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      • The Effect of Split Nerve on Electromyography Signal Pattern in a Rat Model

        Deslivia, Maria,Lee, Hyun-Joo,Zulkarnain, Rizki,Zhu, Bin,Adikrishna, Arnold,Jeon, In-ho,Kim, Keehoon Georg Thieme Verlag KG 2018 Journal of reconstructive microsurgery Vol.34 No.2

        <P> Background Recent developments of prosthetic arm are based on the use of electromyography (EMG) signals. To provide improvements, such as coordinated movement of multiple joints and greater control intuitiveness, higher variability of EMG signals is needed. By splitting a nerve lengthwise, connecting each half to new target muscles, and employing a program to assign each biosignal pattern to a specific movement, we hope to enrich the number of biosignal sites on amputees' stump.</P><P> Methods We split the gastrocnemius muscle of 12 Sprague-Dawley rats into two muscle heads, searched for the peroneal nerve, divided them lengthwise, and connected one half of the nerve to the tibial nerve innervating both muscle heads (SN_50, n = 8). In another group, we connected the undivided peroneal nerve to the nerve of a single muscle head (non-SN_100, n = 6), while the other muscle head received different innervation (non-SN_0, n = 6). After 10 weeks, we stimulated the peroneal nerve and measured the EMG amplitude.</P><P> Results Mean EMG amplitude of the muscle head innervated by one half of the nerve (SN_50; 1.77 [range: 0.71-3.24] mV) and by the undivided nerve (non-SN_100; 3.45 mV [range: 1.13-5.34]) was not significantly different. However, the mean EMG amplitude produced by SN_50 was significantly different from that of the other innervation (i.e., non-SN_0; 0.76 mV [range: 0.41-1.35]), indicating the presence of noise.</P><P> Conclusion Split nerve in combination with split-muscle procedure can yield a meaningful EMG signal that might be used to convey the intention of living organism to a machine.</P>

      • SCISCIESCOPUS

        Reinnervated Split-Muscle Technique for Creating Additional Myoelectric Sites in an Animal Model

        Deslivia, Maria Florencia,Lee, Hyun-joo,Zulkarnain, Rizki Fajar,Zhu, Bin,Adikrishna, Arnold,Jeon, In-ho,Kim, Keehoon Williams & Wilkins 2016 Plastic and reconstructive surgery Vol.138 No.6

        <P>Background: This study proposes a novel reinnervated split-muscle operation to create additional myoelectric sites as sources of command signals of myoelectric prostheses for enhanced dexterous hand-to-wrist motions. The aim of this study was to investigate the postprocedure electromyographic properties of the muscles as distinct myoelectric sites in a rat model. Methods: The reinnervated split-muscle group (n = 6) had the gastrocnemius muscle separated along its longitudinal axis and nerves transferred to each new muscle (peroneal nerve to lateral muscle head and tibial to medial one); the non-split-muscle group (n = 6) only had nerve transfers with its muscle intact. Functional testing was conducted after 10 weeks. The main parameter is the difference in mean electromyographic amplitude between the new muscles, with greater values indicating better separability. Results: After the reinnervated split-muscle procedure, there is a significant increase of the average ratio between two muscles compared with the control group, from 0.44 (range, 0.02 to 0.86) to 0.77 (range, 0.35 to 0.98) (p = 0.011). In addition, compared with the non-split muscle group, nerve transfer in the split-muscle group is more successful in reaching its intended target muscle. Conclusion: A reinnervated split-muscle procedure could be beneficial for acquiring a more precise and discrete command signal in upper limb amputees, thus enabling the creation of more dexterous prosthetic arm.</P>

      • KCI등재

        Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

        이현주,김풍택,Maria Florencia Deslivia,전인호,이석중,김상진 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.3

        Background: Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods: The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results: The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions: The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results.

      • KCI등재

        Thorough Comparative Analysis of Stand-Alone Cage and Anterior Cervical Plate for Anterior Cervical Discectomy and Fusion in the Treatment of Cervical Degenerative Disease: A Systematic Review and Meta-analysis

        Savio Sherly Desnita,Deslivia Maria Florencia,Arimbawa Ida Bagus Gede,Suyasa I Ketut,Wiguna I Gusti Lanang Ngurah Agung Artha,Ridia Ketut Gede Mulyadi 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5

        In this systematic review and meta-analysis, we aim to thoroughly describe and objectively compare the efficacy of anterior cervical plate (ACP) and stand-alone cage (SAC). Although recognized as an effective procedure for cervical degenerative disease (CDD), a debate between the methods of anterior cervical discectomy and fusion exists. ACP provides stability to the fusion construct; however, some complications have been reported, such as dysphagia, adjacent disc disease, and soft tissue injury. To overcome these complications, a SAC was later introduced. A systematic search was conducted on the basis of PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines to identify relevant studies through PubMed, Google Scholar, and Cochrane database. A total of 14 studies (960 patients) were included in the meta-analysis. Twenty outcomes were clinically and radiologically compared between the two procedures. ACP and SAC were comparable in terms of dysphasia rate, loss of segmental angle, loss of disc height, the Odom criteria, Robinson’s criteria, hospital stay, Japanese Orthopaedic Association score, Neck Disability Index, Visual Analog Scale, and fusion time. However, SAC was superior in terms of shorter operation time, less blood loss, lower dysphagia rate, and lower rate of adjacent level disease, whereas ACP was advantageous in terms of lower subsidence rate, better maintenance of the cervical global and segmental angles and disc height, and higher fusion rate. Both procedures can be used in patients with CDD, although it might be more beneficial to choose ACP in patients with multi-level pathologies, wherein better mechanical stability is provided. However, SAC may be more beneficial to use in patients with comorbidities, anemia, or swelling problems because it offers lower complication rates.

      • KCI등재

        Applicative Factors of Helmet Molding Therapy in Late-diagnosed Positional Plagiocephaly

        Kim Min Ji,Kang Min Kyu,Deslivia Maria Florencia,Kim Yong Oock,최종우 대한의학회 2020 Journal of Korean medical science Vol.35 No.36

        Background: Although the benefits of helmet therapy for positional plagiocephaly are strongly correlated with age, the effective period remains controversial. However, most physicians agree that effective results can be obtained in patients within the age of 6 months. Owing to the characteristics of positional plagiocephaly in Koreans, many Korean patients have delayed diagnosis, and because this results in delayed onset of the helmet therapy, the outcomes remain largely underevaluated. In the management of late-diagnosed positional plagiocephaly, we aimed to determine the factors affecting the effective application of helmet therapy. Methods: We recruited 39 consecutive patients with positional plagiocephaly who received helmet therapy and completed the treatment between December 2008 and June 2016. The ages at initiation and completion of treatment, duration of daily use, initial and final absolute diagonal differences, cephalic index, and cranial vault asymmetry index (CVAI) were analysed using data retrospectively collected from the patients' medical records. Results: We identified 12 patients with late-diagnosed positional plagiocephaly, of whom 83.33% were effectively treated. The effective change in CVAI (%) was affected by age at treatment initiation (P = 0.001), initial absolute diagonal distance differences (P < 0.001), and initial CVAI (P < 0.001). Up to 9 months, a gradual change of at least 1% CVAI was attained. Treatment initiation at ages < 5.5 months was beneficial. Even at a later age, patients with an initial absolute diagonal distance difference of > 13.50 mm and initial CVAI of > 11.03% could receive effective helmet therapy. Conclusion: The efficacy of helmet therapy in late-diagnosed patients can be predicted on the basis of not only age at treatment initiation, but also initial absolute diagonal distance differences and initial CVAI. We anticipate that even patients with late-diagnosed positional plagiocephaly can expect better helmet therapy outcomes.

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