은 Edama 등의 분류법을 사용하였고, 앞아래정강종아리인대 아래다발의 존재 여부, 앞아래정강종아리 인대 아래다발의 유형과 앞아래정강종아리인대 아래다발의 길이와 너비, 앞아래정강종아리인대 아래다발과 앞목말 종아리인대와의 병합 유무, 먼쪽정강이뼈의 관절면과 앞아래정강종아리인대 아래다발의 아랫면이 이루는 각도를 측 정하였다. 연구 결과 앞아래정강종아리인대 아래다발은 96.2%에서 확인되었으며, 제I유형이 20쪽(25.3%), 제II유형 이 21쪽(26.5%), 제III유형이 24쪽(30.3%), 제IV유형이 11쪽(13.9%), 없음이 3쪽(3.7%)으로 나타났다. 먼쪽 정강이 뼈의 관절면과 앞아래정강종아리인대 아래다발이 이루는 경사각은 138.2±13.4°였으며, 앞아래정강종아리인대의 아 래다발과, 앞목말종아리인대는 61.8%로 병합이 확인되었다. 앞아래정강종아리인대의 아래다발의 길이는 21.6±2.6 mm였으며, 너비는 정강이뼈부착부위가 5.9±1.3 mm, 인대의 정중간부위가 3.9±0.8 mm, 종아리뼈부착부위가 3.6± 0.7 mm였다. 본 연구를 통해 한국인의 체질인류학적 기초자료를 작성하였고, 발목의 안쪽번짐염좌와의 연관성을 밝 혀내 임상에서 적용할 수 있는 해부학적 근거를 마련하였다. 이와 더불어 생체역학적인 연구를 통해서 발목염좌에서 앞아래정강종아리인대 아래다발과 앞목말종아리인대의 연관성에 대해 자세하게 살펴볼 필요성이 있음을 제안하는 바이다 The aim of this study is to clarify morphological characteristics of the inferior fascicle of the anterior inferior tibiofibular ligament (AITFL) in Korean cadavers and provide anatomical evidence regarding the role of the inferior fascicle of the AITFL in ankle impingement syndrome. For this study, 79 feet from formalin fixed Korean cadavers(76.86±11.97 years) were dissected, 50 male and 29 female feet, 40 right and 39 left feet. The inferior fascicle of the AITFL were classified using Edama et al’s method. Also, its length, and width were measured, as well as the conjoined between it and the anterior talofibular ligament (ATFL) and the angle between the lower surface of it and articular surface of the tibia plafond. As a result, the inferior fascicle of the AITFL was confirmed in 96.2% of cases, with type Ⅰ in 20 feet (25.3%), type Ⅱ in 21 feet (26.5%), type Ⅲ in 24 feet (30.3%), type Ⅳ absent in 11 feet (13.9%), and absent in 3 feet (3.7%). The angle between the articular surface of the distal fibula and the inferior fascicle of the AITFL was 138.2±13.4°, conjoined between the inferior fascicle of the AITFL and the ATFL was confirmed in 61.8% of cases. The length of the inferior fascicle of the AITFL was 21.6±2.6 mm, and the width at the attachment site of the tibia was 5.9±1.3 mm, at the midpoint of the ligament was 3.9±0.8 mm, and at the attachment site of the fibula was 3.6±0.7 mm. In conclusion, we established anthropological data of the Koreans and provided anatomical evidence that can be applied clinically to understand the association with ankle sprains.

신경속 보존술을 이용한 상지 신경초종 절제 수술의 결과

최진희,양태영,이태경,우상현 대한수부외과학회 2019 대한수부외과학회지 Vol.24 No.1

Purpose: To analyze the risk factors and the rate of neurological complication occurring after micro-surgical enucleation of schwannoma, and the relationship between single fascicle resection and neurological deficiency.Methods: From January 2010 through September 2018, a total of 65 patients underwent micro-surgical enucleation for schwannoma in the forearm and hand. The factors affecting new neurological deficiency after surgery were analyzed, and the differences in neurological incidence were compared between those that preserved the fascicle and those that were un-avoidable to resect the fascicle at surgery.Results: Immediately neurological complications were reported in 16 patients (24.6%) after the surgery, with 4 patients (6.2%) remaining in the final outcome. Neurological complication (50.0%) was higher in case of resection of fascicle at surgery (hazard ratio, HR=18.791, p<0.05). The preoperative misdiagnosis also increased the incidence of neurological complications (HR=10.693, p<0.05).Conclusion: Accurate diagnosis before surgery and preservation of the nerve fascicle at surgery are important to reduce postoperative neurological complications in the treatment of schwannoma. For accurate diagnosis, detailed history tak-ing, physical examination and magnetic resonance imaging should be actively done, and during surgery, efforts should be made to preserve the nerve fascicle as much as possible by using microscopic surgical techniques. 목적: 전완부 및 수부에 발생한 신경초종의 미세수술적 적출술 후 발생한 신경학적 결손의 빈도와 이에 영향을 미치는 인자 및 수술적 과정 중 종양 관련 단일 신경속 절제가 신경학적 결손에 미치는 영향에 대해 분석하고자 한다.방법: 2010년 1월부터 2018년 9월까지 총 65명의 환자에서 전완부 및 수부에 발생한 신경초종에 대한 미세수술적 피막 내 적출술을 시행하였다. 수술 후 새로 발생한 신경학적 결손에 영향을 미치는 인자를 분석하였으며, 신경속을 보존한 군과 수술 과정에서 신경속 절제가 불가피했던 군 간에 신경학적 발생률의 차이를 비교 분석하였다. 결과: 수술 시행 후 초기 신경학적 합병증이 16명(24.6%)에서 나타났으며 최종 추시에서는 4명(6.2%)에서 신경학적 합병증이 남아 있었다. 수술 중 신경속을 절제한 경우에서 신경학적 합병증 발생률(50.0%)이 더 높게 나타났으며(hazard ratio, HR=18.791, p<0.05) 수술 전 오진(HR=10.693, p<0.05) 여부 또한 신경학적 합병증 발생률을 높이는 것으로 나타났다.결론: 신경초종의 치료에서 수술 전 정확한 진단을 위해 자세한 문진 및 신체검진, 자기공명영상 등을 적극 활용해야 하며 수술 후 신경학적 합병증을 줄이기 위해 미세수술적 술기를 이용하여 신경속을 보존하려는 노력을 해야 한다.

ORIGINAL : Acute Changes in Fascicle Behavior and Electromyographic Activity of the Medial Gastrocnemius during Walking in High Heeled Shoes

( Jin Sun Kim ),( Hae Dong Lee ) 한국운동역학회 2016 한국운동역학회지 Vol.26 No.1

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: 23.1 ± 2.0 yr, height: 162.4 ± 4.9 cm, weight: 54.4 ± 8.5 kg) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking (37.64 ± 8.59 mm to 43.99 ± 8.66 mm) in comparison with barefoot walking (48.26 ± 9.02 mm to 53.99 ± 8.54 mm) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.

≪殷虛文字丙編≫005~011譯註

김혁 고려대학교 중국학연구소 2018 中國學論叢 Vol.0 No.59

In this thesis, by witnessing and examining real objects, 005-011 of Fascicle Three of Inscriptions from the Yin Ruins(≪殷虛文字丙編≫), with the Binzubuci(賓組卜辭) of YH127 in Yin Ruins, are arranged as completely as possible for the use of scholars to study and review. Fascicle Three(≪丙編≫)005 is that the Zhi(旨) from the west can expect the king’s work without worries. Fascicle Three(≪丙編≫)006 on the back of the Fascicle Three(≪丙編≫)005 indicates that the king had predicted the victory of the war by seeing a divinatory sign, so Zhi(旨) would have been involved in a war in the west. Fascicle Three(≪丙編≫)007 is a ritual in which people use Qiang(羌) as a sacrifice, whether to beat them with a club or cut their throats by catching them on a specific day. The method of killing the sacrifice at the time was also an important decision from Fascicle Three(≪丙編≫)007. Fascicle Three(≪丙編≫)008 is the prediction of whether Shang(商) dynasty long farming will turn out to be a good harvest. On the back of the Fascicle Three(≪丙編≫)009, the king saw a sign and concluded that the result would be a good harvest. Ten was the prediction of whether or not the farming in the 亞 region would perform a good harvest.

≪殷虛文字丙編≫005~011譯註

김혁 ( Kim Hyeok ) 고려대학교 중국학연구소 2018 中國學論叢 Vol.0 No.59

In this thesis, by witnessing and examining real objects, 005-011 of Fascicle Three of Inscriptions from the Yin Ruins(≪殷虛文字丙編≫), with the Binzubuci (賓組卜辭) of YH127 in Yin Ruins, are arranged as completely as possible for the use of scholars to study and review. Fascicle Three(≪丙編≫)005 is that the Zhi(旨) from the west can expect the king’s work without worries. Fascicle Three(≪丙編≫)006 on the back of the Fascicle Three(≪丙編≫)005 indicates that the king had predicted the victory of the war by seeing a divinatory sign, so Zhi(旨) would have been involved in a war in the west. Fascicle Three(≪丙編≫)007 is a ritual in which people use Qiang(羌) as a sacrifice, whether to beat them with a club or cut their throats by catching them on a specific day. The method of killing the sacrifice at the time was also an important decision from Fascicle Three(≪丙編≫)007. Fascicle Three(≪丙編≫)008 is the prediction of whether Shang(商) dynasty long farming will turn out to be a good harvest. On the back of the Fascicle Three(≪丙編≫)009, the king saw a sign and concluded that the result would be a good harvest. Ten was the prediction of whether or not the farming in the 亞 region would perform a good harvest.

Acute Changes in Fascicle Behavior and Electromyographic Activity of the Medial Gastrocnemius during Walking in High Heeled Shoes

Kim, Jin-Sun,Lee, Hae-Dong Korean Society of Sport Biomechanics 2016 한국운동역학회지 Vol.26 No.1

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: $23.1{\pm}2.0yr$, height: $162.4{\pm}4.9cm$, weight: $54.4{\pm}8.5kg$) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking ($37.64{\pm}8.59mm$ to $43.99{\pm}8.66mm$) in comparison with barefoot walking ($48.26{\pm}9.02mm$ to $53.99{\pm}8.54mm$) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.

Acute Changes in Fascicle Behavior and Electromyographic Activity of the Medial Gastrocnemius during Walking in High Heeled Shoes

김진선,이해동 한국운동역학회 2016 한국운동역학회지 Vol.26 No.1

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: 23.1 ± 2.0 yr, height: 162.4 ± 4.9 cm, weight: 54.4 ± 8.5 kg) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking (37.64 ± 8.59 mm to 43.99 ± 8.66 mm) in comparison with barefoot walking (48.26 ± 9.02 mm to 53.99 ± 8.54 mm) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.