• Clinics in Shoulder and Elbow
• /
• v.26 no.4
• /
• pp.366-372
• /
• 2023

Background: There is minimal literature on the morphology of partial distal biceps tendon (DBT) tears. We sought to investigate tear morphology by retrospectively reviewing 3-Tesla magnetic resonance imaging (3T MRI) scans of elbows with partial DBT tears and to propose a basic classification system. Methods: 3T MRI scans of elbows with partial DBT tears were retrospectively reviewed by two experienced observers. Basic demographic data were collected. Tear morphology was recorded including type, presence of retraction (>5 mm), and presence of discrete long-head and short-head tendons at the DBT insertion. Results: For analysis, 44 3T MRI scans of 44 elbows with partial DBT tears were included. There were 9 isolated long-head tears (20%), 13 isolated short-head tears (30%), 2 complete long-head tears with a partial short-head tear (5%), 5 complete short-head tears with a partial long-head tear (11%), and 15 peel-off tears (34%). Retraction was seen in 5 or 44 partial tears (11%), and 13 of the 44 DBTs were bifid tendons at the insertion (30%). Conclusions: Partial DBT tears can be classified into five sub-types: long-head isolated tears, short-head isolated tears, complete long-head tears with partial short-head involvement, complete short-head tears with partial long-head involvement, and peel-off tears. Classification of tears may have implications for operative and non-operative management. Level of evidence: III.

• PNF and Movement
• /
• v.18 no.1
• /
• pp.127-132
• /
• 2020

Purpose: This study aimed to investigate the impact of resistance on the muscle activities of the long and short heads of the biceps brachii, according to the elbow angle in supination, and the difference in muscle activity between the long and the short heads. Methods: This study was conducted with 22 men in their 20s who voluntarily agreed to participate. With the glenohumeral joint neutral in a position of supination, the elbow angle was randomly moved to 0°, 30°, 60°, and 90°. Using an 8-channel surface EMG while the participants held a 2-kg. dumbbell, the muscle activities of the long and the short heads of the biceps brachii were measured. The measured data were statistically processed using SPSS for Windows 12.0. For the activities of the short and the long heads according to the angle, a one-way ANOVA was conducted, and subsequently, to check the results of an analysis of the difference between groups, an LSD post-hoc test was conducted. An independent t-test was used to compare the activities of the long head and the short head according to the angles. Results: The analysis of the impact of the load of the dumbbell at each elbow angle on the muscle activities of the long and short heads of the biceps brachii revealed significant differences in both heads (p < 0.05). The result of the post-hoc analysis showed significant differences in both heads at angles between 0° and 30°, between 0° and 60°, and between 0° and 90°. Analysis of the impact of the load of the dumbbell in supination on the muscle activities of the long and short heads showed a significant difference at the angle between 0° and 30° (p < 0.05). Conclusion: The long head of the biceps brachii mainly acts in supination; however, in supination at elbow-bending angles of 60° and 90°, there was no difference in muscle activity between the short head and the long head.

• Journal of Audiology & Otology
• /
• v.25 no.1
• /
• pp.43-48
• /
• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

• Korean Journal of Audiology
• /
• v.25 no.1
• /
• pp.43-48
• /
• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

• Clinics in Shoulder and Elbow
• /
• v.26 no.2
• /
• pp.191-204
• /
• 2023

Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

• Journal of Electrical Engineering and Technology
• /
• v.9 no.6
• /
• pp.1882-1890
• /
• 2014

This paper proposes an augmented Lagrange Hopfield network (ALHN) based method for solving multi-objective short term fixed head hydrothermal scheduling problem. The main objective of the problem is to minimize both total power generation cost and emissions of $NO_x$, $SO_2$, and $CO_2$ over a scheduling period of one day while satisfying power balance, hydraulic, and generator operating limits constraints. The ALHN method is a combination of augmented Lagrange relaxation and continuous Hopfield neural network where the augmented Lagrange function is directly used as the energy function of the network. For implementation of the ALHN based method for solving the problem, ALHN is implemented for obtaining non-dominated solutions and fuzzy set theory is applied for obtaining the best compromise solution. The proposed method has been tested on different systems with different analyses and the obtained results have been compared to those from other methods available in the literature. The result comparisons have indicated that the proposed method is very efficient for solving the problem with good optimal solution and fast computational time. Therefore, the proposed ALHN can be a very favorable method for solving the multi-objective short term fixed head hydrothermal scheduling problems.

• International Journal of Vascular Biomedical Engineering
• /
• v.3 no.1
• /
• pp.14-22
• /
• 2005

In the present study, our aim is to investigate whether responses to the head-up tilt (HUT) on nonlinear properties of heart rate variability (HRV) in young and elderly subjects are different or not. Thirteen young-healthy subjects ($24.5{\pm}3.7$ years) and 18 old-aged healthy subjects ($74.5{\pm}7.4$ years) participated in this study. An electrocardiogram (ECG) in the supine posture, at $0^{\circ}$, and in the standing posture, at $70^{\circ}$ of head-up tilt, was recorded. Detrended fluctuation analysis (DFA) and approximate entropy (ApEn), measures of short-/long-term correlation properties and overall complexity of heart rate (HR) respectively, along with spectral components of HR variability (HRV) were analyzed for both the supine and HUT postures. We observed that the short-term fractal exponent ${\alpha}_1$ increased during HUT posture (F(1, 29) = 39.79, P = 0.000), especially, the young subjects showed a significantly higher values compared to the elderly subjects. ApEn significantly decreased (F(1, 29) = 8.61, P = 0.006) during HUT posture. HUT posture decreased the complexity in HR dynamics and increased short-term fractal exponent values in young subjects but not in elderly subjects. These results imply that there are differences of response to HUT on nonlinear properties between young and elderly subjects.

• Journal of The Korean Society of Integrative Medicine
• /
• v.1 no.2
• /
• pp.37-46
• /
• 2013

Purpose : The purpose of the research was to analyze foot pressure, foot temperature, and correlation between foot pressure and foot temperature to grasp impact on foot pressure and body temperature distribution chart depending on functional difference of leg length. Method : After measuring leg length, put 15 students whose functional difference of leg length was over 10mm to difference group and 15 students whose functional difference of leg length was under 5mm to normal group and categorize soles of foot into 6 sections of hallux head, 1st metatarsal head, 2-4 metatarsal head, 5 metatarsal head, lateral heel, and then measure by foot pressure analyzer to analyze characteristic of pressure distribution and classify into front of the lower leg, back of the lower leg, soles of foot and measure by body temperature analyzer to analyze by checking body temperature. Result : Weight difference depending on foot pressure and body temperature was bigger when functional difference of leg length was bigger, and it could be confirmed that foot pressure and body temperature of short leg side were higher than those of short leg side. Thus, if difference exists in leg length, weight load on short leg side increases which results in higher foot pressure and body temperature, therefore enabling an assumption that mechanical problem will occur in short leg. Conclusion : When functional leg length inequality, weight bearing and pressure was getting high as a result, temperature was getting high in short leg.

• PNF and Movement
• /
• v.21 no.1
• /
• pp.47-52
• /
• 2023

Purpose: This study aims to examine the functional difference in the long and short heads of the biceps brachii by investigating the onset time of muscle contractions in the biceps brachii in the supination motion according to whether the flexor of the elbow joint is excluded. Methods: This study was conducted with 21 healthy men aged in their 20s. While performing forearm pronation at an elbow flexion angle of 90 degrees, the onset time of muscle contractions in the long and short heads of the biceps brachii was measured and compared in a posture where the humerus is placed on a table and the posture is lifted against gravity. Using an independent samples t-test, the difference in the onset time of muscle contractions in the long and short heads of the biceps brachii was analyzed. Results: The onset time of the long head was shorter if the flexor activity of the elbow joint was excluded, while that of the short head of the biceps brachii was shorter if it was not excluded. Conclusion: It is noted that the long head of the biceps brachii mainly functions as a supinator muscle, while the short head of the biceps brachii plays a role in stabilizing and maintaining flexion of the elbow joint.

• The Korean Journal of Physiology
• /
• v.30 no.2
• /
• pp.237-247
• /
• 1996

This study was carried out to determine the effect of $-6^{\circ}$ head-down bedrest on the cardiovascular and hormonal responses to orthostasis and to evaluate the mechanism of orthostatic intolerance. Ten healthy young men were changed the body position from $-6^{\circ}$ head-down or supine bedrest for 2 hr to $70^{\circ}$ head-up tilt for 20 min. During the bedrest, there were no differences in hemodynamic and hormonal changes between the head-down and the supine positions. However, the tendency of decreased end-diastolic volume and increased cardiac contractility during the later period of 2 hr showed that the cardiovascular adaptation could be accelerated within a relatively short period in the head-down bedrest. During the head-up tilt, presyncopal signs were developed in five subjects of the supine bedrest, and one of the same subjects of the head-down bedrest. In the tolerant subjects, the increase in cardiac contractility and plasma epinephrine level during the bend-up tilt was greater following the head-down bedrest than that following the supine bedrest to compensate for reduced venous return. The intolerant subjects showed the greater decrease in end-diastolic and stroke volume, and the greater increase in heart rate during the head-up tilt than the tolerant subjects. Cardiac contractility and plasma epinephrine level were remarkably increased. However, arterial pressure was not maintained at the level for the appropriate compensation of the reduced venous return. It seems that the tolerance to orthostasis is more effective after the short-term head-down bedrest than after the supine bedrest, and the secretion of epinephrine induces the higher cardiac performance as a compensatory mechanism fur the reduced venous return during the orthostasis following the head-down bedrest than the supine bedrest.