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Morphological and Biomechanical Study of the Pulley System of the Thumb

  • Kim, Ji-Won
    • Physical Therapy Korea
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    • v.12 no.4
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    • pp.33-40
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    • 2005
  • The purpose of this study was to define more precisely the anatomy of the thumb flexor pulley system and to determine the relative contribution of each of the pulleys to the biomechanics of thumb motion at the metacarpophalangeal (MP) and interphalangeal (IP) joints. For this, 22 hands from 11 cadavers were used and randomly assigned to two groups. In the first group, the first annular (A1) pulley was cut first followed by the variable annular (Av) pulley and then the oblique pulley. In the second group, the oblique pulley was cut first followed by the, pulley and then the Av pulley. In 7 of 22 hands, it was a transverse structure parallel to the, pulley with a gap between the A1 and Av pulleys, referred to here as type I. In 9 hands, the A1 and Av pulleys were connected without any gap (type II). In 6 hands, the space between the A1 and Av pulleys were triangular in shape with fibers of the Av pulley converging toward the radial side (type III). In biomechanical study of both first and second experiments, there was no significant difference in MCP joint flexion between the all intact, A1 section, A1/Av section, A2 intact (A1/Av/oblique section), and no pulley configuration (p>.05). In occurring displacements less than 10 mm, there was no significant difference in IP joint flexion (p>.05). However, there was a significant decrease in IP joint flexion occurred in both 15 mm and 20 mm excursion (p<.05), when the oblique pulley was resected additionally after cutting the A1 and Av pulleys in first experiment, and when the A1 pulley was resected additionally after cutting the oblique pulley. According to the results, the injury of only the oblique pulley does not decrease thumb motion significantly. The oblique pulley injury with both the A1 and Av pulleys laceration decreased thumb motion significantly. The additional laceration of the A2 pulley does not decrease thumb motion.

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MICRODONTIA IN A CHILD TREATED WITH CHEMOTHERAPEUTIC AGENT (항암 화학치료를 받은 아동의 치아발육이상 : 증례 보고)

  • Kye, Hi-Ran;Lee, Jae-Ho;Kim, Seong-Oh;Sohn, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.146-150
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    • 1999
  • With the improved cure rates for childhood malignant conditions in the past decade, late effects of cancer therapy must be recognized to minimize their impact on the quality of life in long-term survivors. Chemoradiation therapy is a major part of pediatric oncology treatment and is implicated in causing tooth agenesis, microdontia, root shortening, early apical closure, and coronal hypocalcification. Dental development may be affected by illness, trauma, chemotherapy, or radiation therapy at any point prior to complete maturation. Treatment given during the first 3.5 years of life was more likely to affect the dental lamina and crown formation and result in a small tooth. Dental treatment affected by chemoradiation damage to developing teeth includes orthodontic tooth movement, prosthetic abutment consideration, periodontal health, space maintenance, requirement for home fluoride regimens to protect hypomineralized teeth, and enodontic procedures. Dental abnormalities are common in patients treated for cancer, and these children require aggressive dental follow-up. Meticulous surveillance may facilitate detection of abnormalities, enabling the dental practitioner to intervene earlier in promoting a more aggressive regimen of oral care, thus reducing the morbidity associated with dental sequelae of oncotherapy, specifically periodontal disease and malocclusion. In this case, we report microdontia of all permanent second premolar and second molar in an 8 year old boy treated with chemotherapeutic agents during period of active dental development(14 months to 38 months of age).

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Effects of Electrical Stimulation on Normal Soleus Muscle in Rat (전기자극이 흰쥐의 정상 가자미근 형태에 미치는 영향)

  • Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.6 no.1
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    • pp.61-74
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    • 1994
  • This study was carried out to determine effects of electrical stimulation on the soleus, target muscle of the sciatic newt, of white rat normal muscles. The biometric, histochemical, ultrastructural observations were made. The following results were obtained. A daily electrical stimulation of the skeletal muscle of the normally-functioning rat caused an increase of girth and weight of the muscle fibers for 2 weeks. No noticeable change was observed afterwards. More specifically, the density of volume of the red muscle fiber increased. whereas the density of the white muscle fiber decreased. The electrical stimulation group(experimental group) showed hypertrophy of the muscle fibers and narrowing of the space between perimysium and endomysium. Normally, glycogen granules are accumulated regardless of classification of muscle fibers. In addition, the NADH-TR reaction results were in agreement with the biometric findings, in that the red muscle fibers significantly increased. The ultrastructural observations revealed that mitochondria was formed in the red muscle fiber parallel to the muscle fibers of normal muscle, while mitochondria was observed in the sarcomere region of the white muscle fiber. However, activation of mitochondria took place in the sarcolemma region of the muscle fiber, and generation of mitochondria was observed in the sarcomere region of the white muscle fiber.

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The Relationship of the L-type $Ca^{2+}$ Channel on the Depolarization-and Depletion of SR $Ca^{2+}$ -induced Smooth Muscle Contraction and Intracellular $Ca^{2+}$ Mobilization (탈분극과 근장그물 내 $Ca^{2+}$ 고갈-유도 평활근의 수축 및 세포 내 $Ca^{2+}$ 변동에 관여하는 L-형 $Ca^{2+}$ 통로의 상관성)

  • Kim, Jung-Hwan
    • The Journal of Korean Physical Therapy
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    • v.19 no.5
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    • pp.65-76
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    • 2007
  • Purpose: It is generally accepted that smooth muscle contraction is triggered by intracellular $Ca^{2+}$ ($[Ca^{2+}]_i$) released from intracellular $Ca^{2+}$ stores such as sarcoplasmic teticulum (SR) and from the extracellular space. The increased $[Ca^{2+}]^i$ can phosphorylate the 20,000 dalton myosin light chain $(MLC_{20})$ by activating MLC kinase (MLCK), and this initiates smooth muscle contraction. In addition to the $[Ca^{2+}]_i$MACK-tension pathway, a number of intracellular signal molecules, including mitogen-activated protein kinase (MAPK), protein kinase C (PKC) and others, play important roles in the regulation of smooth muscle contraction. However, the mechanisms regulating contraction of depletion of SR $Ca^{2+}$ in mouse gastric smooth muscle strips is not still clear. Methods: To investigate the rotes of $Ca^{2+}$ influx and SR $Ca^{2+}$ release channel on gastric motility, isometric contraction and $[Ca^{2+}]_i$ were examined in mouse gastric smooth muscle strips. Results: High KCl, ryanodine, an activator of $Ca^{2+-}$induced $Ca^{2+}$ release channel, and cyclopiazonic acid (CPA), an inhibitor of SR $Ca^{2+-}$ATPase evoked a sustained increase in muscle contraction and $[Ca^{2+}]_i$. These increases induced by high KCl, ryanodine, and CPA were partially blocked by application of verapamil ($10{\mu}M$), a L-type $Ca^{2+}$ channel inhibitor. Additionally, in $Ca^{2+-}$free solution (1 mM EGTA), ryanodine and CPA had no effect contraction and $[Ca^{2+}]_i$ in fundic muscle strips. Conclusion: These results that extracellular $Ca^{2+}$ influx and depletion of SR trigger $Ca^{2+}$ influx through verapamil-sensitive $Ca^{2+}$ channel, and extracellular and SR $Ca^{2+}$ store may functionally involve in the subcellular $Ca^{2+}$ mobilization in mouse gastric muscle.

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Motor Function Recovery after Adipose Tissue Derived Mesenchymal Stem Cell Therapy in Rats with Cerebral Infarction

  • Kim, Chang-Hwan;Kim, Yang-Woon;Jang, Sung-Ho;Chang, Chul-Hoon;Jung, Jae-Ho;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.267-272
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    • 2006
  • Objective : There have been recent reports that mesenchymal stromal cells that are harvested from adipose tissue are able to differentiate into neurons. In the present study, we administered adipose tissue derived stem cells in rats with cerebral infarction in order to determine whether those stem cells could enhance the recovery of motor function. Methods : Cerebral infarction was induced by intraluminal occlusion of middle cerebral artery in rats. The adipose tissue-derived mesenchymal stem cells were harvested from inguinal fat pad and proliferated for 2 weeks in DMEM media. Approximately $1{\times}10^6$ cells were injected intravenously or into subdural space of the peri-lesional area. The rotor rod test was performed at preoperative state[before MCA occlusion], and 1, 2, 3, 4, 6, 8 and 10 weeks after the cell therapy. Results : The motor functions that were assessed by rotor rod test at 1 week of the cell therapy were nearly zero among the experimental groups. However, there was apparent motor function recovery after 2 weeks and 4 weeks of cell injection in intravenously treated rats and peri-lesionaly treated rats, respectively, while there was no significant improvement till 8 weeks in vehicle treated rats. Conclusion : These results demonstrate that the adipose derived stem cell treatment improves motor function recovery in rats with cerebral infarction.

Comparing the Immediate Effectiveness of Lumbar Flexion and Extension Exercise With Regards to Pain, Range of Motion, Pelvic Tilt, and Functional Gait Ability in Patients With Lumbar Spinal Stenosis

  • Do, Hyun-ho;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.26 no.4
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    • pp.10-19
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    • 2019
  • Background: In patients with lumbar spinal stenosis (LSS), lumbar flexion exercise (LFE) is considered a standard therapeutic exercise that widens the space between the spinal canal and intervertebral foramen. However, some researchers have reported that lumbar extension exercise (LEE) may improve lumbar pain and functional ability in patients with LSS. Although exercise intervention methods for patients with LSS have been widely applied in clinical settings, few studies have conducted comparative analysis of these exercise methods. Objects: This study aimed to compare the effects of LFE, LEE, and lumbar flexion combined with lumbar flexion-extension exercise (LFEE) on pain, range of motion (ROM), pelvic tilt angle, and functional gait ability in patients with LSS. Methods: A total of 30 patients with LSS, LFE (n1=10), LEE (n2=10), and LFEE (n3=10) were assigned to each of the three exercise groups. The numerical pain rating scale (NPRS), modified-modified schober test (MMST)-flexion, MMST-extension, pelvic tilt inclinometer, and 6-minute walking test (6MWT) were measured. Results: After the intervention, statistically significant differences were observed in the NPRS (p=.043), MMST-flexion (p<.001), MMST-extension (p<.001), and 6MWT (p=.005) between groups. According to the post hoc test, the NPRS was statistically significant difference between the LFEE and LEE groups (p=.034). The MMST-flexion was statistically significantly different between the LFE and LEE (p=.000), LFE and LFEE (p=.001), and LEE and LFEE (p=.001) groups. The MMST-extension was statistically significantly different between the LFE and LEE (p<.001), LFE and LFEE (p=.002), and LEE and LFEE (p=.008) groups. The 6MWT was statistically significantly different between the LFE and LFEE (p=.042) and the LEE and LFEE (p=.004) groups. Conclusion: This study suggested that LFEE was the most effective exercise for pain and functional gait ability in patients with LSS, LFE was the most effective exercise for lumbar flexion ROM, and LEE was the most effective exercise for lumbar extension ROM.

A case study on the application of new hand splint using 3D printing (3D 프린팅을 사용해 제작한 새로운 손 보조기 적용 사례연구)

  • Shin, Su-Jung;Ahn, Cho-Keun;Park, Kyoung-Young
    • Journal of Convergence for Information Technology
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    • v.7 no.2
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    • pp.25-29
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    • 2017
  • The purpose of this study was to investigate the effect of a new designed splint on the hand function. A new design splint that enlarges the area between thumb and index finger was manufactured using 3D printing. After wearing a new splint the patient was possible to open thumb and hold a small object. She showed improvement in overall hand function and could move eight blocks in box and block test. But grasping a cup without a handle has become more difficult than before. Also there is a disadvantage that it could not be fixed by water. This study is meaningful in that it is the first splint application study using 3D printing. In the future, we expect that various patient-specific splints will be developed through 3D printing in the field of occupational therapy.

Effect of Proprioceptive Neuromuscular Facilitation Chopping Pattern on Neglect, Balance, and Activity of Daily Living of Stroke Patients with Hemi-Spatial Neglect: A randomized clinical trial (고유수용성신경근촉진법 내려치기 패턴 훈련이 편측무시가 있는 뇌졸중 환자의 편측무시, 균형능력 및 일상생활수행능력에 미치는 영향: 무작위 임상 시험)

  • Kang, Tae-Woo;Kim, Beom-Ryong
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.2
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    • pp.107-115
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    • 2019
  • PURPOSE: This study examined the effects of the chopping pattern of proprioceptive neuromuscular facilitation (PNF) on the neglect, balance ability, and activities of daily living in stroke patients with hemi-spatial neglect. METHODS: Twenty stroke patients with neglect volunteered for this study. The subjects were assigned randomly to either the experimental group (EG, n=10) or control group (CG, n=10). The chopping pattern of PNF and exercise therapy were applied in the EG and CG, respectively, for four weeks. Neglect, balance, and activities of daily living were evaluated at the pre-and post-intervention. The assessment tools included a line-bisection test, balance test using Space balance 3D, and modified Barthel index. The pre-and post-intervention values were compared in each group using a paired t-test and the between-group differences were assessed using an independent t-test. Statistical significance was set to ${\alpha}=.05$ for all variables. RESULTS: Significant differences were observed between the EG and CG in terms of neglect, balance, and activities of daily living (p<.05). Both groups showed significant improvement in neglect, balance, and activities of daily living (p<.05). CONCLUSION: These results suggest that the chopping pattern of PNF is effective in improving the hemi-spatial neglect, balance, and activities of daily living in stroke patients with neglect.

In Vivo Enhanced Indocyanine Green-Photothermal Therapy for a Subconjunctival Tumor

  • Kim, Chang Zoo;Lee, Sang Joon;Hwang, Sang Seok;Chae, Yu-Gyeong;Kwon, Daa Young;Ko, Taek Yong;Kim, Jun Hyeong;Jung, Min Jung;Masanganise, Rangarirai;Oak, Chulho;Ahn, Yeh-Chan
    • Current Optics and Photonics
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    • v.5 no.3
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    • pp.311-321
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    • 2021
  • Indocyanine green (ICG) is a dye approved for use in clinical diagnostics. ICG remains in the intravascular space following intravenous administration, due to its ability to rapidly bind to the plasma proteins, and its therapeutic potential has been studied in well-vascularized cutaneous tumors. Here we have evaluated the clinical response of a subconjunctival tumor to photothermal therapy (PTT) using an ICG-enhanced near-infrared diode laser and its adverse effects, in a rabbit. 22 male New Zealand white rabbits with subconjunctival tumors were enrolled (control group 6, laser-only group 8, laser-with-ICG group 8). Rabbits in the laser-with-ICG group received ICG (twice, 2 mg/kg each time, intravenously) directly followed by irradiation with a diode laser (λ = 810 nm). Rabbits in the laser-only group were irradiated with the diode laser. ICG angiography, ultrasonography, and pathologic examination were performed to evaluate PTT response at specific time points (0, 2, and 4 weeks after PTT). Two weeks after initial treatment, the eight rabbits treated by laser with ICG showed a 100% response rate. There was no clinical response in both laser-only and control groups. ICG-PTT is a potential and effective palliative therapeutic modality for subconjunctival tumors.

Effect of Home Activity Support Program on Daily Living Performance Skills in Children with Cerebral Palsy and their Parents

  • Ko, Seok-Ho;Kim, Jae-Eun;Koo, Jung-Wan
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.24-31
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    • 2022
  • Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.