• Title/Summary/Keyword: ambulatory system

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Reconstruction of a Severely Crushed Leg with Interpositional Vessel Grafts and Latissimus Dorsi Flap

  • Park, Chan Woo;Kim, Youn Hwan;Hwang, Kyu Tae;Kim, Jeong Tae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.417-421
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    • 2012
  • We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time.

Meridian Sinews and Sagittal Spinal Balance (경근(經筋)과 인체 시상균형에 관한 소고(小考))

  • Nam, Tong-Hyun;Shin, Sang-Hun
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.13 no.2
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    • pp.129-139
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    • 2009
  • Sagittal spinal balance means standing postural balance at sagittal plane. Postural imbalance with displacement of the patient's center of gravity can cause chronic back pain and ambulatory difficulty. The sagittal spinal balance is determined based on the deviation of the C7 plumb line, originating at the middle of the C7 vertebral body, from the posterior superior endplate of S1. The line is called as sagittal vertical axis (SVA). In the traditional Korean medicine, the meridian sinews, which are the most superficial pathways of the meridian system, associated with movement, muscle balance and defense. They too are separate from the main meridians, though they intersect the main meridians. Some creative and pioneer researchers in Korea thought that the anatomy trains, which suggested by Myers is a concept familiar to the meridian sinews. A reciprocal relationship between the superficial back line and the superficial front line used to be compared to the rigging of a sailboat. Therefore, We suggest that spine may be compared to a mast of the sailboat and that the sagittal spinal balance can be maintained with systemic reciprocal interacts between the front line muscles and the back.

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Estimation and Elimination of ECG Artifacts from Single Channel Scalp EEG (단일 채널 두피 뇌전도에서의 심전도 잡음 추정 및 제거)

  • Cho, Sung-Pil;Song, Mi-Hye;Park, Ho-Dong;Lee, Kyoung-Joung;Park, Young-Cheol
    • Proceedings of the KIEE Conference
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    • 2007.07a
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    • pp.1910-1911
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    • 2007
  • A new method for estimating and eliminating electrocardiogram (ECG) artifacts from single channel scalp electroencephalogram (EEG) is proposed. The proposed method consists of emphasis of QRS complex from EEG using least squares acceleration (LSA) filter, generation of synchronized pulse with R-peak and ECG artifacts estimation and elimination using adaptive filter. The performance of the proposed method was evaluated using simulated and real EEG recordings, we found that the ECG artifacts were successfully estimated and eliminated in comparison with the conventional multi-channel techniques, which are independent component analysis (ICA) and ensemble average (EA) method. In conclusion, we can conclude that the proposed method is useful for the detecting and eliminating the ECG artifacts from single channel EEG and simple to use for ambulatory/portable EEG monitoring system.

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The Study of Muscle Activity Change with Lower Extremity during Stair and Ramp Walking in Young Adults (젊은 성인의 계단과 경사로 오르기 동안 하지의 근활성도 변화 연구)

  • Han, Jin-Tae;Nam, Tae-Ho;Shin, Hyung-Soo;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.3
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    • pp.177-183
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    • 2008
  • Purpose : The purpose of this study was to investigate characteristics of the muscle activities during level walking and stairs ascending in young adults. Methods : Fifteen young adult were recruited this study. Muscle activity (BIOPAC System Inc., Santa Barbara, U.SA). Statistical analysis was difference between level and stair walking. Results : In stance phase, muscle activity of low extremity generally more increased during ramp ascent both young adults. In swing phase, muscle activity of low extremity generally more increased during stairs ascent in young adults. Conclusion : These results indicate that stair and ramp ascent is more difficult task than level walking in young adults. Muscle activity was more changed at ramp ascent. In the future, we suggest that studies of stair and ramp gait pattern regarding ambulatory patient with disabilities be further studied and an appropriate stairs and ramp inclination will be indicated.

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The Effects of Fatigue in the Non-Paretic Plantarflexor Muscle on Spatial and Temporal Gait Parameters during Walking in Patients with Chronic Stroke (만성 편마비 환자의 비마비측 발바닥굽힘근 근피로가 시·공간적 보행변수에 미치는 영향)

  • Lee, Jae-Woong;Koo, Hyun-Mo
    • PNF and Movement
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    • v.16 no.3
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    • pp.355-363
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    • 2018
  • Purpose: The purpose of this study was to obtain detailed and quantified data concerning the effects of plantarflexor muscle fatigue induced in the non-paretic side on the spatial and temporal gait parameters of the bilateral lower extremities during walking in stroke patients. Methods: This study was conducted on 20 patients with chronic stroke. The load contraction fatigue test was applied to induce muscle fatigue in the non-paretic plantarflexor muscle. Step length, stride length, double support, gait velocity and cadence, and functional ambulatory profile (FAP) score in the bilateral lower extremities were measured using a gait analysis system in order to investigate changes in temporal and spatial gait parameters caused by muscle fatigue on the non-paretic side. The statistical significance of the results was evaluated using a paired t-test. Results: A review of the results for gait parameters revealed a significant increase in double support (p<0.05) and a significant decrease in step length, stride length, gait velocity and cadence, and FAP score (p<0.05). Conclusion: These results indicate that the muscle fatigue in the non-paretic side of the stroke patients also affected the paretic side, which led to a decrease in gait functions. This implies a necessity to perform exercise or training programs in a range of clinical aspects not causing muscle fatigue.

Physical Function Monitoring Systems for Community-Dwelling Elderly Living Alone: A Comprehensive Review

  • Jo, Sungbae;Song, Changho
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.49-57
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    • 2022
  • Objective: This study aims to conduct a comprehensive review of monitoring systems to monitor and manage physical function of community-dwelling elderly living alone and suggest future directions of unobtrusive monitoring. Design: Literature review Methods: The importance of health-related monitoring has been emphasized due to the aging population and novel corona virus (COVID-19) outbreak.As the population gets old and because of changes in culture, the number of single-person households among the elderly is expected to continue to increase. Elders are staying home longer and their physical function may decline rapidly,which can be a disturbing factorto successful aging.Therefore, systematic elderly management must be considered. Results: Frequently used technologies to monitor elders at home included red, green, blue (RGB) camera, accelerometer, passive infrared (PIR) sensor, wearable devices, and depth camera. Of them all, considering privacy concerns and easy-to-use features for elders, depth camera possibly can be a technology to be adapted at homes to unobtrusively monitor physical function of elderly living alone.The depth camera has been used to evaluate physical functions during rehabilitation and proven its efficiency. Conclusions: Therefore, physical monitoring system that is unobtrusive should be studied and developed in the future to monitor physical function of community-dwelling elderly living alone for the aging population.

Effects of Ginseng Total Saponin on methamphetamine-induced Hyperactivity and Striatal Dopamine Increase in Mice

  • Kim, H.-S.;G. C. Wagner;G.-S. Yoo;D.-K. Lim;Kim, K.-M.;K. W. Oh
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1995.04a
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    • pp.102-102
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    • 1995
  • The present study was undertaken to investigate the behavioral and biochemical effects of ginseng total sponin (GTS) on methamphetamine-treated mice. GTS (50 or 100 mg/kg) was administered intraperitoneally two times with 2 hour interval. Two hours after the second injection of GTS, methamphetamine (2 mg/kg) was administered subcutaneously. The ambulatory activity of mice was measured by the ti1ting-type ambulometer every 10 min. for 1 hour. Methamphetamine-induced hyperactivity was reduced by GTS. in a dose-dependent manner. To study the neurochemical mechanism underlying the GTS effects, monoamine contents were measured from brain tissues. After 45 min. of methamphetamine injection. mice were sacrificed and monoamine contents were determined from the striatum. Biochemical analysis revealed that GTS reduced the methamphetamine- induced increase in striatal dopamine contents. These observations indicate that inhibition of methamphetamine-induced hyperactivity by GTS is mediated by the modulation of dopaminergic nervous system, and it could be helpful for the therapy of hyperactivity.

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Equity of Access to Health Services under National Health Insurance System in Korea (의료서비스에 대한 접근성의 형평 분석)

  • 장동민;문옥륜
    • Health Policy and Management
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    • v.6 no.1
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    • pp.110-143
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    • 1996
  • The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

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The Usability Study for Gross Motor Function Classification System as Motor Development Prognosis in Children With Cerebral Palsy (뇌성마비 아동 운동발달 예후 지표로 대동작 기능 분류법 활용에 관한 연구)

  • Song, Jin-Yeop;Choi, Jin-Suk
    • The Journal of Korean Physical Therapy
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    • v.20 no.1
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    • pp.49-56
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    • 2008
  • Purpose: Lack of a valid prognosis of gross motor development in children with cerebral palsy (CP) and the absence of longitudinal data on which to base an opinion in Korea have made it difficult to plan treatment and counsel prognosis issues accurately. The purposes of this study were to examine whether the Gross Motor Function Classification System (GMFCS) is valuable to prognostication about gross motor progress in children with CP in Korea. Methods: Medical records of 61 patients were retrospectively reviewed that visited outpatient department and were diagnosed as CP. Various information was surveyed including CP type, visual acuity, cognitive function, motor acquisition age, ambulatory status, development curves of Gross Motor Function Measure (GMFM) according to each of the 5 level of GMFCS. All of them were compared with other studies. Also the gross motor development curves and the maximum GMFM score derived from this study were compared with the Palisano's report and the Rosenbaum's report. Results: Based on a total of 494 GMFM assessments provided by this study, the 5 distinct motor development curves and the maximum GMFM score were created. These observations is corresponding with the Palisano's and the Rosenbaum`s Development curves. Conclusion: The 5 distinct motor development curves (GMFCS) that were created by Palisano's and Rosenbaum's study is useful in Korea, providing parents and clinicians with a means to plan interventions and to judge progress over time.

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Implications of Price Setting Strategies for New Health Technologies from Five Countries (신의료기술에 대한 진료비 지불: 외국사례와 시사점)

  • Chung, Seol-hee;Kwon, Ohtak;Choi, Yeonmi;Moon, Kyeongjun;Chae, Jungmi;Lee, Ruri
    • Health Policy and Management
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    • v.30 no.2
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    • pp.164-177
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    • 2020
  • This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.