Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.
The purpose of this study was to provide fundamental information for success factors of techniques through kinematic analysis including coordination of lower extremities and landing stability according to the success and failure of $540^{\circ}$ Dwihuryeochagi in Taekwondo. Twenty Taekwondo athletes: ten success group (S, age: $22.3{\pm}1.8$ yrs, height: $172.1{\pm}5.4$ cm, body mass: $64.4{\pm}4.2$ kg) and ten failure group (F, age: $22.3{\pm}1.8$ yrs, height: $172.1{\pm}5.4$ cm, body mass: $64.4{\pm}4.2$ kg) participated in this study. Three-dimensional motion analysis using a system of 3 video cameras with a sampling of 60 fields/s was performed during the competition of $540^{\circ}$ Dwihuryeochagi. Motions were divided into five events: pivot foot landing (E1), pivot foot toe off (E2), COM max height (E3), kick impact (E4) and landing (E5). At E1, the stride width was greater for S than for F (p<.05) while the time was greater for S than for F during P4 (p<.05). At E4, knee angle was greater for S than for F (p<.05). At E5, hip angle was greater for S than for F (p<.05) while kick distance was greater for S than for F (p<.05). Furthermore, at P3, the time would be related to kicking velocity (p<.05), while at P4, the time, range of hip angle and knee angle would be related to kick distance (p<.05). At P1, COM horizontal velocity would be related to COM vertical velocity of P1 and P2 (p<.05). Based on the findings, success factors of $540^{\circ}\acute{y}$ Dwihuryeochagi were COM horizontal velocity of P1, COM vertical velocity of P2, the time, kick distance, velocity, angle of lower extremities and coordination of P3-P4.
The Journal of the Korean bone and joint tumor society
/
v.11
no.1
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pp.100-104
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2005
Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.
This article describes a simplified mathematical model and the relevant numerical algorithm to simulate the draped cloth on virtual human body. The proposed algorithm incorporates an elliptical, or non-consecutive, method to simulate the cloth wrinkles on moving bodies without resorting to the result of the past time-steps of drape simulation. A global-local analysis technique was employed to decompose the drape of cloths into the global deformation and the local wrinkles that will be superposed linearly The global deformation is determined directly by the rotation and the translation of body parts to generate a wrinkle-free yet globally deformed shape of cloth. The local wrinkles are calculated by solving simple elliptical equations based on the orthogonality between conjugate harmonic functions representing the wrinkle amplitude and the direction of wrinkles. The proposed method requires no interpolative time frames even for discontinuous body postures. Standing away from the incremental approach of time integration in conventional methods, the proposed method yields a remarkable reduction of CPU time and an enhanced stability. Also, the transient motion of cloth could be achieved by interpolating between the deformations corresponding to each static posture.
Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.
Journal of the Earthquake Engineering Society of Korea
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v.15
no.2
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pp.23-33
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2011
In this study, a CFPBS (Cone-type Friction Pendulum Bearing System) was developed which controls the acceleration delivered to the structure to prevent damage and degradation of the critical communication equipment in case of an earthquake. The isolation performance of the CFPBS was evaluated by numerical analysis. The CFPBS was manufactured in the shape of a cone differenced from the existing FPS (Friction Pendulum System), and a pattern was engraved on the friction surface. The natural frequencies of the CFPBS were evaluated from a free-vibration test with the seismic isolator system consisting of four CFPBSs. In order to verify its earthquake-resistant performance, a numerical analysis program was created from the equation of the CFPBS induced from the equations of motion. A simplified theoretical equation of the CFPBS was proposed to manufacture the equipment which could demonstrate the necessary performance. Artificial seismic waves satisfying the maximum earthquake scale of the Korean Building Code-Structural (KBC-2005) were created and verified to review the earthquake-resistant performance of the CFPBS by numerical analysis. The superstructural mass of the CFPBS and skew angle of the friction surface were considered for numerical analysis with El Centro NS (1940), Kobe NS (1995) and artificial seismic waves. The CFPBS isolation performance evaluation was based on the results of numerical analysis and the executed comparative analysis between the results from numerical analysis and the simplified theoretical equation under the same conditions.
Purpose: We evaluated calcium resolution and clinical improvement of calcific tendinitis after conservative and arthroscopic treatment. Materials and Methods: We reviewed 126 patients of calcific tendinitis treated from January, 2002 to April, 2005. Average age was 53 and female dominant in 77% of the cases. Calcium deposits were involved in supraspinatus tendon in 84% of the cases. We compared clinical changes for 64 cases treated with injection, and 12 cases treated by arthroscopic decompression with 6 month follow-up. Results: 77%(49/64) of the cases with steroid injection showed symptom improvement. Even though complete resolution of calcific deposit occurred in 36%(23/64), incomplete resolution in 17%(11/64) and no change in 47%(30/64), Pain was relieved in 87%(20/23), 82%(9/11) and 67%(20/30), respectively. With arthroscopic treatment, calcium deposit completely resolved in 83%(10/12), and all cases showed pain free motion after 6 months. Conclusion: Conservative treatment with steroid injection was effective for acute pain in resorptive phase. In cases of arthroscopic treatment, there was no need for complete removal of calcium deposit during the procedure, but clinical symptoms improved with resolution of the deposit.
Recently, as the demand for immersive videos increases, efficient video processing techniques for omnidirectional immersive video is actively developed by MPEG-I. While the omnidirectional video provides a larger degree of freedom for a free viewpoint, the size of the video increases significantly. Furthermore, in order to compress 6 degree-of-freedom (6 DoF) videos that support motion parallax, it is required to develop a codec to yield better coding efficiency. In this paper, we develop a 6 DoF codec using Versatile Video Coding (VVC) as the next generation video coding standard. To the authors' best knowledge, this is the first VVC-based 6 DoF video codec toward the future ISO/IEC 23090 Part 7 (Metadata for Immersive Media (Video)) MPEG-I standardization. The experiments were conducted on the seven test video sequences specified in Common Test Condition (CTC) in two operation modes of TMIV (Test Model for Immersive Media) software. It is demonstrated that the proposed codec improves coding performance around 33.8% BD-rate reduction in the MIV (Metadata for Immersive Video) mode and 30.2% BD-rate reduction in the MIV view mode as compared to the state-of-the-art TMIV reference software. We also show the performance comparisons using Immersive Video PSNR (IV-PSNR) and Mean Structural Similarity (MSSIM).
Kang, Boram;Kim, Taikon;Kim, Mi Jung;Lee, Kyu Hoon;Choi, Seungyoung;Lee, Dong Hun;Kim, Hyo Ryoung;MA, Byol Jun;Park, Seen Young;Lee, Sung Jae;Park, Si-Bog
Annals of Rehabilitation Medicine
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v.39
no.6
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pp.957-963
/
2015
Objective To compare the pain-reducing effect of forest bathing alone versus forest bathing in combination with stretching and strengthening exercises in patients with chronic posterior neck pain. Methods Sixty-four subjects with posterior neck pain that had lasted more than 3 months were enrolled. They were randomly divided into a forest bathing alone (FBA) group and a forest bathing with exercise (FBE) group; each group included 32 subjects. All subjects from both groups walked every morning in the forest for about 2 hours for 5 days. In the afternoon, the FBE group did a stretching and strengthening exercise for about 4 hours; the FBA group had free time in the woods. Visual analog scale (VAS) on one day, VAS over the previous week, neck disability index (NDI), EuroQol 5D-3L VAS (EQ VAS) and index (EQ index), McGill pain questionnaire (MPQ), the number of trigger points in the posterior neck region (TRPs), and the range of motion of the cervical spine were evaluated on the first and last day of the program and compared between the two groups. Results The number of TRPs were significantly reduced in the FBE group compared with the FBA group (p=0.013). However, the other scales showed no significant difference between the two groups. Conclusion When patients with chronic posterior neck pain underwent a short-term forest bathing (less than 7 days) program, FBE was more effective in the reduction of the number of TRPs than FBA. However, all other pain measurement scales we evaluated showed no statistically significant difference between the two protocols.
Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.
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