• Title/Summary/Keyword: ACL

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A Case Report of a Proprioceptive Neuromuscular Facilitation Intervention Strategy Applied with an ICF Tool in a Patient with Anterior Cruciate Ligament Reconstruction (ICF 도구를 적용한 앞십자인대 재건술 환자의 고유수용성신경근촉진법 중재전략의 증례)

  • Song, Myung-Soo;Kim, Beom-Ryong;Kim, Chang-Heon;Noh, Hyun-Jeong;Kang, Mi-Gyeong
    • PNF and Movement
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    • v.15 no.1
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    • pp.1-11
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    • 2017
  • Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

Electromyographic Analysis of Hamstrings and Quadriceps Coactivation During Single-limb-deadlift Exercises according to the Angle of the Knee Joint (무릎관절 각도에 따른 한 다리 데드리프트 운동시 뒤넙다리근과 넙다리네갈래근의 근활성도 비교)

  • Moon, Sang-Jae;Kim, Jeong-Wook;Park, Min-Chull
    • PNF and Movement
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    • v.19 no.1
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    • pp.79-86
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    • 2021
  • Purpose: The purpose of this study was to investigate muscle activity according to knee flexion angle during single-limb-deadlift exercises. Methods: In total, 26 healthy volunteers participated. The single-limb-deadlift consisted of 0˚, 15˚, and 30˚ knee joint bending. The electromyography data were collected from the semitendinosus (SM), the biceps femoris (BF), the rectus femoris (RF), the vastus lateralis (VL), and the vastus medialis (VM). In addition, hamstrings and quadriceps (HQ) ratio was measured during the single-limb-deadlift using electromyography. Results: During the single-limb-deadlift, RF, VL, and VM were significantly higher at 30˚ bending angles compared to muscle activity of 0˚ and 15˚ knee-joint bending. The HQ ratio had significant differences in all three knee joint bending angles. In particular, the single-limb-deadlift carried out to a 30˚ knee-joint bend showed the closest value to 1. Conclusion: The most balanced coactivation ratios were observed during a single-limb-deadlift to a 30˚ knee-joint bend angle. A single-limb-deadlift at a knee-bend angle of less than 30˚ could be used as an exercise to prevent ACL injury. It could also be used for post-injury rehabilitation programs by increasing knee-joint stability.

A Blockchain-enabled Multi-domain DDoS Collaborative Defense Mechanism

  • Huifen Feng;Ying Liu;Xincheng Yan;Na Zhou;Zhihong Jiang
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.17 no.3
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    • pp.916-937
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    • 2023
  • Most of the existing Distributed Denial-of-Service mitigation schemes in Software-Defined Networking are only implemented in the network domain managed by a single controller. In fact, the zombies for attackers to launch large-scale DDoS attacks are actually not in the same network domain. Therefore, abnormal traffic of DDoS attack will affect multiple paths and network domains. A single defense method is difficult to deal with large-scale DDoS attacks. The cooperative defense of multiple domains becomes an important means to effectively solve cross-domain DDoS attacks. We propose an efficient multi-domain DDoS cooperative defense mechanism by integrating blockchain and SDN architecture. It includes attack traceability, inter-domain information sharing and attack mitigation. In order to reduce the length of the marking path and shorten the traceability time, we propose an AS-level packet traceability method called ASPM. We propose an information sharing method across multiple domains based on blockchain and smart contract. It effectively solves the impact of DDoS illegal traffic on multiple domains. According to the traceability results, we designed a DDoS attack mitigation method by replacing the ACL list with the IP address black/gray list. The experimental results show that our ASPM traceability method requires less data packets, high traceability precision and low overhead. And blockchain-based inter-domain sharing scheme has low cost, high scalability and high security. Attack mitigation measures can prevent illegal data flow in a timely and efficient manner.

Anterior Cruciate Ligament Double Bundle Reconstruction with Hamstring Tendon Autografts - Technical Notes (자가 슬괵건을 이용한 전방 십자 인대 이준 다발 재건술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Ahn, Hyung-Kwon;Kang, Hong-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.222-231
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    • 2005
  • Purpose: This article describes a double-bundle ACL reconstruction technique using a five-strand hamstring tendon autograft with conventional anteromedial bundle reconstruction and additional posterolateral bundle reconstruction. Operative technique: For the tibial tunnel, the conventional single tunnel technique is performed and for the femoral tunnel, the double tunnel technique is performed with the anteromedial and posterolateral bundle. After minimal notchplasty, the anteromedial femoral tunnel is prepared with leaving one milimeter of posterior femoral cortex within the over-the-top, which if positioned at the 11-o'clock orientation for the right knee or at the 1-o'clock position for the left knee. The posterolateral femoral tunnel that is located 5 to 7 mm superior to the inner margin of the lateral meniscus anterior horn at $90^{\circ}$ of flexion is prepared with tile outside-in technique using a 4.5 cannulated reamer. The graft material for the double bundle reconstruction is made of the conventional four-strand hamstring autograft in the anteromedial bundle and of a single-strand semitendinosus tendon in the posterolateral bundle. The anteromedial bundle is fixed with using a rigid fix system on the femoral side and the posterolateral bundle is fixed to tie with the miniplate from the outside femur. Then, with the knee in $10^{\circ}\;to\;20^{\circ}$ of flexion, a bioabsorbable screw is simultaneously applied to achieve tibial fixation with tensioning of both bundles. Conclusion: A double bundle reconstruction with five-strand hamstring autograft, which is designed with a favorable conventional anteromedial bundle and an additional posterolateral bundle to restore rotation stability, seems to be a very effective method for the treatment for ACL instabilities.

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Quantitative Analysis of Magnetization Transfer by Phase Sensitive Method in Knee Disorder (무릎 이상에 대한 자화전이 위상감각에 의한 정량분석법)

  • Yoon, Moon-Hyun;Sung, Mi-Sook;Yin, Chang-Sik;Lee, Heung-Kyu;Choe, Bo-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.98-107
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    • 2006
  • Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.

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Comparison of Clinical Results in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft (자가 슬괵건과 동종 전경골건을 이용한 전방 십자 인대 재건술의 임상적 결과 비교)

  • Lee, Hee-Young;Choi, Chul-Jun;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.109-114
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    • 2009
  • Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

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Comparison of Anterior Cruciate Ligament Reconstruction using Autogenous Patellar Tendon versus Quadruple Hamstring Tendon (자가 슬개건과 네 겹 슬괵건을 이용한 전방 십자 인대 재건술의 비교)

  • Kim, Seok-Jung;Kwon, Oh-Soo;Choi, Dong-Won;Song, Ho-Wook;Kang, Hyun-Taek;In, Yong
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.19-25
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    • 2004
  • Purpose: To compare the results of two different autografts used to reconstruct the anterior cruciate ligament(ACL): bone-patellar tendon-bone and quadruple hamstring tendon. Materials and Methods: Forty one cases (20 bone-patellar tendon-bone cases and 21 quadruple hamstring tendon cases) were followed up more than 2 years postoperatively. Patellar tendons were fixed with interference screws and hamstring tendons were fixed with cross pins and intrafix sheaths and screws. Follow-up results were evaluated with KT-2000 arthrometer, International knee Documentation Committee(IKDC) evaluation form and follow up X-ray Donor site morbidity was analysed. Results: Final IKDC) scores more than B grade and side to side differences of manual maximum test using KT-2000 arthrometer showed insignificant differences(p>) between the two groups. Plain radiographs of hamstring group showed marked widening of the femoral and tibial tunnels at postoperative 2 years. Patellar tendon group showed 30% rate of anterior knee complications. Conclusion: ACL reconstruction using autogenous hamstring graft with new fixation method showed comparable clinical results to using autogenous patellar tendon graft with fewer anterior knee symptoms.

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The Effect of Meniscectomy on Clinical Result After ACL Reconstruction (전방십자인대 재건술에서 반월상 연골 절제술의 영향)

  • Cho, Hyung-Jun;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Yoon, Kyoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

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Development of Agent-based Platform for Coordinated Scheduling in Global Supply Chain (글로벌 공급사슬에서 경쟁협력 스케줄링을 위한 에이전트 기반 플랫폼 구축)

  • Lee, Jung-Seung;Choi, Seong-Woo
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.213-226
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    • 2011
  • In global supply chain, the scheduling problems of large products such as ships, airplanes, space shuttles, assembled constructions, and/or automobiles are complicated by nature. New scheduling systems are often developed in order to reduce inherent computational complexity. As a result, a problem can be decomposed into small sub-problems, problems that contain independently small scheduling systems integrating into the initial problem. As one of the authors experienced, DAS (Daewoo Shipbuilding Scheduling System) has adopted a two-layered hierarchical architecture. In the hierarchical architecture, individual scheduling systems composed of a high-level dock scheduler, DAS-ERECT and low-level assembly plant schedulers, DAS-PBS, DAS-3DS, DAS-NPS, and DAS-A7 try to search the best schedules under their own constraints. Moreover, the steep growth of communication technology and logistics enables it to introduce distributed multi-nation production plants by which different parts are produced by designated plants. Therefore vertical and lateral coordination among decomposed scheduling systems is necessary. No standard coordination mechanism of multiple scheduling systems exists, even though there are various scheduling systems existing in the area of scheduling research. Previous research regarding the coordination mechanism has mainly focused on external conversation without capacity model. Prior research has heavily focuses on agent-based coordination in the area of agent research. Yet, no scheduling domain has been developed. Previous research regarding the agent-based scheduling has paid its ample attention to internal coordination of scheduling process, a process that has not been efficient. In this study, we suggest a general framework for agent-based coordination of multiple scheduling systems in global supply chain. The purpose of this study was to design a standard coordination mechanism. To do so, we first define an individual scheduling agent responsible for their own plants and a meta-level coordination agent involved with each individual scheduling agent. We then suggest variables and values describing the individual scheduling agent and meta-level coordination agent. These variables and values are represented by Backus-Naur Form. Second, we suggest scheduling agent communication protocols for each scheduling agent topology classified into the system architectures, existence or nonexistence of coordinator, and directions of coordination. If there was a coordinating agent, an individual scheduling agent could communicate with another individual agent indirectly through the coordinator. On the other hand, if there was not any coordinating agent existing, an individual scheduling agent should communicate with another individual agent directly. To apply agent communication language specifically to the scheduling coordination domain, we had to additionally define an inner language, a language that suitably expresses scheduling coordination. A scheduling agent communication language is devised for the communication among agents independent of domain. We adopt three message layers which are ACL layer, scheduling coordination layer, and industry-specific layer. The ACL layer is a domain independent outer language layer. The scheduling coordination layer has terms necessary for scheduling coordination. The industry-specific layer expresses the industry specification. Third, in order to improve the efficiency of communication among scheduling agents and avoid possible infinite loops, we suggest a look-ahead load balancing model which supports to monitor participating agents and to analyze the status of the agents. To build the look-ahead load balancing model, the status of participating agents should be monitored. Most of all, the amount of sharing information should be considered. If complete information is collected, updating and maintenance cost of sharing information will be increasing although the frequency of communication will be decreasing. Therefore the level of detail and updating period of sharing information should be decided contingently. By means of this standard coordination mechanism, we can easily model coordination processes of multiple scheduling systems into supply chain. Finally, we apply this mechanism to shipbuilding domain and develop a prototype system which consists of a dock-scheduling agent, four assembly- plant-scheduling agents, and a meta-level coordination agent. A series of experiments using the real world data are used to empirically examine this mechanism. The results of this study show that the effect of agent-based platform on coordinated scheduling is evident in terms of the number of tardy jobs, tardiness, and makespan.

The Incidence and the Patterns of Associated Injuries of Anterior Cruciate Ligament Tear (전방십자인대 파열 시 동반 손상의 빈도 및 양상)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Eo, Jae-Hyoung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.24-31
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    • 2008
  • Purpose: We purposed to analyze the incidence and the patterns of the injuries associated with anterior cruciate ligament(ACL) tears. Materials and Methods: We retrospectively reviewed 547 knees that had undergone ACL reconstructions and compared the associated injuries according to the time of injury(acute vs. chronic), the cause of injury(sports vs. non-sports) and the type of sports. Results: Medial collateral ligament(MCL) injury and bone contusion were more in acute injury group less than 3 months after trauma(p=0.001, 0.019) and the injuries of medial or lateral meniscus were more in chronic injury group more than 3 months after trauma(p=0.014, 0.029). The trochlea in acute injury group(p=0.027) and the medial femoral condyle in chronic injury group(p=0.011) had higher incidence of chondral injury. Grade I, II chondral injury was frequent in acute injury group(p=0.016) and grade III, IV chondral injury was frequent in chronic injury group(p=0.017). Lateral meniscus injury was frequent in sports injury group(P=0.035). Medial collateral ligament injury was frequent in ski(P=0.005), and chondral injury was in gymnastics(P=0.017). Conclusions: The incidences of medial and lateral meniscus tears and grade III, IV chondral defects were high in chronic injury group. According to the causes of the tears and the types of sports, some differences in the incidence and pattern of associated injuries were found.

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