• Title/Summary/Keyword: LOWER LIMB

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Development of Three-Dimensional Contact Model of Human Knee Joint During Locomotion (보행 중 인체 슬관절의 3차원 접촉 모델 개발)

  • Kim, Hyo-Shin;Park, Seong-Jin;Mun, Joung-Hwan
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.11 s.176
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    • pp.182-189
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    • 2005
  • The human knee joint is the intermediate joint of the lower limb that is the largest and most complex joint in the body. Understanding of joint-articulating surface motion is essential for the joint wear, stability, mobility, degeneration, determination of proper diagnosis and so on. However, many studies analyzed the passive motion of the lower limb because of the skin marker artefact and some studies described medial and lateral condyle of a femur as a simple sphere due to the complexity of geometry. Thus, in this paper, we constructed a three-dimensional geometric model of the human knee from the geometry of its anatomical structures using non-uniform B-spline surface fitting as a study for the kinematic analysis of more realistic human knee model. In addition, we developed and verified 6-DOF contact model of the human knee joint using $C^2$ continuous surface of the inferior region of a femur, considering the relative motion of shank to thigh during locomotion.

A case of a missense DYNC1H1 mutation causing spinal muscular atrophy with lower limb predominance concurrent with germ cell tumor

  • Myung Ah Lee;Myungshin Kim;Jung Hwan Lee
    • Annals of Clinical Neurophysiology
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    • v.26 no.1
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    • pp.26-29
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    • 2024
  • We report a patient diagnosed with a germ-cell tumor presenting with spinal muscular atrophy with lower limb predominance (SMA-LED) caused by a DYNC1H1 genetic variant. His clinical and electrophysiologic phenotype was compatible with SMA-LED. We identified a heterozygous missense variant (c.1793G>T) of DYNC1H1. This report expands the clinical spectrum of DYNC1H1-related disorders, and reinforces the importance of DYNC1H1 in both central and peripheral neuronal functions. We suggest that germ-cell tumors should be considered as a possible phenotype of DYNC1H1-related disorders.

Optimization of Tube Voltage according to Patient's Body Type during Limb examination in Digital X-ray Equipment (디지털 엑스선 장비의 사지 검사 시 환자 체형에 따른 관전압 최적화)

  • Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.379-385
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    • 2017
  • This study identifies the optimal tube voltages depending on the changes in the patient's body type for limb tests using a digital radiography (DR) system. For the upper-limp test, the dose area product (DAP) was fixed at $5.06dGy{\ast} cm^2$, and for the lower-limb test, the DAP was fixed at $5.04dGy{\ast} cm^2$. Afterwards, the tube voltage was changed to four different stages and the images were taken three times at each stage. The thickness of the limbs was increased by 10 mm to 30 mm to change in the patient's body type. For a quantitative evaluation, Image J was used to calculate the contrast to noise ratio (CNR) and signal to noise ratio (SNR) among the four groups, according to the tube voltage. For statistical testing, the statistically significant differences were analyzed through the Kruskal-Wallis test at a 95% confidence level. For the qualitative analysis of the images, the pre-determined items were evaluated based on a 5-point Likert scale. In both upper-limb and lower-limb tests, the more the tube voltage increased, the more the CNR and SNR of the images decreased. The test on the changes depending on the patient's body shape showed that the more the thickness increased, the more the CNR and SNR decreased. In the qualitative evaluation on the upper limbs, the more the tube voltage increased, the more score increased to 4.6 at the maximum of 55kV and 3.6 at 40kV, respectively. The mean score for the lower limbs was 4.4, regardless of the tube voltage. The more either the upper or lower limbs got thicker, the more the score generally decreased. The score of the upper limps sharply dropped at 40kV, whereas that of the lower limps sharply dropped at 50kV. For patients with a standard thickness, the optimized images can be obtained when taken at 45kV for the upper limbs, and at 50kV for the lower limbs. However, when the thickness of the patient's limbs increases, it is best to set the tube voltage at 50 kV for the upper limbs and at 55 kV for the lower limbs.

The Quality of Life after Lymphaticovenous Anastomosis in 118 Lower Limb Lymphedema Patients

  • Jin Geun Kwon;Yeongsong Kim;Min Young Jang;Hyunsuk Peter Suh;Changsik John Pak;Vaughan Keeley;Jae Yong Jeon;Joon Pio Hong
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.514-522
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    • 2023
  • Background This is a prospective study on 118 patients who underwent lymphaticovenous anastomosis (LVA) due to secondary lower limb lymphedema between January 2018 and October 2020 to evaluate patients' quality of life (QOL) using the Quality of Life Measure for Limb Lymphedema (LYMQoL) questionnaire. Methods The outcome measurement included the LYMQoL leg scoring system tool evaluating the function, appearance, symptom, mood, and overall outcome. In addition, correlation analysis was performed for three factors: based on International Society of Lymphology (ISL) stages, disease duration, and amount of volume reduction. Results The LYMQoL tool overall satisfaction score significantly increased at all intervals from 4.4 ± 0.2 preoperative to 6.5 ± 0.3 postoperative at 12 months (p < 0.001). Significant findings were seen for each domain scores compared preoperatively and at 12 months: function score (18.6 ± 0.5 to 15.4 ± 0.6), appearance score (17.8 ± 0.5 to 16.0 ± 0.6), symptom score (11.8 ± 0.3 to 8.9 ± 0.4), and mood score (14.5 ± 0.4 to 11.4 ± 0.5; p < 0.05). The correlation analysis between improvement of the overall score and the ISL stage (p = 0.610, correlation coefficient [r] = -0.047), disease duration (p = 0.659, r = -0.041), and amount of limb volume reduction (p = 0.454, r = -0.070) showed no statistical significance. Conclusion The QOL of secondary lower limb lymphedema patients was significantly improved after LVA regardless of the severity of disease, duration of disease, and amount of volume reduction after LVA. Understanding the patient-reported outcome measurement will help the surgeons to manage and guide the expectations of the patients.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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Study on Efficacy of Gait Training for Hemiplegia Patients Using Lower-Limb Wearable Robot (착용형 하지 로봇을 이용한 편마비 보행 재활 훈련 효과에 관한 연구)

  • Ji, Younghoon;Yun, Deokwon;Jang, Hyeyoun;Lee, Dongbock;Khan, Abdul Manan;Kim, Sol;Kim, Mijung;Han, Jungsoo;Han, Changsoo
    • Journal of the Korean Society for Precision Engineering
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    • v.32 no.10
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    • pp.879-883
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    • 2015
  • Conventional gait rehabilitation requires at least three therapists in a traditional rehabilitation training program. Several robots have been developed to reduce human burden and increase rehabilitation efficacy. In this study, we present a lower-limb wearable robot (WA-H) for gait rehabilitation of hemiplegia patients, and propose a protocol of 12 weeks gait rehabilitation training program using WA-H. To identify the efficacy of the robot and protocols, we conducted a clinical study with two actual hemiplegia patients and observed a chronological change of ambulation ability through four assessments. We discovered the progression of results by 6 minute walking test, TUGT (Timed Up and Go Test), SPPB (Short Physical Performance Battery), BBS (Berg Balance Test), and Fugl-Meyer score. The torques generated in the normal side and paralyzed side of the patient became similar, indicating rehabilitation. The result also showed the walking of the paralysis patient improved and imbalance motion had considerable improved performance.

A Study on the Slacks Pattern Making according to the Movement-Fitness [Part II] -On the Hip Region- (동작적합성에 따른 Slacks Pattern 설계에 관한 연구[Part II] -엉덩이 부위를 중심으로-)

  • 박영득
    • Journal of the Korean Home Economics Association
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    • v.35 no.4
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    • pp.159-172
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    • 1997
  • The purpose of this study was to investigate the slacks pattern making on the movement -fitness of the hip region. The experimental items were divided into the 5 lower limb movements(M1-M5) and the 12 revision pattern constructions of slacks. This study was done by clothing pressure test sensory evaluation test and the difference shape-transformation of wearing-slacks. The summarized finding resulted from experiments and investigation are suggested as follows: First by the clothing pressure tested by lower limb movements the clothing pressure score of the rabbit leap movement(M3) was the highest of all lower limb movements and the order of it in the another movement was the sit on knee(M4) the sit on chair(M2) the noble sitting(M5) from the highest to the lowest. And in comparision of clothing pressure tested by revision pattern to cover the extend of crotch-length 20。 inclined back-line construction method (CA4) showed the lowest. And in comparision of clothing pressure tested by revision pattern to cover the extend of crotch-length 20。 inclined back-line construction method (CA4) showed the lowest. And also for a role to cover hip circumference extendign CC4(1/5 hip.1cm longrightarrow linked back -line) method showed the lowest. Second by the sensory evaluation test based on the movement and revision patterns it was found that the functional factor score of the rabbit leap movement was the lowest in all movement however the score of revision patterns were higher than basic pattern. Third by the test to show difference in the shape-transformation of wearing-slacks on chair(M2) also need to be analyzed. The ration of the shape-transformation of the knee region showed the least value in the increased patterns of inclined angle of back-line(CA) and the differential methods of back-line inclined pattern making. But that of the hem-line did not show remarkable difference.

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