• Archives of Plastic Surgery
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• v.37 no.4
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• pp.499-530
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• 2010

Purpose: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. Methods: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. Results: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. Conclusion: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

• Clinical Endoscopy
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• v.51 no.6
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• pp.552-557
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• 2018

Although colonoscopy was originally a diagnostic imaging procedure, it has now expanded to include an increasing range of therapeutic interventions. These procedures require precise maneuvers of instruments, execution of force, efficient transmission of force from the operator to the point of application, and sufficient dexterity in the mobilization of endoscopic surgical instruments. The conventional endoscope is not designed to support technically demanding endoscopic procedures. In case of colonoscopy, the tortuous anatomy of the colon makes inserting, moving, and orientating the endoscope difficult. Exerting excessive pressure can cause looping of the endoscope, pain to the patient, and even perforation of the colon. To mitigate the technical constraints, numerous technically enhanced systems have been developed to enable better control of instruments and precise delivery of force in the execution of surgical tasks such as apposing, grasping, traction, counter-traction, and cutting of tissues. Among the recent developments are highly dexterous robotic master and slave systems, computer-assisted or robotically enhanced conventional endoscopes, and autonomously driven locomotion devices that can effortlessly traverse the colon. Developments in endoscopic instrumentations have overcome technical barriers and opened new horizons for further advancements in therapeutic interventions. This review describes examples of some of these systems in the context of their applications to advanced therapeutic colonoscopy.

• PNF and Movement
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• v.18 no.3
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• pp.445-452
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• 2020

Purpose: The purpose of this study was to evaluate the analysis of the association between upper extremity function and the Wolf Motor Function Test (WMFT) for chronic hemiparetic stroke patients and investigate the evidence of the WMFT as a clinical tool of upper extremity function in individuals with chronic hemiparetic stroke. Methods: This study applied an observational, cross-sectional design in outpatients at three local rehabilitation units in Seoul. Forty-nine individuals who had a diagnosis of first stroke participated in this study. All participants were analyzed for four clinical measures, including the Box and Block Test (BBT), the WMFT, grip strength, and the Canadian Occupational Performance Measure (COPM). Results: Upon analysis, a significant relationship was found between the WMFT scores and BBT scores as well as the grip strength. The WMFT score was statistically and positively associated with the COPM satisfaction score; however, it was not related to the COPM performance score. Conclusion: The results of this study suggest that the WMFT is positively related to simple tasks, such as hand muscle strength and manual dexterity. However, the WMFT does not have a relationship with complex tasks, which are measured by COPM performance abilities.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.3
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• pp.316-321
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• 2023

Developmental venous anomalies (DVAs) are composed of mature venous vessels that lack malformed or neoplastic elements. Although the hemorrhage risk is considered negligible, some patients may have neurological symptoms attributable to acute infarction or intracranial hemorrhage secondary to thrombosis, in the absence of a coexisting cavernous malformation. We report the case of a 42-year-old patient who presented with acute left-hand paresis secondary to a subcortical hemorrhage. This bleeding originated from a DVA in the corticospinal tract area and was surgically drained through an awake craniotomy. To accomplish this, we used a trans-precentral sulcus approach. After the complete removal of the coagulum, small venous channels appeared, which were coagulated. No associated cavernoma was found. Although the main DVA trunk was left patent, no signs of ischemia or venous infarction were observed after coagulating the small venous channels found inside the hematoma cavity. Two weeks after the procedure, the patient's hand function improved, and he was able to resume desktop work. DVA-associated hemorrhage within the cortico-spinal tract could be safely removed with modern awake mapping techniques. This technique allowed the patient to rapidly improve his hand function.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.371-381
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• 2015

Object : The purpose of this study was to investigate aging-related changes of intrinsic and extrinsic hand muscles in their strength, cross-sectional area and volume, force control, and multi-digit synergies. It was hypothesized that aging would negatively affect distal muscles (intrinsic muscles) more than proximal muscles (extrinsic muscles). Method : Nine young and eleven older right-handed participants underwent MRI scans of the hand and forearm. Muscle cross-sectional areas and volumes of the intrinsic and extrinsic hand muscles were determined. Result : Muscle volume of the intrinsic muscles were larger in the younger group than the older group while muscle volume of the extrinsic muscles did not differ. For the cross-sectional area, both the intrinsic and extrinsic muscles of the younger group were larger than the older group. The maximum strength of the intrinsic muscles of the young group was 31% greater than the older group ($399.1{\pm}26.4$ vs $270.2{\pm}22.9Ncm$, p < 0.05) while the extrinsic muscles showed no significant difference. Although the elderly group showed a trend of decreased force control and multi-digit synergies, no statistical differences were found. These findings indicate aging-related decreases in hand muscle size and strength affect intrinsic muscles more than extrinsic muscles, thus supporting the hypothesis that sarcopenia affects the muscle size and strength of distal muscles more than proximal muscles. Conclusion : The aging-related decreases in hand muscle size and function were more apparent in intrinsic hand muscles, located more distally, than extrinsic muscles, located more proximally.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.20 no.3
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• pp.156-167
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• 2010

To evaluate the effect of lead biomarkers including bone lead on neurobehavioral test in retired lead workers, 131 retired lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 56 non-occupationally lead exposed subjects were recruited from same area of retired lead workers with consideration of demographic characteristics. The mean levels of blood and bone lead of retired lead workers were significantly higher than control group and there were significant correlation among other lead biomarkers. Compared with controls without occupational lead exposure, lead exposured subjects had worse performance on 10 tests out of 12 neurobehavioral tests, but only two tests(Purdue pegboard nondominant and both hand) showed statistical significance of differences. In multiple linear regression analysis of neurobehavioral tests with lead biomarkers and demographic and lifestyle variables, age was associated negatively with 11 neurobehavioral tests, whereas log-transformed ZPP was associated with Purdue pegboard(both hand) and Santa Ana manual dexterity(non-dominant hand). On the other hand, tibia lead was associated Pursuit aiming test(correct) and Purdue pegboard(dominant hand) and calcaneal lead was associated with Purdue pegboard(dominant hand). This study confirmed that among all relevant variables age was most significantly associated with the poor performance of neurobehavioral tests. The blood lead did not have any significant association with neurobehavioral tests, but tibia and calcaneal bone lead and blood ZPP showed significant association with a few tests even after more than mean 9 years from their retirements.

• Physical Therapy Rehabilitation Science
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• v.2 no.2
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• pp.99-103
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• 2013

Objective: Clinical measures that quantify upper extremity function are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the relationship between the Unified Parkinson's Disease Rating Scale (UPDRS)-Motor Exam and upper extremity performance as a quantifying clinical tool of upper extremity function in persons with Parkinson's disease. Design: Cross-sectional study. Methods: Thirty-two idiopathic Parkinson's Disease persons participated in this study. To investigate the relationship between the UPDRS-motor exam, Box and Block test (BBT), and Action Research Arm Test (ARAT) by two physical therapists. The examination took up to 1 hour, and the participants were invited to rest between each clinical measure in order to minimize the effects of fatigue. Clinical measures were assessed while the subjects were in the "on" phase of their medication cycle, generally 1-3 hour after taking their anti-Parkinson's medications. Results: In more affected side, the UPDRS-motor exam was significantly negative correlated with the BBT (p<0.05) but it was not significantly correlated with the ARAT. In less affected side, only positively correlation was significantly shown between BBT and ARAT (p<0.05). On the other hand, between BBT and ARAT were not significantly correlated with the UPDRS-motor exam. Conclusions: The UPDRS-motor exam is effective tool which was significantly correlated with manual dexterity in more affected upper extremity. But The UPDRS-motor exam is not effective tool in less affected upper extremity.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.248-251
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• 2011

Objective : In the field of spinal surgery, a few laboratory results or clinical cases about robotic spinal surgery have been reported. In vivo trials and development of related surgical instruments for spinal surgery are required before its clinical application. We investigated the use of the da $Vinci^{(R)}$ Surgical System in spinal surgery at the craniovertebral junction in a human cadaver to demonstrate the efficacy and pitfalls of robotic surgery. Methods : Dissection of pharyngeal wall to the exposure of C1 and odontoid process was performed with full robotic procedure. Although assistance of another surgeon was necessary for drilling and removal of odontoid process due to the lack of appropriate end-effectors, successful robotic procedures for dural sutures and exposing spinal cord proved its safety and dexterity. Results : Robot-assisted odontoidectomy was successfully performed in a human cadaver using the da $Vinci^{(R)}$ Surgical System with few robotic arm collisions and minimal soft tissue damages. Da $Vinci^{(R)}$ Surgical System manifested more dexterous movement than human hands in the deep and narrow oral cavity. Furthermore, sutures with robotic procedure in the oral cavity demonstrated the advantage over conventional procedure. Conclusion : Presenting cadaveric study proved the probability of robot-assisted transoral approach. However, the development of robotic instruments specific to spinal surgery must first precede its clinical application.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.386-397
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• 1995

A cross sectional study was performed to evaluate the neurobehavioral effects of chronic exposure of complex organic solvents, using NCTB(Neurobehavioral Core Test Battery) recommended by WHO(World Health Organization). Forty female shoe factory workers and twenty-two controls matched with age were participated. The tests were performed in the morning before start of work, to exclude the effects of acute exposure. Workers were exposed mainly to toluene, methyl ethyl ketone, n-hexane, cyclo-hexane, dichloroethylene, trichloroethylene, benzene, xylenes etc. The ranges of present solvent exposure of hygienic effect were $0.46\sim0.71$ in the process using adhesives indirectly, and $1.83\sim2.39$ in the process using it directly. We reclassified the subjects, according to cumulative exposure. It showed significantly poorer performances in high exposed group on Santa Ana Dexterity and Benton Visual Retention, compared with control group. After controlling confounder, the significances were still remained. But, further cohort studies, having the information of personal exposure dose from entering a factory, are required to clarify the effects of chronic exposure of complex organic solvents in relation to dose and duration of exposure.

• Journal of Music and Human Behavior
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• v.8 no.1
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• pp.1-16
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• 2011

This study was to investigate the influence of using Therapeutic Instrumental Music Performance (TIMP) in uninvolved hand function for children with spastic cerebral palsy. Participants were recruited from a welfare center for people with cerebral palsy(CP). Ages ranged from 11 to 12, and a total of 15 TIMP sessions were provided for 3 weeks. Hand function tests were used including Jebsen Hand Function Test for hand function, Box and Block Test for dexterity of uninvolved hand, and MIDI (Musical Instrument Digital Interface) evaluation for velocity of fingers. The TIMP program consisted of hand percussion playing and keyboard playing with changes of timbre and tempo. While the scores of Jebsen test and Box and Block test were improved for all participants, outcomes of MIDI analysis showed differences among participants. Overall, hand function improvements were observed after the completion of using the TIMP program, and the results implies that the TIMP program can be applied in upper extremity rehabilitation for children with CP.