• Title/Summary/Keyword: Skin motion

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Open Reduction of Acromioclavicular Joint for the Acromioclavicular Joint Dislocations (견봉 쇄골 관절 탈구에 대한 견봉 쇄골 관절의 관혈적 정복술)

  • Song, Hyun-Seok;Choi, Nam-Yong;Han, Suk-Ku;Nah, Ki-Ho;Nam, Won-Sik;Yang, Hyuk-Jae;Park, Sung-Jin
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.189-195
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    • 2006
  • Purpose: To analyze the result of the accurate open reduction of acromioclavicular (AC) joint and pin fixation, coracoclavicular (CC) screw fixation without CC ligament repair for AC joint injuries. Materials and Methods: Between January 2000 and December 2003, seventeen cases with at least one year follow-up among twenty-one cases underwent operation for AC-CC ligament injuries. A transverse incision approximately 5 cm in length was made over the clavicle, and the AC joint was reduced accurately. Under the image intensifier, a cannulated screw and washer were inserted for the CC ligament. Two Steinman pins were inserted for the AC joint and the AC ligament was repaired with nonabsorbable suture. Gentle passive range of motion was begun postoperative 2 weeks. The pins were removed at $6{\sim}8$ weeks and the screw was removed at $10{\sim}12$ weeks. The results were evaluated by a distance between AC and CC joints on plain films and ASES score at last follow-up. Results: At the last follow-up, there was no limitation of motion and average ASES score was 96($86{\sim}100$ points). There was no failure showing over 5 mm difference of distance compared to opposite side on the plain films. Seven cases had the skin damages and local infection due to pin migration and three cases showed the loosening of CC screw. Conclusion: We could have satisfactory results by accurate reduction of AC joint and simple pins and screw fixation for AC-CC ligament injuries.

Arthroscopic Cannulated Screw Fixation Technique for Avulsion Fracture of the Intercondylar Eminence of the Tibia (삽관 나사못(Cannulated screw)을 사용한 경골 과간 융기부 견열 골절의 관절경적 치료 기법)

  • Lee, Kee-Byoung;Chang, Ho-Guen;Lee, Seok-Beom;Moon, Young-Wan;Kang, Ki-Hoon;Lee, Wook-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.127-131
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    • 1999
  • Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.

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Impact of Respiratory Motion on Breast Cancer Intensity-modulated Radiation Therapy (유방암 세기조절방사선치료에서의 호흡운동 영향)

  • Chung, Weon Kuu;Chung, Mijoo;Shin, Dong Oh;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.27 no.2
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    • pp.93-97
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    • 2016
  • In this study, we evaluate the effect of respiration on the dose distribution in patient target volume (PTV) during intensity-modulated radiation therapy (IMRT) and research methods to reduce this impact. The dose distributions, homogeneity index (HI), coverage index (CVI), and conformity index of the PTV, which is calculated from the dose-volume histogram (DVH), are compared between the maximum intensity projection (MIP) image-based plan and other images at respiration phases of 30%, 60% and 90%. In addition, the reducing effect of complication caused by patient respiration is estimated in the case of a bolus and the expended PTV on the skin. The HI is increased by approximately twice, and the CVI is relatively decreased without the bolus at other respiration phases. With the bolus and expended PTV, the change in the dose distribution of the PTV is relatively small with patient respiration. Therefore, the usage of the bolus and expended PTV can be considered as one of the methods to improve the accuracy of IMRT in the treatment of breast cancer patients with respiratory motion.

Musculocutaneus Island Flap Based on the Distal Vascular Pedicle of Gracilis Muscle (박근의 원위혈관경을 이용한 도서형 근피판술)

  • Chung, Duke-Whan;Lee, Yong-Wook;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.96-102
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    • 1997
  • The gracilis that is frequently used as a donor of free muscle trasfer is appropriate in the muscular shape and vascular position. This muscle is belonged to the second type of muscle group by the classification of the pattern of muscular nutrient vessel. The adductor branch or first perforating branch of deep femoral artery which supplies the proximal 1/3 of this muscle is a dominant one and this is used for the microscopic anastomosis of muscle or musculocutaneous flap. The minor vascular pedicles which enter the distal 1/3 of this of this muscle are branches of the superficial femoral artery and it is 0.5mm in diameter, 2cm in length with two venae comitantes. These minor pedicles supplies distal half of the gracilis muscle. This island musculocutaneous flap using distal vascular pedicle can be used to cover the defect of soft tissue around the distal femoral supra-condylar area, knee joint and proximal tibial condyle area which cause limitation of motion of knee joint, or in the cases that usual skin graft is impossible. The important operative procedure is as follows; The dissection is carried proximally and distally and the entire gracilis muscle including proximal and distal pedicle is completely dissected. After temporary blocking of the proximal vascular pedicle, the adequate muscle perfusion by the distal pedicle is identified and it is rotated to the recipient site around knee joint. The advantages of this procedure are simple, no need of microscopic vascular anastomoses and no significant functional loss of donor site. Especially in the cases of poor condition of the recipient vessel, this procedure can be used effectively. From 1991 to 1996, we performed 4 cases; complete survival of flap in 3 cases and partial survival of flap with partial necrosis in 1 case. This procedure is though to be useful in the small sized soft tissue defect of distal femoral supra-condylar area, knee joint and proximal tibial condylar area, especially in the defect of anterior aspect which expected to cause limitation of motion of knee joint due to scar contracture. But the problems of this procedure are the diameter of distal vascular pedicle is small and the location of distal vascular pedicle is not constant. To reduce the failure rate, identify the muscular perfusion of distal vascular pedicle after blocking the proximal pedicle, or strategic delay will be helpful.

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Comparison of Human Sensibility in Driving Simulator and Roller-Coaster Simulator (자동차 시뮬레이터와 롤러코스터 시뮬레이터 주행에 따른 감성 비교)

  • 민병찬;전효정;강인형;성은정;김철중;윤석준
    • Science of Emotion and Sensibility
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    • v.6 no.3
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    • pp.13-20
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    • 2003
  • In an experimental study, we assessed human sensibility in terms of psychophysiological response according to change of speeds (40, 70, 100km/h) in a driving simulator and application of motion fitters (washout filter, non-washout later) in a roller coaster simulator. For the driving and roller coaster simulators, a group of 12 healthy men in their twenties and a group of 8 healthy men in their twenties, respectively, participated. Participants each completed a simulator sickness questionnaire (SSQ), a subjective assessment of sensations of pleasantness, tension, and arousal, and perception of speed. Physiological signals were measured by 1/f fluctuation of EEG (electroencephalogram), ECG (electrocardiogram), and GSR (galvanic skin response). These were measured pre-to-post under the experimental conditions for each simulator. Subjective pleasantness, tension, arousal, and perception of speed and physiological responses indicating a feeling of pleasantness by 1/f fluctuation were higher for the roller coaster simulator than those measured for low speed driving in the driving simulator. The mean frequency of alpha band (8-l3㎐) in EEG increased with exposure to the driving simulator relative to that for the roller coaster simulator. Heart rate variability and GSR were significantly changed between pre- and post- under each condition in the driving and roller coaster simulators. The data suggest that subjective sensibility was elevated according to gain of speed and variety of simulator motion, and physiological responses were activated with increased speed.

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ILIZAROV FIXATION FOR THE TYPE C TIBIAL PLAFOND FRACTURES (C형 경골천정 골절에 대한 일리자로브 외고정술)

  • Cho, Hyoun-Oh;Kwak, Kyoung-Duck;Cho, Sung-Do;Kim, Byung-Yong;Oh, Jang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.51-58
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    • 1997
  • The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

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Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

  • Chui, Christopher Hoe-Kong;Wong, Chin-Ho;Chew, Winston Y.;Low, Mun-Hon;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.130-136
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    • 2012
  • Background : Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner. Methods : A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study. Results : We present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from $4{\times}9cm$ ($36cm^2$) to $15{\times}30cm$ ($450cm^2$) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11 to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was $102^{\circ}$ (range, $45^{\circ}$ to $140^{\circ}$). Conclusions : In our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and, access to fascia lata grafts for reconstruction of the triceps tendon.

Respiration Measurement System using Textile Capacitive Pressure Sensor (전기용량성 섬유 압력센서를 이용한 호흡측정 시스템)

  • Min, Se-Dong;Yun, Young-Hyun;Lee, Chung-Keun;Shin, Hang-Sik;Cho, Ha-Kyung;Hwang, Seon-Cheol;Lee, Myoung-Ho
    • The Transactions of the Korean Institute of Electrical Engineers P
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    • v.59 no.1
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    • pp.58-63
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    • 2010
  • In this paper, we proposed a wearable respiration measurement system with textile capacitive pressure sensor. Belt typed textile capacitive pressure sensor approach of respiration measurement, from which respiration signatures and rates can be derived in real-time for long-term monitoring, are presented. Belt typed textile capacitive pressure sensor has been developed for this measurement system. the distance change of two plates by the pressure of motion has been used for the respiration measurement in chest area. Respiration rates measured with the textile capacitive pressure sensor was compared with standard techniques on 8 human subjects. Accurate measurement of respiration rate with developed sensor system is shown. The data from the method comparison study is used to confirm theoretical estimates of change in capacitance by the distance change. The current version of respiratory rate detection system using textile capacitive pressure sensor can successfully measure respiration rate. It showed upper limit agreement of $3.7997{\times}10^{-7}$ RPM, and lower limit of agreement of $-3.8428{\times}10^{-7}$ RPM in Bland-Altman plot. From all subject, high correlation were shown(p<0.0001). The proposed measurement method could be used to monitor unconscious persons, avoiding the need to apply electrodes to the directly skin or other sensors in the correct position and to wire the subject to the monitor. Monitoring respiration using textile capacitive pressure sensor offers a promising possibility of convenient measurement of respiration rates. Especially, this technology offers a potentially inexpensive implementation that could extend applications to consumer home-healthcare and mobile-healthcare products. Further advances in the sensor design, system design and signal processing can increase the range and quality of the rate-finding, broadening the potential application areas of this technology.

Dynamic Bayesian Network based Two-Hand Gesture Recognition (동적 베이스망 기반의 양손 제스처 인식)

  • Suk, Heung-Il;Sin, Bong-Kee
    • Journal of KIISE:Software and Applications
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    • v.35 no.4
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    • pp.265-279
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    • 2008
  • The idea of using hand gestures for human-computer interaction is not new and has been studied intensively during the last dorado with a significant amount of qualitative progress that, however, has been short of our expectations. This paper describes a dynamic Bayesian network or DBN based approach to both two-hand gestures and one-hand gestures. Unlike wired glove-based approaches, the success of camera-based methods depends greatly on the image processing and feature extraction results. So the proposed method of DBN-based inference is preceded by fail-safe steps of skin extraction and modeling, and motion tracking. Then a new gesture recognition model for a set of both one-hand and two-hand gestures is proposed based on the dynamic Bayesian network framework which makes it easy to represent the relationship among features and incorporate new information to a model. In an experiment with ten isolated gestures, we obtained the recognition rate upwards of 99.59% with cross validation. The proposed model and the related approach are believed to have a strong potential for successful applications to other related problems such as sign languages.

A Response to Postural Response to Sine Curve Vestibular Electric Stimulation during Standing (기립자세동안 전정기관에 인가된 정현파 전류자극에 대한 자세균형 응답)

  • Lee, Ah-Reum;Yu, Mi;Kim, Jin-Ho;Kim, Dong-Wook;Kim, Jung-Ja
    • Journal of Biomedical Engineering Research
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    • v.31 no.3
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    • pp.210-216
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    • 2010
  • This study is vestibular electric stimulation applied between the mastoids during quiet standing elicits postural sway. The aim of this study was to characterize the postural sway response to continuous sinusoidal vestibular electric stimulation across various stimulus frequencies and amplitudes. Binaural bipolar sinusoidal vestibular electric stimulation was applied to the skin overlying the mastoid processes of 10 subjects while they stood on a force plate. The position of the center of pressure(COP) and signals at the feet are obtained on an force plate, while the head and whole body center of mass(COM) was measured with motion analysis system. The stimulus conditions included eight frequencies (1/64, 1/32, 1/16, 1/8, 1/4, 1/2, 1, and 2Hz) and six peak amplitudes (0.1, 0.25, 0.5, 0.7, 1 and 2mA). Each subject experienced one trial at each amplitude-frequency pair. The stimuli elicited sway in lateral plane in all subjects, as evidenced by changes in the stimulus frequency. Our results demonstrate that the vestibular system is sensitive to vestibular electric stimulation intensity changes and responds by altering the magnitude of the response accordingly.