Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.
The purpose of this study was to examine the muscle activation in trunk and low-limbs muscle during squat exercise on various instability surface. 10 subject performed squat with 75% of 1 repetition maximum (1RM) on a stable floor, stability blue, stability black and BOSU. Electromyographic (EMG) activity was measured trunk muscle such as rectus abdomina (RA), external obliques (EO), internal obliques (IO), multifidus (MF), and low-limbs muscle such as gluteus maximus (GMA), gluteus medius (GME), biceps femoris (BF), rectus femoris (RF), vastus medialis oblique (VMO), vastus lateral oblique (VLO), medialis gastrocnemius (MG), lateral gastrocnemius (LG), soleus (SOL) and anterior tibia (AT) when ascending and descending squat phase. One-way ANOVA repeated measure with Sheffe used to compare the muscle activity on the stable and unstable surface. Squat with BOSU ball induces higher muscle activity of IO, MF, GMA and GME compared with stability and stability blue and blackduring descending motion. Squat with BOSU ball induces higher muscle activity of GMA compared with stability and stability blue and blackduring ascending motion. This results suggested that BOSU ball in the squat could be effective increasing of trunk stability and gluteal muscle activity. However, there was no difference of squat on low-limb muscle with or without instability.
This study analyzed kinematic variables about the cross step, the delivery and the release for women's javelin athletics recorded over 50m in the 2004 Busan International Athletics Competition. It was used the Kwon3D Motion Analysis Package Ver. 3.1 Program(Kwon, 2000) for analysing the kinematic variables about the distance, the velocity, and the angle, then we had the results as follows; 1 In the Cross step phase, the COG velocity was low because their step length was short. To keep the CM velocity from the approach to the last cross over step contact, the athletes have to keep the longer step length within about 130% of the athletics' height. 2. In the Delivery phase, the athletics' COG height was gradually lower, and the deceleration of the COG was going up. As the same in the cross step, Therefore the athletes have to increase the step length within about 100% of their height, in order to increasing the COG velocity. And it was shown they have to make small angle of the elbow as possible from the right foot contact to the left foot contact in order to being the big acceleration of the upperarm at the release phase. 3. In the release phase, it was shown to being low position of the release point as the COG was low and then the release velocity of the upperarm was low. Specially when the shoulder lean lateral angle is big at the release phase, it was shown they have a excessive release angle. And, when it was shown the high rotation angle of the shoulder, the shoulder was opened forward bigger than the trunk was opened forward. So the transmission of velocity from the proximal segments was a fast change.
Glass fiber-reinforced polymer (GFRP) bars have been introduced as an effective alternative for the conventional steel reinforcement in concrete structures to mitigate the costly consequences of steel corrosion. However, despite the superior performance of these composite materials in terms of corrosion, the effect of replacing steel reinforcement with GFRP on the seismic performance of concrete structures is not fully covered yet. To address some of the key parameters in the seismic behavior of GFRP-reinforced concrete (RC) structures, two full-scale beam-column joints reinforced with GFRP bars and stirrups were constructed and tested under two phases of loading, each simulating a severe ground motion. The objective was to investigate the effect of damage due to earthquakes on the service and ultimate behavior of GFRP-RC moment-resisting frames. The main parameters under investigation were geometrical configuration (interior or exterior beam-column joint) and joint shear stress. The performance of the specimens was measured in terms of lateral load-drift response, energy dissipation, mode of failure and stress distribution. Moreover, the effect of concrete damage due to earthquake loading on the performance of beam-column joints under service loading was investigated and a modified damage index was proposed to quantify the magnitude of damage in GFRP-RC beam-column joints under dynamic loading. Test results indicated that the geometrical configuration significantly affects the level of concrete damage and energy dissipation. Moreover, the level of residual damage in GFRP-RC beam-column joints after undergoing lateral displacements was related to reinforcement ratio of the main beams.
Pardalopoulos, Stylianos I.;Pantazopoulou, Stavroula J.;Ignatakis, Christos E.
Earthquakes and Structures
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v.11
no.2
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pp.195-215
/
2016
Rehabilitation of historical unreinforced masonry (URM) buildings is a priority in many parts of the world, since those buildings are a living part of history and a testament of human achievement of the era of their construction. Many of these buildings are still operational; comprising brittle materials with no reinforcements, with spatially distributed mass and stiffness, they are not encompassed by current seismic assessment procedures that have been developed for other structural types. To facilitate the difficult task of selecting a proper rehabilitation strategy - often restricted by international treaties for non-invasiveness and reversibility of the intervention - and given the practical requirements for the buildings' intended reuse, this paper presents a practical procedure for assessment of seismic demands of URM buildings - mainly historical constructions that lack a well-defined diaphragm action. A key ingredient of the method is approximation of the spatial shape of lateral translation, ${\Phi}$, that the building assumes when subjected to a uniform field of lateral acceleration. Using ${\Phi}$ as a 3-D shape function, the dynamic response of the system is evaluated, using the concepts of SDOF approximation of continuous systems. This enables determination of the envelope of the developed deformations and the tendency for deformation and damage localization throughout the examined building for a given design earthquake scenario. Deformation demands are specified in terms of relative drift ratios referring to the in-plane and the out-of-plane seismic response of the building's structural elements. Drift ratio demands are compared with drift capacities associated with predefined performance limits. The accuracy of the introduced procedure is evaluated through (a) comparison of the response profiles with those obtained from detailed time-history dynamic analysis using a suite of ten strong ground motion records, five of which with near-field characteristics, and (b) evaluation of the performance assessment results with observations reported in reconnaissance reports of the field performance of two neoclassical torsionally-sensitive historical buildings, located in Thessaloniki, Greece, which survived a major earthquake in the past.
Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.
Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.
Kim, Won Kyun;Lee, Youn Soo;Won, Joong-Sun;Min, Kyung Duck;Lee, Younghoon
Economic and Environmental Geology
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v.30
no.5
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pp.459-467
/
1997
In order to examine the primary trends and characteristics of geological lineaments along the southwestern boundary of Okcheon zone, we carried out the analysis of geological lineament trends over six selected sub-areas using Landsat-5 TM images and digital elevation model. The trends of lineaments is determined by a minimum variance method, and the resulting geological lineament map can be obtained through generalized Hough transform. We have corrected look direction biases reduces the interpretability of remotely sensed image. An approach of histogram modification is also adopted to extract drainage pattern specifically in alluvial plains. The lineament extracting method adopted in this study is very effective to analyze geological lineaments, and that helps estimate geological trends associated various with the tectonic events. In six sub-areas, the general trends of lineaments are characterized NW, NNW, NS-NNE, and NE directions. NW trends in Cretaceous volcanic rocks and Jurassic granite areas may represent tension joints that developed by rejuvenated end of the Early Cretaceous left-lateral strike-slip motion along the Honam Shear Zone, while NE and NS-NNE trends correspond to fault directions which are parallel to the above Shear Zone. NE and NW trends in Granitic Gneiss are parallel to the direction of schitosity, and NS-NNE and NE trends are interpreted the lineation by compressive force which acted by right-lateral strike-slip fault from late Triassic to Jurassic. And in foliated Granite, NE and NNE trends are coincided with directions of ductile foliation and Honam Shear Zone, and NW-NNW trends may be interpreted direction of another compressional foliation (Triassic to Early Jurassic) or end of the Early Cretaceous tensional joints. We interpreted NS-NNE direction lineation is related with the rejuvenated Chugaryung Fault System.
Purpose : The purpose of this study was to examine the effects of ankle kinesio taping on postural control function during exercise in university students. Method : Thirty subjects were randomly allocated to three groups: Y taping group (n=20), I taping group (n=20) and Non-taping group (n=20). All groups underwent the same exercise program including stretching for 30 minutes. The exercise program proceeded in the following order: five minutes of stretching, a 20-minutes exercise program, and additional five 5 minutes of stretching. Of the eight exercise methods suggested by Purcell et al, seven were chosen (lateral shuffle, forward & backward running, agility ladder, figure-of-8, forward jogging while jumping over cones, wall jumps and zigzags); $90^{\circ}$ cuts with lateral shuffle were omitted. The postural control functions was measured participants's perceptions of stability, confidence, and reassurance using methods suggested by Purcell et al,. Result : The confidence was significant difference in I taping group compared to Non taping group. The reassurance was significant difference in Y taping group and I taping group compared to Non taping group. Conclusion : The Kinesio taping increased confidence, and reassurance during exercise in university students. Additional research on Kinesio taping for improving range of motion and agility is need.
Objective : The purpose of this study was to determine the anatomic relationships between neurovascular structures and the transverse carpal ligament so as to avoid complications during endoscopic carpal tunnel surgery. Methods : Twenty-eight patients (age range, 35-69 years) with carpal tunnel syndrome were entered into the study. We examined through wrist magnetic resonance imaging in three different positions (neutral, radial flexion, and ulnar flexion) and determined several anatomic landmark (distance from the hamate hook to the median nerve, ulnar nerve, and ulnar vessel) based on the lateral margin of the hook of the hamate. The median nerve and ulnar neurovascular structure were studied with the wrist in the neutral, ulnar, and radial flexion positions. Results : The ulnar neurovascular structures usually passed just over or ulnar to the hook of the hamate. However, in 12 hands, a looped ulnar artery coursed 0.6-3.3 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-5.2-1.8 mm radial to the hook of the hamate) with the wrist in radial flexion. During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (-2.5-5.7 mm). Conclusion : It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure.
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