• Title/Summary/Keyword: Physical wedge

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Forefoot disorders and conservative treatment

  • Park, Chul Hyun;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.92-98
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    • 2019
  • Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

Physically Compatible Characteristic Length of Cutting Edge Geometry (공구날 특이길이의 물리적 적합성 고찰)

  • Ahn, Il-Hyuk;Kim, Ik-Hyun;Hwang, Ji-Hong
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.3
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    • pp.279-288
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    • 2012
  • The material removal mechanism in machining is significantly affected by the cutting edge geometry. Its effect becomes even more substantial when the depth of cut is relatively small as compared to the characteristic length which represents the shape and size of the cutting edge. Conventionally, radius or focal length has been employed as the characteristic length with the assumption that the shape of cutting edge is round or parabolic. However, in reality, there could be various ways to determine the radius or focal length even for the same tool edge profile, depending on the region to be considered as cutting edge in the measured profile and the constraints to be set in constructing the best fitted circle or parabola. In this regard, the present study proposes various models to determine the characteristic length in terms of radius or focal length. Their physical compatibility are validated by carrying out 2D orthogonal cutting experiments using inserts with a wide range of characteristic length ($30{\sim}180\;{\mu}m$ in terms of radius) and then by investigating the correlation between the characteristic length and the cutting forces. Such validation is based on the common belief that the larger the characteristic length is, the blunter the cutting edge is and the higher the cutting forces are. Interestingly, the results showed that the correlation is higher for the radius or focal length obtained with a constraint that the center of best fitted circle or the focus of the best fitted parabola should be on the bisectional line of the wedge angle of tool.

Numerical Simulation of Spilling Breaker using the Modified Marker-density Method (수정된 밀도함수법을 이용한 Spilling Breaker의 수치시뮬레이션)

  • Jeong, Kwang-Leol;Lee, Young-Gill
    • Journal of the Society of Naval Architects of Korea
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    • v.51 no.1
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    • pp.58-66
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    • 2014
  • Numerical simulations for the flows containing free surface remain difficult problems because the drastic differences of physical properties of water and air, The difference of densities makes the solution instable in particular. For the stabilities of the solutions, the most typical methods to simulate free surface flows, such as Volume Of Fluid(VOF) and Level-Set(LS) methods, impose transient zones where the physical prosperities are continuously distributed. The thickness of the transient zone is the source of the numerical errors. The other side, marker-density method does not use such a transient zone. In the traditional marker-density method, however, the air velocities of free surface cells are extrapolated from the water velocity, and the pressures on the free surface are extrapolated from the air pressures for the stability of the solution. In this study, the marker-density method is modified for the decrease of such numerical errors. That is, the pressure on the free surface is determined to coincide with the pressure gradient terms of the governing equations, and the velocity of free surface cells are calculated with the governing equations. Two-dimensional steady spilling breakers behind of a submersed hydrofoil and three-dimensional spilling breaker near a wedge shaped ship model are simulated using INHAWAVE-II including the modified marker-density(MMD) method. The results are compared with the results of Fluent V6.3 including VOF method and several published research results.

A case of Pulmonary Veno-occlusive Disease (폐정맥 패쇄에 의한 폐고혈압증 1예)

  • Cho, Jae-Youn;Lee, Sang-Youb;Lee, Sang-Hwa;Park, Sang-Myeon;Suh, Jeong-Kyung;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa;Kim, Kwang-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.274-279
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    • 1996
  • Pulmonary veno-occlusive disease is a rare cause of pulmonary hypertension in which the primary abnormality is obliterative obstruction of pulmonary veins, especially venules. Clinicaly, we should suspect this disease in the case of congestive cardiac failure with pulmonary hypertension, chronic interstitial pulmonary edema, and normal or elevated wedge pressure on cardiac catheterization. We experience a case of pulmonary hypertension due to pulmonary veno-occlusive disease. A 55-years -old woman developed progressive dry cough and dyspnea for 3 months. Physical examination showed normal heart sounds, diffuse crackles in the whole lung fields. The liver was not palpable and pitting edema was absent. The diagnosis was made by chest HRCT, 2-D echocardiography, normal pulmonary capillary wedge pressure on cardiac catheterization, and confirmed by thoracoscopic lung biopsy. This patient was treated with vasodilator(calcium antagonist) and with mild symptomatic improvement. We reported a case of pulmonary veno-occlusive disease with review of literatures.

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Study for correlation between MMPI results and Sasang constitutions, in out-patients of Oriental Neuropsychiatry (내원 환자의 MMPI 군집분석과 사상체질과의 상관성 연구)

  • Kim, Jin-Hyung;Yang, Hee-Sook;Guk, Yun-Jea;Lo, Im-Sun;Lee, Sung-Geun;Jang, Hyun-Ho;Kim, Tae-Heon;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.1
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    • pp.175-185
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    • 2004
  • Objective : For investigating correlation among diagnostic types, MMPI results and Sasang constitutions, in out-patients of Oriental Neuropsychiatry. Method: We got the following result by comparing the out-patients' MMPI and QSCCII from 2000/12/1 to 2001/12/30 at Sanbon Hospital of Oriental Medicine, Wonkwang University. Result and Conclusion: 1. A specific character of population for study's objects was that female (128, 68.4%) was twice bigger that the male(59, 31.6%). And their education levels were 52 of college graduate (27.8%), 40 of high school graduate (21.4%), and 14 of middle school graduate (14 %). A distribution of the occupation, there are 62 of labors (33.2%), 62 of white collars (33.2%), 30 of sales (16%), 16 of students (8.6%). Their marrige statuses were 144 of married (77%), 31 of single (16.6%), 4 of divorced (2.1%), and 1 of bereavement (0.5%). 2. In the physical constitutions there were 70 of Soeumin(37.4%), 56 of Soyangin(29.9%) 55 of Taeumin (29.4%), 6 of others (3.2%). A differentiation with their diagnosis, there were 55 of palpitations (29.4%), 45 of depression (24.1%), 18 of women's diseases (9.6%), 14 of insomnia (7.5%), 13 of headache (7%), 8 of pain (4.3%), 8 of hwabyung (4.3%), 7 of psychosis (3.7%), 4 of dizziness (2.1%), and 15 of others(8%). 3. A result of groupling MMPI, we could classify into 4 different groups. Group 1 is a profile of trasition in a neurosis. Group 2 is a proflie of a mental disease. Group 3 is a proflie of $'{\wedge}'$ type neurosis. And group 4 has normal profile. 4. Regarding each group with physical constitution and a distribution of diagnosis, Group 1 is found out 36.4 % of Soeumin, 34.10 % of palpitations. And group 2 showed 43.6% of Soyangin, 25.6% of depression. Group 3 showed 46.4% of Soyangin, 31.90% of palpitations. Group 4 showed the most in 34.3% of Soyangin, and 31.40% of palpitations 5. A result of the study using Chi-square test is that there is no correlation between the 4 different groups and the Sasang physical constitution.

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Treatment of Quadriceps Contracture with Femoral Shortening Ostectomy, Rectus Femoris Muscle Transposition and Dynamic Stifle Flexion Apparatus in a Dog

  • Roh, Yoon-Ho;Choi, Min-Ho;Lee, Je-Hun;Mok Jeong, Seong;Lee, HaeBeom
    • Journal of Veterinary Clinics
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    • v.37 no.3
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    • pp.163-167
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    • 2020
  • A 13-month-old, 3.3 kg castrated male Shih-tzu presented with right hindlimb lameness. The physical examination revealed atrophy of the right thigh muscles, hyperextension of the stifle joint and external torsion of the tibia. On the radiographic examination, patella alta and genu recurvatum were observed. A biapical deformity of the tibia and external torsion of the distal tibia were detected by computed tomography (CT). A three-dimensional (3D) printed bone model was designed and constructed for the preoperative plan prior to surgery. Rectus femoris muscle transposition, femoral shortening ostectomy and open wedge osteotomy of the distal tibia were performed using hybrid external skele/t0al fixation (hybrid-ESF). A dynamic stifle flexion apparatus was used to prevent recurrence of a quadriceps contracture (QC). Intense physiotherapy was administered postoperatively. The dog began to use the affected limb one week after surgery. Functional improvement in the affected limb was observed, and full weight-bearing was possible at 3 months after surgery. Union of the osteotomy lines was observed at 3 months, and the stifle joint was fully movable at 7 months after surgery. Regarding the treatments for QC, these methods may be excellent candidates, as they do not lead to severe damage to the limb or amputation.

A Case of Choledochal Cyst Complicated by Liver Cirrhosis on Pathology in a 20-Month-Old-Girl (수술 후 임상증상이 호전된 간경화를 합병한 2세 여아에서의 총수담관낭 1례)

  • Bae, Sun Hwan;Choi, Sung Yun;Lee, Tae Seok;Lee, Ho Jeong
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.104-107
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    • 2005
  • Choledochal cyst is considered to be congenital anomalies of the biliary tract, characterized by varying degrees of cystic dilatation at various segments of the biliary tract. A 20-month-old girl was admitted to Eul-Ji general hospital because of abdominal distension. Physical examination revealed marked splenomegaly and hepatomegaly with nodular surface and hard consistency. Laboratory examination showed elevated transaminase level, alkaline phosphatase level and gamma glutamyltranspeptidase level without evidence of cholestasis. Diagnostic imaging study revealed choledochal cyst with Todani classification type 1. Cholecystectomy and Roux-en-Y choledochojejunostomy was performed, and wedge liver biopsy showed diffuse periportal fibrosis with cirrhotic change and ductular proliferation in the portal area. After operation, hepatosplenomegaly and abnormal laboratory examinations improved rapidly, and in 9 months, the liver and spleen became not palpable. We experienced a case of choledochal cyst complicated by liver cirrhosis on pathology in a 20 month-old girl, and removal of choledochal cyst improved clinical manifestations rapidly.

The Analysis of MMPI and Clinical Study for Somatization Disorder and Depressive Disorder Patients (우울증성 장애 및 신체형 장애 환자에 대한 MMPI분석과 임상고찰)

  • Choe, Byeong-Man;Jung, In-Chul;Lee, Sang-Ryong;Park, Ji-Un
    • Journal of Oriental Neuropsychiatry
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    • v.13 no.2
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    • pp.41-56
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    • 2002
  • The Analysis of MMPI and Clinical Study was carried out the 28 patients with somatoform disorder and depressive disorder who were treated in Daejeon University Oriental Hospital from 19 June 2001 to 17 April 2002. The results were summarized as follows. 1. The ratio of female was higher, especially in the depressive disorder, the ratio of female was higher and in the age distribution, the 40 aged were higher frequence. 2. In the somatoform disorder, symptoms appeared to be busy in physical symptoms, and they were in descending order the digestive organs system, head and face portion and musculoskeletal system symptoms, in the depressive disorder, appeared to be busy in psychosomatic system symptoms and in the prescription drugs, soyosan(逍遙散), punsimkiyyin(分心氣飮) were used to be busy. 3. In the scales of L, F, K, somatoform disorder showed ${\wedge}$ typed graph, and depressive disorder showed ${\vee}$ typed graph. 4. In the somatoform disorder, scales of Hs, Hy, D, Pa were higher, and in the depressive disorder, scales of Hy, Hs, Pd, D were higher. 5. In the scales of Hs, D, Hy, somatoform disorder showed ${\vee}$ typed graph, and depressive disorder showed/typed graph. 6. the average of T-scores and the ratio over 65 score and 70 score showed common distribution.

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On the Use of Standing Oblique Detonation Waves in a Shcramjet Combustor

  • Fusina, Giovanni;Sislian, Jean P.;Schwientek, Alexander O.;Parent, Bernard
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2004.03a
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    • pp.671-686
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    • 2004
  • The shock-induced combustion ramjet (shcramjet) is a hypersonic airbreathing propulsion concept which over-comes the drawbacks of the long, massive combustors present in the scramjet by using a standing oblique detonation wave (a coupled shock-combustion front) as a means of nearly instantaneous heat addition. A novel shcramjet combustor design that makes use of wedge-shaped flameholders to avoid detonation wave-wall interactions is proposed and analyzed with computational fluid dynamics (CFD) simulations in this study. The laminar, two-dimensional Navier-Stokes equations coupled with a non-equilibrium hydrogen-air combustion model based on chemical kinetics are used to represent the physical system. The equations are solved with the WARP (window-allocatable resolver for propulsion) CFD code (see: Parent, B. and Sislian, J. P., “The Use of Domain Decomposition in Accelerating the Convergence of Quasihyperbolic Systems”, J. of Comp. Physics, Vol. 179, No. 1,2002, pages 140-169). The solver was validated with experimental results found in the literature. A series of steady-state numerical simulations was conducted using WARP and it was deter-mined by means of thrust potential calculations that this combustor design is a viable one for shcramjet propulsion: assuming a shcramjet flight Mach number of twelve at an altitude of 36,000 m, the geometrical dimensions used for the combustor give rise to an operational range for combustor inlet Mach numbers between six and eight. Different shcramjet flight Mach numbers would require different combustor dimensions and hence a variable geometry system in or-der to be viable.

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Management for Gait Disturbance and Foot Pain in a Patient with Klippel-Trenaunay-Weber Syndrome : A case report

  • Choi, Yoon-Hee
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.4
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    • pp.85-89
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    • 2021
  • Background : Klippel-Trenaunay-Weber syndrome (KTS) is a rare congenital medical condition characterized by complex vascular malformation. KTS consists of a classic triad of capillary malformation (hemangioma), venous malformations and bone or soft tissue hypertrophy causing limb asymmetry. The aim of this report is to describe management for gait disturbance and foot pain in a Patient with KTS using custom-made total contact insole. Case presentation : A 32-year-old man with KTS presented with a 3-year history of gait disturbance on hard surface due to right first toe pain and Achilles tendon tightness. The patient had soft tissue hypertrophy, varicose veins and port-wine stains over the right lower limb associated with KTS. True leg length discrepancy was 2 cm. We prescribed custom-made total contact insole to protect his deformed foot and correct leg length discrepancy. The insole of right side included wedge shaped heel lift and the insole of left side included full length lift to add extra support on unaffected side. Also, we provided compression stocking and physiotherapy including manual lymphatic drainage for lymphedema and stretching exercise for tightness in right lower extremity. At 3 years follow-up, postural alignment including pelvic obliquity was improved using a custom-made total contact insole. The degree of scoliosis and foot pain were also reduced. Conclusion : An individualized and multidisciplinary approach is essential regarding the complexity of comorbidities in patients with KTS. For patients with KTS, orthotic management should be considered to prevent and correct deformities related to KTS. Active orthotic management, compression stocking and physiotherapy can enhance the quality of life and function in patients.