Effect of Ramp on Joint Moment of Attendants during Manual Control of Wheelchairs

Objective@#This study aimed to predict the injury risk to attendants by simulating and analyzing the joint moment that occurs during wheelchair transportation for five different ramp ratios and five different velocities. Method: Three-dimensional musculoskeletal models and rigid structure of a standard wheelchair were developed using the AnyBody Modeling System. The ramp ratio was set to 1：6 (the steepest), 1：8, 1：10, 1：12, and 1：14 (the gentlest). The wheelchair speeds were set to 0.4, 0.5, 0.6, 0.7, and 0.8 m/s. Both the uphill and downhill movement conditions were investigated. @*Results@#Most of the joint moments that occur in the wrist joint, elbow and shoulder while driving uphill increased or decreased proportionally to the slope and speed of the ramp. However, the external moment of the wrist occurring downhill was largely influenced by the slope, and the joint moment of the shoulder showed a dynamic pattern of change in the middle of the ramp in spite of constant driving speed. @*Conclusion@#The influence that occurs during deceleration while wheelchair driving on a ramp is primarily on the proximal shoulder joint, and the influence of the release control in the middle of driving primarily causes loads on the distal wrist and forearm. A high risk of damage exists because the moment change value of the load on the shoulder joint is relatively large and increases with inclination. The increase in wrist abduction moment for deceleration while driving downhill also suggests the possibility of damage.

Acute Ischemic Stroke Caused by Detachment of Cardiac Papillary Fibroelastomas

Cardiac papillary fibroelastomas are associated with a high risk of systemic embolization in spite of benign nature. We report a case of 85-year-old patient with left supraclinoid internal carotid artery occlusion who treated with aspiration thrombectomy. Despite of the absence of residual mass on echocardiography, we could analyze pathologic specimens using retrieved embolus and confirmed cardiac papillary fibroelastoma as a rare cause of stroke.

The Survey of Recognition about Rehabilitative Robots for Treatmentin Physical Therapists

Purpose@#This study examined the recognition of rehabilitative robots for treatment in physical therapists. @*Methods@#This study surveyed 100 physical therapists in Seoul and Gyeonggi-do using Google Form, an online survey tool. The questionnaire consisted of 21 questions, including eight questions on the general characteristics, 13 questions on the recognition of rehabilitative robots. @*Results@#The general characteristics of the physical therapists showed differences and influences on recognition of rehabilitative robots, and there were statistically significant differences. There were significant differences in the recognition of rehabilitation robots according to general characteristics in gender, age, education degree, type of hospital, average weekly working time, and treatment field. Multiple regression analysis found that gender and the type of hospital influenced the recognition of rehabilitation robots. @*Conclusion@#Physical therapists showed differences in recognition of rehabilitative robots according to their general characteristics, and gender and the type of hospital influence the recognition of rehabilitation robots. Sufficient systematic education programs should be provided, and physical therapists require policy adjustments to increase their accessibility to rehabilitation robots through continuing education.

The Survey of Recognition about Rehabilitative Robots for Treatmentin Physical Therapists

Purpose@#This study examined the recognition of rehabilitative robots for treatment in physical therapists. @*Methods@#This study surveyed 100 physical therapists in Seoul and Gyeonggi-do using Google Form, an online survey tool. The questionnaire consisted of 21 questions, including eight questions on the general characteristics, 13 questions on the recognition of rehabilitative robots. @*Results@#The general characteristics of the physical therapists showed differences and influences on recognition of rehabilitative robots, and there were statistically significant differences. There were significant differences in the recognition of rehabilitation robots according to general characteristics in gender, age, education degree, type of hospital, average weekly working time, and treatment field. Multiple regression analysis found that gender and the type of hospital influenced the recognition of rehabilitation robots. @*Conclusion@#Physical therapists showed differences in recognition of rehabilitative robots according to their general characteristics, and gender and the type of hospital influence the recognition of rehabilitation robots. Sufficient systematic education programs should be provided, and physical therapists require policy adjustments to increase their accessibility to rehabilitation robots through continuing education.

Choice of Muscles for Extracting Consistent Motor Modules: The Effect of Trial-to-Trial Electromyography Repeatability / 医用生物力学

Objective To identify the effect of the repeatability of muscle activations on extraction of consistent motor modules across trials. Methods The activities of sixteen muscles in twelve subjects who consistently walked at a self-selected speed were recorded. The intraclass correlation coefficient (ICC) was used to identify inter-stride repeatability of muscle activities and motor modules. Based on the repeatability of muscle activation, three types of muscle sets were organized. Results The reliable set containing the muscles showed high ICC (>0.4), but the whole-body and mixed sets containing the muscles showed poor ICC (＜0.4). When motor modules were extracted from each set, the reliable set showed the highest repeatability of motor module extraction, but the whole-body and mixed sets presented significantly lower repeatability. Conclusions Greater repeatability of muscle activations result ed in consistent motor modules. Extraction of consistent motor modules was a critical issue, especially in real-time motion recognition based on muscle patterns.

Arteriovenous Malformation with a Retention Cyst of the Pancreas / 대한췌담도학회지

Arteriovenous malformation (AVM) of the pancreas is exceedingly rare, although it may be increasingly diagnosed due to the widespread use of cross-sectional imaging of the abdomen; even rarer is its association with pancreatitis. A 45-year-old male was admitted to our hospital with symptom of epigastric pain. Dynamic contrast imaging scans of the abdomen showed a focal acute pancreatitis and pancreatic AVM. The angiography findings were compatible with pancreatic AVM. The cause of abdominal pain was diagnosed by acute pancreatitis caused by pancreatic AVM, and, for definitive treatment of symptomatic pancreatic AVM, distal pancreatectomy with splenectomy was performed. The histological results confirmed the presence of irregular dilated tortuous arteries and veins, and a retention cyst with epithelial cell lining. We experienced a rare case of a 45-year-old-Korean male who had acute pancreatitis associated with pancreatic AVM. Pancreatic AVM is extremely rare; even rarer is its association with pancreatitis.

Genetic Polymorphisms of Cytochrome P450 2C19 in Functional Dyspeptic Patients Treated with Cimetidine

Inter-individual pharmacokinetic variation of H2-receptor antagonist is related to genetic polymorphism of CYP2C19. We investigated the frequency of CYP2C19 genetic polymorphism and the treatment duration of cimetidine by CYP2C19 genotypes in functional dyspeptic patients without definite causes who were treated with cimetidine in Korea. One hundred subjects with functional dyspepsia participated in this study from March 1, 2010 to June 30, 2011. They were tested by upper gastrointestinal endoscopy and treated for their dyspepsia with cimetidine. The single nucleotide polymorphisms (SNPs) of CYP2C19 were genotyped using the Seeplex CYP2C19 ACE Genotyping system. There were no significant differences in the demographic, clinical, or laboratory findings among the CYP2C19 subgroups which are wild type homozygote (W/W), heterozygote (W/V), and variant homozygote (V/V). The frequencies of CYP2C19 subgroups were 33 (33%) in W/W, 49 (49%) in W/V, and 18 (18%) in V/V, respectively. The mean duration of cimetidine treatment (in weeks) was the shortest in the V/V among the CYP2C19 genotypes (W/W: 5.1+/-1.5, W/V: 4.0+/-1.7, V/V: 2.1+/-0.7; p<0.001). This study can also act as a basis for further investigation to identify the underlying genetic, epigenetic, or environmental factors in CYP2C19 enzyme activity.