• Title/Summary/Keyword: Limb

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Effect of Vibration Stimulation Training on Upper Extremity Function in Children with Cerebral Palsy (뇌성마비 아동의 진동 자극 훈련이 상지기능에 미치는 영향)

  • Kang, Set-Byul;Kim, Man-Je;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.23-33
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    • 2023
  • Objective : The purpose of this study is was to find ouetermine whether training to applying vibration stimulation to the biceps brachii of children in the late stages of spasticity hemiplegic cerebral palsy can helps to improve the function of the upper extremity. Methods : This The study was conducted on with three children with cerebral palsy, all between the ages of 13 and 15 years. Among the experimental research methods of used with individual subjects, an AB research design using multiple basic baseline individual experimental studies was used, and vibration stimulation was provided to the paralyzed hand during the intervention period. The An evaluation was conducted before and after each session used to measure the function of the upper extremity using was conducted after each session of the Rapael Smart Board and The Jebsen-Tayler hand function test and the Motor Activity Log (MAL) were conducted before and after the experiment. Results : As a result of measuring the smooth The average score and total scores of for using the Rapael Smart Board to measure the upper extremity function in following each therapeutic session using the Rafale smart pegboard showed that, Subject 3 did not showevidenced a no significant change in the average value, and but Subjects 1 and 2 did showed a significant changes in their average values. All three subjects showed significant changes in the Jepson-Taylor hand function test and in the Motor Activity Log test, as evaluated before and after the intervention. Conclusion : Training The using use of vibration stimulation showed a positive effect on in improving upper limb function and exercise in hemiplegia hemiplegic children with who had little experience on using their hemiplegic side.

CNN-LSTM-based Upper Extremity Rehabilitation Exercise Real-time Monitoring System (CNN-LSTM 기반의 상지 재활운동 실시간 모니터링 시스템)

  • Jae-Jung Kim;Jung-Hyun Kim;Sol Lee;Ji-Yun Seo;Do-Un Jeong
    • Journal of the Institute of Convergence Signal Processing
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    • v.24 no.3
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    • pp.134-139
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    • 2023
  • Rehabilitators perform outpatient treatment and daily rehabilitation exercises to recover physical function with the aim of quickly returning to society after surgical treatment. Unlike performing exercises in a hospital with the help of a professional therapist, there are many difficulties in performing rehabilitation exercises by the patient on a daily basis. In this paper, we propose a CNN-LSTM-based upper limb rehabilitation real-time monitoring system so that patients can perform rehabilitation efficiently and with correct posture on a daily basis. The proposed system measures biological signals through shoulder-mounted hardware equipped with EMG and IMU, performs preprocessing and normalization for learning, and uses them as a learning dataset. The implemented model consists of three polling layers of three synthetic stacks for feature detection and two LSTM layers for classification, and we were able to confirm a learning result of 97.44% on the validation data. After that, we conducted a comparative evaluation with the Teachable machine, and as a result of the comparative evaluation, we confirmed that the model was implemented at 93.6% and the Teachable machine at 94.4%, and both models showed similar classification performance.

Korean Medicine for Gait Disturbance Accompanying Lower Limb Rigidity Caused by Bleeding of Spinal Cavernous Hemangioma: A Case Report (척추 해면상 혈관종 출혈로 인해 발생한 하지 강직감을 동반한 보행 장애에 대한 한의학 치료의 효과: 증례보고)

  • Hyunjin Choi;Seung Ho Yu;Sangjoon An;Seyun Kim;Woochul Shin;Jae-Heung Cho;Won-Seok Chung;Mi-Yeon Song;Hyungsuk Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.243-249
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    • 2023
  • This case study showed improvement both in pain and gait disturbance caused by SCH. KM can be a positive treatment for reducing pain or improving gait disturbance caused by SCH, and it can be considered a treatment option for SCH. Future studies with a larger number of cases and longer period of follow-up in SCH with gait disturbance and rigidity are needed.

Quantitative Evaluation of Gastrocnemius Medialis Stiffness During Passive Stretching Using Shear Wave Elastography in Patients with Parkinson's Disease: A Prospective Preliminary Study

  • Lu Yin;Lijuan Du;Yuanzi Li;Yang Xiao;Shiquan Zhang;Huizi Ma;Wen He
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1841-1849
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    • 2021
  • Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson's disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young's modulus-ankle angle curve was constructed. The GM slack angle and baseline Young's modulus (E0) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion: The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

Comparison of Veno-arterial Extracorporeal Membrane Oxygenation Configurations for Patients Listed for Heart Transplantation

  • Jung Ae Hong;Ah-Ram Kim;Min-Ju Kim;Dayoung Pack;Junho Hyun;Sang Eun Lee;Jae-Joong Kim;Pil Je Kang;Sung-Ho Jung;Min-Seok Kim
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.535-547
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    • 2023
  • Background and Objectives: Veno-arterial extracorporeal membrane oxygenation (VAECMO) as a bridge to eventual heart transplantation (HT) is increasingly used worldwide. However, the effect of different VA-ECMO types on HT outcomes remains unclear. Methods: This was a retrospective observational study of 111 patients receiving VA-ECMO and awaiting HT. We assessed 3 ECMO configuration groups: peripheral (n=76), central (n=12), and peripheral to central ECMO conversion (n=23). Cox proportional hazards regression and landmark analysis were conducted to analyze the effect of the ECMO configuration on HT and in-hospital mortality rates. We also evaluated adverse events during ECMO support. Results: HT was performed in the peripheral (n=48, 63.2%), central (n=10, 83.3%), and conversion (n=11, 47.8%) ECMO groups (p=0.133) with a median interval of 10.5, 16, and 30 days, respectively (p<0.001). The cumulative incidence of HT was significantly lower in the conversion group (hazard ratio, 0.292, 95% confidence interval, 0.145-0.586, p=0.001). However, there was no difference in in-hospital mortality (log-rank p=0.433). In the landmark analysis, in-hospital mortality did not differ significantly among the 3 groups. Although we did note a trend toward lower HT in the conversion group, the difference was not statistically significant. Surgical site bleeding occurred mainly in the central, while limb ischemia occurred mainly in the peripheral groups. Conclusions: We suggest that if patients are being stably supported with their initial ECMO configuration, whether it is central or peripheral, it should be maintained, and ECMO conversion should only be cautiously performed when necessary.

Safety and Effectiveness of Passeo-18 Lux Drug-Coated Balloon Catheter in Infrainguinal Endovascular Revascularization in the Korean Population: A Multicenter Post-Market Surveillance Study

  • Tae Won Choi;Je Hwan Won;Hwan Jun Jae;Yong Sun Jeon;Sang Woo Park;Gi-Young Ko;Nam Yeol Yim;Jong Yun Won;Chang Won Kim;Jinoo Kim
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.565-574
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    • 2024
  • Objective: To evaluate the safety and clinical outcomes of the Passeo-18 Lux drug-coated balloon (DCB) in endovascular revascularization procedures under real-world conditions in a Korean population with atherosclerotic disease of the infrainguinal arteries, including below-the-knee (BTK) arteries. Materials and Methods: Eight institutions in the Republic of Korea participated in this prospective, multicenter, single-arm, post-market surveillance study. Two hundred patients with Rutherford class 2-5 peripheral arterial disease and infrainguinal lesions suitable for endovascular treatment were competitively enrolled. Data were collected at baseline, the time of intervention, discharge, and 1-, 6-, 12-, and 24-month follow-up visits. The primary safety endpoint was freedom from major adverse events (MAE) within 6 months (except when limiting the time frame for procedure- or device-related mortality to within 30 days), and the primary effectiveness endpoint was freedom from clinically driven target lesion revascularization (CD-TLR) within 12 months after the procedure. Results: A total of 197 patients with 332 target lesions were analyzed. Two-thirds of the patients had diabetes mellitus, and 41.6% had chronic limb-threatening ischemia. The median target lesion length was 100 mm (interquartile range: 56-133 mm). Of the target lesions, 35.2% were occlusions, and 14.8% were located in the BTK arteries. Rate of freedom from MAE was 97.9% at 6 months, and the rate of freedom from CD-TLR was 95.0% and 92.2% at 12 and 24 months, respectively. Subgroup analysis of 43 patients and 49 target lesions involving the BTK arteries showed rate of freedom from MAE of 92.8% at 6 months and rates of freedom from CD-TLR of 88.8% and 84.4% at 12 and 24 months, respectively. Conclusion: The results of the present study, including the BTK subgroup analysis, showed outcomes comparable to those of other DCB studies, confirming the safety and effectiveness of Passeo-18 Lux DCB in the Korean population.

Is Diabetes a Contraindication to Lower Extremity Flap Reconstruction? An Analysis of Threatened Lower Extremities in the NSQIP Database (2010-2020)

  • Amy Chen;Shannon R. Garvey;Nimish Saxena;Valeria P. Bustos;Emmeline Jia;Monica Morgenstern;Asha D. Nanda;Arriyan S. Dowlatshahi;Ryan P. Cauley
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.234-250
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    • 2024
  • Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.

Effects of the Perceived Value of IP-based Game Character Skins and Purchase Intention on Game Loyalty: Focusing on the MOBA Game Pokemon Unite (IP 기반 게임 캐릭터 스킨의 지각된 가치와 구매의도가 게임 충성도에 미치는 영향 - MOBA 게임 포켓몬 유나이트를 중심으로)

  • Zhang, Yin;Jang, Yu Jin;Limb, Seong-Joon
    • Journal of Service Research and Studies
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    • v.14 no.3
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    • pp.131-152
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    • 2024
  • Recent trends in the gaming industry have highlighted a significant rise in games based on intellectual properties (IP), such as animations and webtoons. This study addresses a critical aspect of revenue generation for game companies: item sales. Specifically, it explores how the perceived value of character skins in IP-based games influences purchase intentions and, subsequently, how these intentions affect game loyalty. Utilizing 'Pokemon Unite'-a game that integrates the prominent IP Pokemon with the dynamic MOBA genre-this research investigates these relationships within a sample of Chinese users. The perceived value of character skins was delineated into six categories: aesthetic value, hedonic value, social value, personal value, economic value, and IP value. Findings indicate that, of these six value dimensions, five-hedonic, social, personal, economic, and IP values-significantly impact purchase intentions, with aesthetic value showing no significant effect. Furthermore, the study demonstrates that purchase intentions have a positive effect on game loyalty, with character loyalty partially mediating this relationship. These results underscore that players of IP-based games weigh a multifaceted array of values when deciding on character skin purchases and highlight the critical role these skins play in not only generating item sales but also enhancing game loyalty.

Clinical and Electrophysiological Study on Guillain-Barr$\acute{e}$ Syndrome (Guillain-Barr$\acute{e}$ 증후군의 임상적 및 전기생리학적 연구)

  • Yun, Sung-Hwan;Hah, Jung-Sang;Joo, Sung-Gyun;Cho, Yong-Kook;Kim, Jung-Hyun;Chung, Ji-Yeun
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.52-61
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    • 2005
  • Background: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. Materials and Methods: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. Results: The male to female ratio was 1.8:1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7 % of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3 %). Intravenous immunoglobulin therapy was performed in 29 cases (64.4 %). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. Conclusion: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

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Lithologic and Structural Controls and Geochemistry of Uranium Deposition in the Ogcheon Black-Slate Formation (옥천대(沃川帶) 우라늄광층(鑛層)의 구조규제(構造規制) 및 지구화학적(地球化學的) 특성연구(特性硏究))

  • Lee, Dai Sung;Yun, Suckew;Lee, Jong Hyeog;Kim, Jeong Taeg
    • Economic and Environmental Geology
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    • v.19 no.spc
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    • pp.19-41
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    • 1986
  • Structural, radioactive, petrological, petrochemical, mineralogical and stable isotopic study as well as the review of previous studies of the uranium-bearing slates in the Ogcheon sequence were carried out to examine the lithological and structural controls, and geochemical environment in the uranium deposition in the sequence. And the study was extended to the coal-bearing formation (Jangseong Series-Permian) to compare the geochemical and sedimentologic aspects of uranium chemistry between Ogcheon and Hambaegsan areas. The results obtained are as follows: 1. The uranium mineralization occurs in the carbonaceous black slates of the middle to lower Guryongsan formation and its equivalents in the Ogcheon sequence. In general, two or three uranium-bearing carbonaceous beds are found with about 1 to 1.5km stratigraphic interval and they extend from Chungju to Jinsan for 90km in distance, with intermittent igneous intrusions and structural Jisturbances. Average thickness of the beds ranges from 20 to 1,500m. 2. These carbonaceous slate beds were folded by a strong $F_1$-fold and were refolded by subsequent $F_1$-fold, nearly co-axial with the $F_1$, resulting in a repeated occurrence of similar slate. The carbonaceous beds were swelled in hing zones and were shrinked or thined out in limb by the these foldings. Minor faulting and brecciation of the carbonaceous beds were followed causing metamorphism of these beds and secondary migration and alteration of uranium minerals and their close associations. 3. Uranium-rich zones with high radioactive anomalies are found in Chungju, Deogpyong-Yongyuri, MiwonBoun, Daejeon-Geumsan areas in the range of 500~3,700 cps (corresponds to 0.017~0.087%U). These zones continue along strike of the beds for several tens to a few hundred meters but also discontinue with swelling and pinches at places that should be analogously developed toward underground in their vertical extentions. The drilling surveyings in those area, more than 120 holes, indicate that the depth-frequency to uranium rich bed ranging 40~160 meter is greater. 4. The features that higher radioactive anomalies occur particularly from the carbonaceous beds among the argillaceous lithologic units, are well demonstrated on the cross sections of the lithology and radioactive values of the major uranium deposits in the Ogcheon zone. However, one anomalous radioactive zone is found in a l:ornfels bed in Samgoe, near Daejeon city. This is interpreted as a thermal metamorphic effect by which original uranium contents in the underlying black slate were migrated into the hornfels bed. 5. Principal minerals of the uranium-bearing black slates are quartz, sericite, biotite and chlorite, and as to chemical composition of the black slates, $Al_2O_3$ contents appear to be much lower than the average values by its clarke suggesting that the Changri basin has rather proximal to its source area. 6. The uranium-bearing carbonaceous beds contain minor amounts of phosphorite minerals, pyrite, pyrrhotite and other sulfides but not contain iron oxides. Vanadium. Molybdenum, Barium, Nickel, Zirconium, Lead, Cromium and fixed Carbon, and some other heavy metals appear to be positive by correlative with uranium in their concentrations, suggesting a possibility of their genetic relationships. The estimated pH and Eh of the slate suggests an euxenic marine to organic-rich saline water environment during uranium was deposited in the middle part of Ogcheon zone. 7. The Carboniferous shale of Jangseong Series(Sadong Series) of Permian in Hambaegsan area having low radioactivity and in fluvial to beach deposits is entirely different in geochemical property and depositional environment from the middle part of Ogcheon zone, so-called "Pibanryong-Type Ogcheon Zone". 8. Synthesizing various data obtained by several aspects of research on uranium mineralization in the studied sequence, it is concluded that the processes of uranium deposition were incorporated with rich organic precipitation by which soluble uranyl ions, $U{_2}^{+{+}}$ were organochemically complexed and carried down to the pre-Ogcheon sea bottoms formed in transitional environment, from Red Sea type basin to Black Sea type basin. Decomposition of the organic matter under reducing conditions to hydrogen sulfide, which reduced the $UO{_2}^{+2}$ ions to the insoluble uranium dioxide($UO_2$), on the other side the heavy metals are precipitated as sulfides. 9. The EPMA study on the identification of uraninite and others and the genetic interpretation of uranium bearing slates by isotopic values of this work are given separately by Yun, S. in 1984.

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