Kareh, Aurora M.;Tadisina, Kashyap Komarraju;Chun, Magnus;Kaswan, Sumesh;Xu, Kyle Y.
Archives of Plastic Surgery
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v.49
no.4
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pp.543-548
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2022
Microvascular reconstruction frequently requires anastomosis outside of the zone of injury for successful reconstruction. Multiple options exist for pedicle lengthening including vein grafts, arteriovenous loops, and arteriovenous bundle interposition grafts. The authors performed a systematic review of arteriovenous bundle interposition grafts to elucidate indications and outcomes of arteriovenous grafts in microvascular reconstruction. A systematic review of the literature was performed using targeted keywords. Data extraction was performed by two independent authors, and descriptive statistics were used to analyze pooled data. Forty-four patients underwent pedicle lengthening with an arteriovenous graft from the descending branch of the lateral circumflex femoral artery. Most common indications for flap reconstruction were malignancy (n = 12), trauma (n = 7), and diabetic ulceration (n = 4). The most commonly used free flap was the anterolateral thigh flap (n = 18). There were five complications, with one resulting in flap loss. Arteriovenous bundle interposition grafts are a viable option for pedicle lengthening when free flap distant anastomosis is required. The descending branch of the lateral circumflex femoral artery may be used for a variety of defects and can be used in conjunction with fasciocutaneous, osteocutaneous, muscle, and chimeric free flaps.
International Journal of Internet, Broadcasting and Communication
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v.14
no.1
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pp.224-232
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2022
The purpose of this study was to investigate the pre- and post-exercise performance, edema, and pain of plyometrics in water and land environments. Twelve males in their 20s were selected as subjects and performed 10 sets of squat jumps 10 times in 2 environmental conditions (water and ground). There was no significant difference in iEMG of vastus medilais according to exercise conditions and time. In MPV of CMJ, there was no significant difference according to exercise conditions and time. The thigh circumference showed a significant difference according to the exercise condition and time, and was higher in the ground condition after exercise. There was a significant difference in pain according to the exercise condition and time, and it was found to be high after exercise, 48 hours, and 72 hours in the ground condition. We believe that plyometric training in an aquatic environment will have less swelling and pain compared to plyometric training conducted in a land environment, and the pain will improve quickly, so we think that training can be conducted in a relatively shorter period than in the land environment.
Objective: The aim of this study was to examine the effect of strength training targeting medial quadriceps/hamstrings and non-targeting strength training on dynamic balance. Method: A total of 51 healthy subjects were randomly assigned to control, targeting strength training, or non-targeting training groups. To measure the dynamic balance, the star excursion balance test (SEBT) was performed before and after training. The SEBT parameters were compared using repeated measures ANOVA, and post-hoc paired t test at a significance level of 0.05. Results: Greater anterior (p= .011), anteromedial (p= .001), medial (p< .001), lateral (p< .001), and anterolateral (p= .001) reach distances were found between pre- and post-training in the strength training targeting medial thigh muscles group. Only greater lateral reach distance was found after non-targeting strength training (p= .029). In addition, no differences were found for any SEBT scores in the control group. Conclusion: Strength training targeting medial quadriceps and hamstrings can improve the dynamic balance, thereby it positively affected in lower extremity injury risk, whereas non-targeting strength training rarely changes the dynamic balance.
Sarah Razaq;James Geffner;Asma Khan;Harry Mee;Cynthia Udensi;Fahim Anwar
Journal of Trauma and Injury
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v.36
no.3
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pp.269-275
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2023
A Morel-Lavallée lesion results from a degloving injury between the muscle fascia and the subcutaneous layer. It is most commonly found in the trochanteric area but can occur at other sites. The treatment of the condition varies according to the medical circumstances, as well as the size and chronicity of the condition. A case of large (18×6 and 10×5 cm) bilateral posttraumatic Morel-Lavallée lesions with no underlying bone fracture is presented; the case occurred in a 49-year-old male patient 4 weeks posttrauma. Ultrasound scans showed bilateral large collections of anechoic fluid, which were aspirated under ultrasound guidance and further managed by compression bandages. There were no further complications. The objective of this case report is to present this unique and educational case, as well as to provide an overview of the pathophysiology, diagnosis, and management of Morel-Lavallée lesions. We conclude by discussing the importance of having a high index of suspicion to ensure early detection and prompt treatment of such lesions to avoid complications.
The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.
Objective: The objective of the study is to develop a portable assistance device to help elderly users reduce strain on the knee and leg muscle while the elderly are standing up. Background: The pose of standing up from a chair is a basic movement, but the elderly often have difficulty standing up due to their weak muscles. We focus on designing a solution that helps the elderly reduce physical problems and support them standing up. Method: This study consists of three parts. Part I explores the way to reduce the refrain of leg muscle while standing up from a chair. In the process of structural development, we found that the moment is minimized when user pushes down the armrests due to a decrease in the force acting on the center of mass. In part II, a user test of 20 participants was carried out to rank the order of comfort of two stimuli: the chair with fixed armrests and the chair with the four-link mechanism that we created-in three different ways; (1) to stand up without touching armrests, (2) to stand up by pushing down on fixed armrests, and (3) to stand up by pushing down on armrests and being supported by the mechanism. To examine the statistically significant differences among the rank means, a Friedman test was conducted. In part III, we analyze the results of the user test and interview feedbacks, focusing on establishing a design strategy from UPO and visualizing it in 1:1 scale. Results: In part I, we decided to develop the four-link mechanism. The bottom is lifted up as the link rises. In part II, based on the rank data, we empirically found that UPO was assessed as the most comfortable during the stimuli. The thigh angle is smaller and the bottom of UPO is separated from a seat. In part III, after assessing the results and feedbacks, we created a visualization strategy for UPO: light, friendly, and novel. Conclusion: The portable and non-mechanical UPO comprises a four-link system that lifts the user's hips while standing. It can help users avoid knee and leg muscle strain. Its universal design considers the elderly's difficulties. Application: In a future study, combining light and durable material in UPO is expected to increase its usability. And this study is an opportunity to design various types of standing assistance devices.
The main purpose of this study was to analyze the reaction time of body guards in different stances to provide quantification of data for educational use. There were 4 martial art trained body guards participating in this study. The results of the EMG analysis and reaction time are as follows. The average reaction time of the whole body was $1.38{\pm}0.07$ seconds. In the first phase the reaction to the signal was $0.22{\pm}0.02$ seconds while in the second phase the reaction after checking was $0.62{\pm}0.10$ seconds, which produced the largest impulse. the reaction times of the third and fourth phase were gradually reduced, $0.29{\pm}0.02$ seconds and $0.26{\pm}0.02$ seconds consecutively. In the body guard posture the following muscles had a high activity level; phase one the right and left of the tibialis anterior muscle, phase two the right and left of the tibialis anterior muscle and the right of the gastrocnemius, phase three the right side of the tibialis anterior and gastrocnemius, phase four the left and right of the biceps femoris and the right side of the rectus femoris. In the first and second phase the shank muscles were used a lot, whereas in the third and fourth phase the shank and thigh muscles were used a lot showing the overall muscle activation of the lower limbs.
Objective: The aim of this study was to investigate the effect Tiger-step walking on the movement of the lower extremities during walking. Method: Twenty healthy male adults who had no experience of musculoskeletal injuries on lower extremities in the last six months (age: 26.85 ± 3.28 yrs, height: 174.6 ± 3.72 cm, weight: 73.65 ± 7.48 kg) participated in this study. In this study, 7-segments whole-body model (pelvis, both side of thigh, shank and foot) was used and 29 reflective markers and cluster were attached to the body to identify the segments during the gait. A 3-dimensional motion analysis with 8 infrared cameras and 7 channeled EMG was performed to find the effect of tigerstep on uphill walking. To verify the tigerstep effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at α=.05. Results: Firstly, Both Tiger-steps showed a significant increase in stance time and stride length compared with normal walking (p<.05), while both Tiger-steps shown significantly reduced cadence compared to normal walking (p<.05). Secondly, both Tiger-steps revealed significantly increased in hip and ankle joint range of motion compared with normal walking at all planes (p<.05). On the other hand, both Tiger-steps showed significantly increased knee joint range of motion compared with normal walking at the frontal and transverse planes (p<.05). Lastly, Gluteus maximus, biceps femoris, medial gastrocnemius, tibialis anterior of both tiger-step revealed significantly increased muscle activation compared with normal walking in gait cycle and stance phase (p<.05). On the other hand, in swing phase, the muscle activity of the vastus medialis, biceps femoris, tibialis anterior of both tiger-step significantly increased compared with those of normal walking (p <.05). Conclusion: As a result of this study, Tiger step revealed increased in 3d range of motion of lower extremity joints as well as the muscle activities associated with range of motion. These findings were evaluated as an increase in stride length, which is essential for efficient walking. Therefore, the finding of this study prove the effectiveness of the tiger step when walking uphill, and it is thought that it will help develop a more efficient tiger step in the future, which has not been scientifically proven.
To learn more about the productivity of edible meat and its functional properties of spent hen, 60 White Leghorn fowls at 20 month of age were randomly divided into 6 groups, 10 hen for each group, and processed. As the productivity of edible meat, the yield of dressed carcass, giblets, cut-up meat, and breast and leg (thigh and drustick) muscles were determined. The approximate chemical composition, the content of salt-soluble protein, the emulsifying capacity and W.H.C. of breast and leg muscle were measured as the functional properties. The results were summarized as follows. 1. The average live weight of spent hen was 1,576.7g from which the yield of dressed carcass and giblets were 998.9g(63.4%) and 75.3g(4.8%) respectively. It means the yield of ready-to-cook form was 1,074.2g(68.2%) and the inedible byproducts was 502.5g (31.8%). 2. The average, weight of each part of cut-up chicken were: neck 41.0g(4.1%), wings 135.9g (13.6%), breast 276.7g (27.7%), legs 323.6g (42.4%). back 176.1g(17.6%) and the cutting-loss was 45.6g(4.6%). 3. The average weight of total edible muscle from breast and leg was 51.5g(85.86% of breast and leg cut weight) and the percentages based on the carcass and live weights were 51.6% and 32.7%, respectively. 4. The contents of H$_2$O, protein, fat and water-protein ratio of breast muscle were 72.95%, 20.54%, 1.59% and 3.55, respectively and those of leg muscle were 71.9%, 19.12%, 3.96% and 3.76%, respectively. 5. The salt-soluble protein contents of breast and leg muscle were 7.97% and 6.26% and their concentrations based on the total protein content were 38.8% and 32.74%, respectively. 6. The emulsifying capacity of breast and leg muscle was 43.23$m\ell$and 43.23$m\ell$, respectively. 7. The W. H. C- of breast and leg muscle was 54.23% and 52.61%, respectively.
Epithelioid sarcomas are rare soft tissue sarcomas with a high tumor grade and high local recurrence and metastasis rates. Although the lung is the most common site of metastasis, endobronchial metastasis hasn't been reported yet. We now report a case of epithelioid sarcoma with endobronchial metastasis. A 28-year-old man had recurrent pneumothorax and underwent wedge resection. He presented at our hospital with hemoptysis, dyspnea, and chest pain. Chest computed tomography revealed left pneumothorax, multiple lung nodules and endobronchial lesions at the right lower basal lobe. Bronchoscopy showed a hemorrhagic mass obstructing the bronchus of the right lower basal lobe. Magnetic resonance imaging revealed multiple nodular lesions in the left thigh muscles. The bronchoscopic biopsy of the endobronchial lesion and the muscle biopsy of the thigh showed the same feature epithelioid sarcoma. This is the first case report of an epithelioid sarcoma with endobronchial metastasis that was diagnosed by bronchoscopic biopsy.
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