Purpose: High tibial valgus osteotomy (HTO) is a well-established surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closed-wedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the short-term results in a consecutive series of patients treated with hybrid CWHTO. Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average follow-up of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The Kellgren-Lawrence grading system and pre- and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed. Results: The FTA and MA significantly changed from $180.7^{\circ}$ to $170.4^{\circ}$ and from $22.0^{\circ}$ to $60.2^{\circ}$, respectively. No significant differences were observed between the mean pre- and postoperative posterior tibial slope, Insall-Salvati ratio, or Caton-Deschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.
Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Kim, Dong Ha;Lee, Sang Weon;Song, Geun Sung
Journal of Korean Neurosurgical Society
/
v.60
no.5
/
pp.577-583
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2017
Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.
The purpose of this study is to determine optimal filtering condition and threshold for the detection of gait-cycles for various walkway slopes as well as gait velocities. Ten young healthy subjects with accelerometer system on thigh and ankle walked on a treadmill at 9 conditions (three speeds and three slopes) for 5 minutes. Two direction signals, i.e. anterior-posterior (AP) and superior-inferior (SI) directions, of each sensor (four sensor orientations) were used to detect specific events of gait cycle. Variation of the threshold (from -1G to 1G) and lowpass cutoff frequency (fc) were applied to the event detection and their performance was evaluated according to the error index (EI), which was defined as the combination of the accuracy and false positive rate. Optimal fc and threshold were determined for each slope in terms of the EI. The optimal fc, threshold and their corresponding EI depended much on the walkway slope so that their coefficients of variation (CV) ranged 19~120%. When all data for 3 slopes were used in the identification of optimal conditions for each sensor, the best error indices for all sensor orientations were comparable ranging 1.43~1.76%, but the optimal fc and threshold depended much on the sensor position. The result indicates that the gait-cycle detection robust to walkway slope is possible by threshold method with well-defined filtering condition and threshold.
Journal of the Korean Academy of Clinical Electrophysiology
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v.6
no.1
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pp.103-114
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2008
The purpose of this study is to use standard and downward slope of the keyboards with taping to influence electromyography of upper trapezius. The effect of taping raise a medical criticism, but we do an experiment on two kind of keyboards with taping in order to decrease stress of shoulder. Subjects are in Seonam university whose are twelve healthy adults in their twenties. This experiment used two kind of keyboards. Standard keyboard's degree is $0^{\circ}$ and another keyboard's degree is $-7.5^{\circ}$. Application of Kinesio taping attached belly of upper trapezius tightly. Measurement of electromyography attached posterior of acromion process go by spinous process of 7th cervical vertebra and upper trapezius. Method of analysis used Repeated measure two-way ANOVA. Result of this experiment, both shoulder's muscle activity increased(p<.05) when used standard keyboard and downward keyboard with taping used. We compared muscle activity that used downward keyboard than standard keyboard. Statistically, it dosen't increase in neck and shoulder(p>.05). Therefore, using a keyboard with upper trapezius's taping in order to decrease muscle activity isn't influenced.
Objective : Although minimally invasive posterior cervical foraminotomy (MI-PCF) is an established approach for motion preservation, the outcomes are variable among patients. The objective of this study was to identify significant factors that influence motion preservation after MI-PCF. Methods : Forty-eight patients who had undergone MI-PCF between 2004 and 2012 on a total of 70 levels were studied. Cervical parameters measured using plain radiography included C2-7 plumb line, C2-7 Cobb angle, T1 slope, thoracic outlet angle, neck tilt, and disc height before and 24 months after surgery. The ratios of the remaining facet joints after MI-PCF were calculated postoperatively using computed tomography. Changes in the distance between interspinous processes (DISP) and the segmental angle (SA) before and after surgery were also measured. We determined successful motion preservation with changes in DISP of ${\leq}3mm$ and in SA of ${\leq}2^{\circ}$. Results : The differences in preoperative and postoperative DISP and SA after MI-PCF were $0.03{\pm}3.95mm$ and $0.34{\pm}4.46^{\circ}$, respectively, fulfilling the criteria for successful motion preservation. However, the appropriate level of motion preservation is achieved in cases in which changes in preoperative and postoperative DISP and SA motions are 55.7 and 57.1%, respectively. Based on preoperative and postoperative DISP, patients were divided into three groups, and the characteristics of each group were compared. Among these, the only statistically significant factor in motion preservation was preoperative disc height (Pearson's correlation coefficient=0.658, p<0.001). The optimal disc height for motion preservation in regard to DISP ranges from 4.18 to 7.08 mm. Conclusion : MI-PCF is a widely accepted approach for motion preservation, although desirable radiographic outcomes were only achieved in approximately half of the patients who had undergone the procedure. Since disc height appears to be a significant factor in motion preservation, surgeons should consider disc height before performing MI-PCF.
Purpose: The purpose of this setback genioplasty study is to develop a prediction method for the calculated osteotomy angle using horizontal and vertical changes as well as to evaluate the proportion of hard and soft tissue changes. Methods: Twelve patients who had received setback genioplasty with other maxillofacial surgery were examined. Three lateral cephalograms were taken just before surgery, immediately after surgery, and 3 months later surgery. A reference line was established to the reference point of the inner most point of the lingual symphysis cortex, incisor tip, and 2nd molar cusp tip. Measuring was conducted from pogonion (Pg), menton (Me), labrale inferius (Li), Mentolabial fold, soft tissue pogonion (Pg'), and soft tissue menton (Me') to the reference lines. Results: In setback genioplasty, the skeletal Pg moved posteriorly 5.07 mm. The ratios of soft tissue to hard tissue movement were 36% posteriorly and 62% inferiorly at Pg', 67% posteriorly and 104% inferiorly at Me', and 34% anteriorly and 164% posteriorly at Li. In reduction & setback genioplasty, skeletal Pg moved posteriorly 4.63 mm and skeletal Me moved superiorly 3.63 mm. The ratios of soft tissue to hard tissue movement were 76% posteriorly and 18% superiorly at Pg', 68% posteriorly and 42% superiorly at Me', and 44% anteriorly, 124% posteriorly at Li. The calculated mean slope angle, based on ${\Delta}H/{\Delta}V$ ratio, was 61.25 and the measured mean slope angle was 60.17. Thus, the calculated and measured slope angles have a similarity. Conclusion: In setback genioplasty, soft tissue moves posteriorly and inferiorly. In particular, at the Me' and Pg', the inferior movement of the soft tissue is greater than the posterior movement. Also, the predictable results (measured slope angle) after operation can be achieved by the calculated slope angle. Thus, the relationship of soft and hard tissue changes must be considered as the results are predictable.
The purpose of this study was to research the condylar path and the anterior angle of glenoid fossae and classify the patterns of condylar path. Thirty male and female dental students with normal occlesion and masticatory system ranging in age from 21 to 30, without present symptoms and an)r history of TM joint disturbance, were selected for this study. Transcranial radiographs of TM joints under mandibular lateral movement were obtained. By the computer analysis on the radiographs, the angle of posterior slope of articular eminance, the sagittal condylar guidance angie, condylar movement patterns and the height of glenoid fossa was measured respectively, and studied their interrelationship comparatively. The results obtained were as follows : 1. The total distance of condylar movement on balancing side during mandibular lateral movement was 4.55mm for Lt. and 4.78mm for Rt. when mandible moved from C.R. to canine to canine relation and 7.86mm for the Lt. and 8.10mm for the Rt. when mandible moved from C.R. to 7.5mm. 2. The horizontal distance of condylar movement on balancing side during mandibular lateral movements was 3.16mm for the Lt. and 3.52mm for the Rt. when mandible moved from C.R. to canine to canine relation and 6.10mm for the Lt. and 6.30mm for the Rt. when mandible moved from C.R. to 7.5mm. 3. The sagittal condylar guidance angle on balancing side during mandibular lateral movements was $45.96^{\circ}$ for the Lt. and $43.22^{\circ}$ for the Rt. when mandible moved from C.R. from canine to canine relation and $41.14^{\circ}$ for the Lt. and $39.77^{\circ}$ for the Rt. when mandible moved from C.R. to 7.5mm. 4. The height of glenoid fossa was 8.23mm for the Lt. and 7.80mm for the Rt. and the angle of posterior slope of articular eminence was $38.30^{\circ}$ for the Lt. and $38.79^{\circ}$ for the Rt. by method-A and $55.61^{\circ}$ for the Lt. and $55.64^{\circ}$ for the Rt. by method-B. 5. The sequence of the frequency of condylar movement patterns on balancing side during mandibular lateral movement were concave type(30 cases), convex type(16 cases), reverse S shape curve(9 cases) and S shape curve(5 cases) when mandible moved from C.R. to canine to canine relation and concave type(27 cases), 5 shape curve(13 cases), convex type(11 cases) and reverse S shape curve(9 cases) when mandible moved from C.R. to 7.5mm.
Objectives: Eyeblinking varied depending on individual cognitive abilities or personality traits thought to related to brain mechanisms of sensory modulation. This study explored whether personality traits are related to the rate of eye blinks and how eyeblink and evoked potential augumenting-reducing(EPAR) interact Methods: Forty four students were studied with EPAR topography to explore how eyeblinks, personality and EPAR interact The Zuckerman Sensation Seeking Scale(SSS) and Eysenck Personality Questionnaire(EPQ) were used as personality measured by a stimulus response program during EP study. Results: Rate of blink increased as intensity of light increased. The General(GEN), Thrill and Adventure Seeking(TAS), Experience Seeking(ES) and Disinhibition(DS) subscales in SSS and Extraversion-Introversion(E) subscale in EPQ showed significant negative correlations with number of eyeblinks in the hightest intensity of light, whereas Neuroticism(N) subscales in EPQ showed a positive correlation. Correlation between number of eyeblinks with the brightest light and EPAR slope varied topographically. The strongest positive correlation was noted in right posterior temporal area. Conclusion: High sensation seekers blinked significantly fewer times than lower sensation seeker did. Higher personality correlations with eyeblink than with EP may imply that the eyeblink works as a primary filter since it is more directly related to central mechanisms of sensory modulation than EP. The right posterior temporal area may play an important role in modulation of visual stimuli.
The purpose of this study is to determine the characteristics of ground reaction force(GRF) in golf swing for various slopes of flat lie and uphill lies of 5 and 10 degrees. Five right-handed professional golfers were selected for the experiment and the 7 iron club was used. We used four forceplates to measure GRF and synchronized with the three-dimensional motion analysis system. Results showed that slope did not affect the total time for golf swing, but the time until the impact had a tendency to slightly increase for the uphill lie(p<0.05). The medial-lateral GRF of the right foot increased toward the medial direction during back swing, but less increases were found with the angle of uphill lie(p<0.05). The GRF of the left foot increased rapidly toward the medial direction at the uncocking and the impact during down swing, but decreased with the increase in the angle of uphill lie(p<0.05). The anterior-posterior GRF of both feet showed almost the same for different slopes. With the slopes, the vertical GRF of the right foot increased, but the vertical GRF of left foot decreased(p<0.05). Uphill lies would have negative effect to provide the angular momentum during back swing, restricting pelvic and trunk rotations, and to provide the precise timing and strong power during down swing, limiting movements of body's center of mass. The present study could provide valuable information to quantitatively analyze the dynamics of golf swing. Further study would be required to understand detailed mechanism in golf swing under different conditions.
Journal of rehabilitation welfare engineering & assistive technology
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v.8
no.4
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pp.259-265
/
2014
The aims of this study are to investigate the walking intention detection of a rollator based on Infraed (IR) sensor measuring knee joint anterior displacement and leg muscle activities. We used Active Walker attached IR sensor to measure the knee joint anterior displacement and EMG signal of leg muscles(rectus femoris, biceps femoris, tibialis anterior, gastrocnemius) were taken by Delsys bagnli-8ch. Subjects were eight healthy males(age $23.7{\pm}0.5years$, height $175.4{\pm}2.3cm$, weight $70.6{\pm}5.6kg$) and they were involved in experiments which had been proceeded 30 minutes a week, during 3 weeks. This system indicates that the knee joint anterior displacement had the distinction increases according to the gait slope and velocity. We showed the increase of the femoral muscle activities along the anterior tilt and the increase of the crural muscle activities along the posterior tilt.
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