Botero, Santiago Salazar;Diaz, Juan Jose Hidalgo;Benaida, Anissa;Collon, Sylvie;Facca, Sybille;Liverneaux, Philippe Andre
Archives of Plastic Surgery
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v.43
no.2
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pp.134-144
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2016
In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning.
In this paper, the activities carried out within the EU funded Clean Sky Joint Technology Initiative (JTI GRA) Project and aimed at developing a morphing flap, are illustrated. The reference device is a regional aircraft single slotted flap, enhanced with deforming capabilities to obtain improved hyper-lift performance. The design started with the identification of the internal architecture, intended to allow camber variations. A concentrated-hinge architecture was selected, for its ability to fit different curvatures and for the possibility of easily realizing an "armadillo-like" configuration, then avoiding the use of a complicate deformable skin. The flap layout is made of segmented ribs, elastically hinged each other and span-wise connected by conventional spars. Relative rotations of the rib elements are forced by SMA structural actuators, i.e., cooperating in the external loads absorption. Super-elastic SMA are used to make up recovery elastic elements, necessary to regain the original shape after activation. These further elements in turn contribute to the overall flap rigidity. After assessing the hinge number and the size of the SMA active and passive elements, the advanced design phase was dealt with. It was aimed at solving manufacturing issues and producing the executive drawings. The realized demonstrator was finally tested in lab conditions to prove its functionality in terms of whether target shape actuation or attained shape preservation under loads. On the basis of the numerical results and the experimental outcomes, precious hints were obtained for further developments of the concept.
This study applies Policy Streams and Expert Group Standing Change Framework (PSECF) proposed by SangJung Park and Chan KOH to analyze the Roh's Participatory government's decision making process on the wartime Operational Control (OPCON) transition. PSECF case study's results are as follows: Strong commitments of the former president Roh Moohyun and the progressive National Security Committee (NSC) were primary drivers in the policy developing process. But military expert groups such as the Ministry of National Defense (MND) and the Joint Chiefs of Staffs (JCS) were thoroughly excluded due to their passive role against the wartime OPCON transition. After the policy resolution, the standing of expert groups changed: the standing of advocate effects, the former progressive NSC who led the wartime OPCON transition in the Roh's Participatory government, went down but the conservatives such as ROK MND and JCS improve their standing because the conservative government kicks off 8 months later from the policy decision. In conclusion, the proposed PSECF through the Roh's Participatory government's case-study is worthy as an explanatory framework for high level national policies.
The purposes of this study were to find correlations among Fugl-Meyer Assessment scale, gait speed, and Timed Up & Go test (TUG) and to predict gait ability from subscales of Fugl-Meyer Assessment scale. The study population consisted of 30 stroke patients referred to the Department of Rehabilitation Medicine in the Bundang Jaesang General Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and gait speed (m/s), TUG (s). The data were analyzed using independent t-test, Pearson product moment correlation analysis and stepwise multiple regression. The results revealed that all items of Fugl-Meyer Assessment scale, except passive joint range of motion were significantly correlated with gait speed and TUG. In particular, sensation score, lower extremity motor and coordination score have a significant correlation with gait speed and TUG (p<.05). The sensation score and lower extremity motor score were important factors in comfortable gait and maximal gait speed. Their power of explanation regarding comfortable gait and maximal gait speed were 63.0% and 65.0%, respectively. The sensation score and lower extremity coordination score were important factors in TUG. Their power of explanation regarding TUG was 55.0%. These results showed that Fugl-Meyer Assessment scale is significantly correlated with gait speed and TUG. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict gait ability of patients with stroke. Further study about gait speed and TUG by change of Fugl-Meyer Assessment score is needed using a longitudinal study design.
Seo Joong-Bae;Choi Eui-Seong;Won Choong-Hee;Kim Yong-Min;Lee Ho-Seung;Kim Eung-Rok
Clinics in Shoulder and Elbow
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v.1
no.2
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pp.186-192
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1998
This study was performed to evaluate the influences of the passive glenohumeral rotation on the scapulothoracic motion. We took anteroposterior radiograms of the right shoulders including the thoracic vertebrae with supine position in 10 normal male adults, at 0 degree abduction, 45 degrees abduction and 90 degrees abduction in scapular plane and in neutral rotation, maximal internal rotation and maximal external rotation in each abduction view. The scapulothoracic motion was measured as the distances between the vertical line drawn from the spinous process of the 7th cervical vertebra and the inferior and superior angles of the right scapula respectively. At 0 degree abduction, the distances were not changed in internal rotation relative to neutral rotation, but decreased significantly in external rotation, that is, the scapula shifts medially on external rotation. At 45 degrees abduction, the distances were increased significantly only in internal rotation, that is, the scapula shifts laterally on internal rotation. At 90 degrees abduction, the scapula rotated laterally on internal rotation and medially on external rotation. In conclusion, when a physician examines the rotation of the shoulder joint, he cannot exclude the scapulothoracic motion just by examining the patient with supine position. And we concluded that the rotatory movement of the shoulder is not solely contributed to the glenohumeral motion.
Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.
This study was to investigate diagnosis of shoulder pain on cerebrovascular attack patients and treatment effects by using physical treatment and orienatal diagnosis aparatus, as oriental diagnosis equipments, these were used thermography, maegzin and yangdorag machine. as physical treatment equipments, these were used Hot pack, TENS (Transcutaneous electrical nerve stimulation), ICT(Interferential current therapy) the results were followed 1. In Sex and Age distribution on cerebrovascular attack patients with shoulder pain, male(51.7%)had many than female(48.3%) and 60s were the top, next 70s 50s 40s. 2. In the reason of cerebrovascular attack and the type of motor paresis, cerebrovascular infarction(73.3%) had many than hemorrhage(26.7%) 3. In hospitalizied period of cerebrovascular attack patients with shoulder pain, the period from 11 to 60 days had almost occupied. 4. Oriental medical diagnositic propriety of shoulder pain by using maegzin and yangdorag machine were not recognized. 5. In measuring passive range of motion of pre and post treatment, improvement effect on Hot pack was not showed, but effects on TENS, ICT were showed. 6. In measuring temperature of painful shouler joint of pre and post treatment by using thermography, the effect of Hot pack was not recognized but the effects of TENS, ICT were recognized.
Ding, Yi;Cao, Yaqin;Duffy, Vincent G.;Zhang, Xuefeng
Safety and Health at Work
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v.11
no.2
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pp.207-214
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2020
Background: Prolonged sitting at work can lead to adverse health outcomes. The health risk of office workers is an increasing concern for the society and industry, with prolonged sitting work becoming more prevalent. Objective: This study aimed to explore the variation in muscle activities during prolonged sitting work and found out when and how to take a break to mitigate the risk of muscle symptoms. Methods: A preliminary survey was conducted to find out the prevalence of muscle discomfort in sedentary work. Firstly, a 2-h sedentary computer work was designed based on the preliminary study to investigate the variation in muscle activities. Twenty-four participants took part in the electromyography (EMG) measurement study. The EMG variations in the trapezius muscle and latissimus dorsi were investigated. Then the intervention time was determined based on the EMG measurement study. Secondly, 48 participants were divided into six groups to compare the effectiveness of every break type (passive break, active break of changing their posture, and stand and stretch their body with 5 or 10 mins). Finally, data consisting of EMG amplitudes and spectra and subjective assessment of discomfort were analyzed. Results: In the EMG experiment, results from the joint analysis of the spectral and amplitude method showed muscle fatigue after about 40 mins of sedentary work. In the intervention experiment, the results showed that standing and stretching for 5 mins was the most effective break type, and this type of break could keep the muscles' state at a recovery level for about 30-45 mins. Conclusions: This study offers the possibility of being applied to office workers and provides preliminary data support and theoretical exploration for a follow-up early muscle fatigue detection system.
Reduction of fishing grounds, which was caused by the recent fisheries agreements between Korea, Japan, and China, Is Increasing the important of coastal fisheries. Korea's coastal fisheries, however, need special management measures owing to the following problems. First, there are too many fishing fleets even though fisheries resources are continuously decreasing. Despite the fact that some of the fishing vessels have been scrapped, there still remain too many vessels and especially approximately 27,000 vessels increased during 1997-1998. Second, as the condition of fisheries resources changed radically, many fishermen are fishing by methods which they were not permitted to. These fishing methods cannot be legally supported and so there is a huge gap between the system and the reality, Third, two or three licenses are given to each coastal fishing vessel because a single license cannot give sufficient income, but some of these are formally acquired. So under such circumstances, efficient management of fisheries is impossible. Fourth, absence of demarcation among regions and industries is causing frequent conflicts and there are concerns about the decreasing fisheries resources due to competitive fishing practices. Therefore, considering the above mentioned problems Korea's coastal fisheries management should be developed as the following: First, new licenses should be limited while expanding the buy-back program. The government is currently planning to limit new licenses by introducing the fixed license number system in coastal fisheries but is somewhat passive about the buy-back program. Second, fisheries management which is based on self-regulation should be established. In order to increase the effect of fisheries management, the fishermen should decide by themselves the fish and fishing methods they would be exploiting and directly regulate them. Third, it is necessary to integrate the licenses of coastal fisheries. Since coastal fisheries management through the license system has distinct limitations, it is preferable to unify risking licenses and let the fishermen decide specific matters on their own. Finally, it is necessary to establish boundaries among the regions and industries. Joint fishing areas among regions(cities and provinces) should be established and fishing in other areas should be permitted on condition of paying the required fees. On the other hand, it is also necessary to permit coastal fishing only within certain distances.
Objective: The purpose of this research was to use data for furnish quality physical therapy service. The research subjects were admitted shoulder pain patients treated with physical therapy that was to grasp physical therapy method as distinguishing application time. Subject: Total number of distributed questionnaire was 563 persons that was to utilized physical therapy room of 56th medical institution and distributed it to each physical therapist in charge. Method: The research used questionnaire in order to research itemized treatment application time that is according to physical therapy method to applicated with shoulder pain patient. The research contents is to received shoulder pain diagnosis period, total duration of utilizing physical therapy room, the number of times per week to used physical therapy room, etc. And we had physical therapist recording the time of application physical therapy method come under the items. Result: The average treatment time was 59.2 minutes at all patients. During this time, 39.7 min was modality treatment. Active movement treatment was only 7.1 min. Total treatment time was longest in general hospital at 64.9 min, it was shortest in clinical hospital at 53.3 min. Treatment time was difference as hospital scale(p<0.001). Active movement treatment time was longest in general hospital at 11.5 min. The average treatment time was 4.5 min in clinical hospital. Therefore, it was related to hospital scale(p<0.05). The average of manual therapy time by physical therapist was 7.5 min. General hospital was linger at 8.6 min than clinical hospital at 6.7 min(p<0.05). Patient of 90.2 % were treated to hot pack, ultra-sound treatment was next as 50.1%. Active strengthening exercise was most carrying out of the active treatment as 25.4 %. Active sensorimotor exercise was practiced only 28 persons of 5.0 %. Most joint mobilization (38.4 %) was used of the passive manual therapy items, next to soft tissue mobilization (33.0 %), and next to manual distraction therapy(14.0 %).
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