• Archives of Plastic Surgery
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• 제42권6호
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• pp.783-787
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• 2015

This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.

• 한국운동역학회지
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• 제19권4호
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• pp.689-696
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• 2009

이 연구는 여성노인의 낙상 예방을 위하여 요부안정화운동을 실시하고 요부 등척성 근력, 복횡근과 다열근의 근두께, 자세안정성의 변화를 측정하였다. 대상자는 광주광역시에 소재한 요양원에서 여성노인 21명을 대상으로 8주간 운동 후 요부 등척성 근력, 복횡근과 다열근의 근두께, 자세안정성을 비교하였다. 요부 등척성 근력은 페가수스 근력 측정장치(3D Pegasus system, Germany), 복횡근과 다열근의 근두께는 초음파영상 계측장치(Sonoace 6000C, Korea), 자세안정성은 BBS 균형측정장치(Biodex Balance System SD, USA)로 측정하고 분석하였다. 요부 등척성 근력 중 굴곡, 신전, 좌회전과 복횡근 이완(횡)두께는 운동 전보다 운동 후에 통계학적으로 유의하게 증가하였으며, 자세안정성변화에서 전체 좌우 전후균형지수 모두 운동 후 통계학적으로 유의하게 감소하였다. 요부안정화운동이 근력 및 자세안정성에 영향을 미쳐 여성노인의 낙상 예방에 효과적이다 라는 결론을 얻었다.

• 대한후두음성언어의학회지
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• 제14권1호
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• pp.40-46
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• 2003

Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

• Archives of Plastic Surgery
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• 제47권2호
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• pp.171-177
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• 2020

Background Infrabrow blepharoplasty has become a common surgical method used to rejuvenate aged upper eyelids in Asians. In this paper, we describe the parallel excision method for infrabrow blepharoplasty as a useful alternative to the conventional elliptical excision method. The authors' experience over a 3-year period is presented and reviewed. Methods A retrospective review of parallel excision infrabrow blepharoplasty cases at our hospital between 2014 and 2017 was performed. Three oculoplastic surgeons compared preoperative and postoperative photographs using the Strasser grading system. Results From the medical records of 123 patients, a total of 93 patients with moderate-to-severe bilateral dermatochalasis were selected as subjects. The exclusion criterion was levator function less than 8 mm. The total mean follow-up period was 2 years (range, 0.5-3.5 years). The mean skin excision height and width were 9.75 mm (range, 5-16 mm) and 58.51 mm (range, 42-75 mm), respectively. All patients who underwent surgery recovered without major complications, and all patients had high levels of satisfaction and improvements in their visual field. In the Strasser evaluation performed by the oculoplastic surgeons, most patients were found to have excellent results. Conclusions The parallel excision method for infrabrow blepharoplasty is a safe and effective technique that yields more natural- and youthful-looking eyelids than the conventional elliptical excision method. In our method, more effective manipulation of the orbicularis oculi muscle led to a reduction in frontalis compensation, resolution of sunken eyelids, and correction of lateral hooding.

• Journal of Oral Medicine and Pain
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• 제19권1호
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• pp.137-149
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• 1994

This study was performed to investigate the relationship between Forward Head Posture(FHP) and Craniomandlbular Disorders(CMDs). Many studies reported that there was some relationship between them, however, there is still controversy. So It Is necessary to observe and compare many more patients with CMDs wirh normal controls. For the study 85 patients with CMDs and 37 dental students were selected as experimentals and controls, respectively. And the experimentals were classified Into two groups, that is, TMJ internal derangement group and muscle disorders group according to clinical diagnosis. For measuring the FHP, CROM(Cervical-Range-of-Notion)was used. This goniometer is composed of three part. First, gravity goniometer for flexion and extension. Second, magnetic compass and yoke for rotational movement. And last, forward head arm and vertebra locator for forward head posture. Next T-Scan, electronic occlusal analyzer, was used for recording of occlusal contact state. Other items such as maximum opening, lateral excursion, Helkimo's anamnestic index, and muscle palpation point from Friction's craniomandibular index were checked clinically by one examiner. The result of this study were as follows : 1. In male, control group showed much more measurement in resting forward head posture than did experimental group. But there were not significant differences between groups in female subject. From this results, the author contended that CROM is new measuring system and differ from other goniometers in some aspect, so that results should be re-evaluated 2. Mean value of maximum mouth opening in nearly all groups were greater than 40mm. and mouth opening had a significant correlation with occlusal force and with anamnestic index both sex. 3. Mean value of palpation point had not any correlationship with forward head posture in both sex, but there was significant difference between upper and lower group by rounded shouldes. 4. In summary, there was no significant relationship between forward head posture and sign and symptom of Craniomandibular Disorders.

• 치과방사선
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• 제23권2호
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• pp.365-372
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• 1993

Branchial cleft cyst is the most common lateral neck cyst; the vast majority are of the second branchial cleft origin. This presumably reflects the greater depth and longer persistence of the second cleft, compared with the first, third, and fourth clefts. We experienced a 49-year-old male whose chief complaint was a abnormal mass of the left parotid gland area and neck. As a result of careful analysis of clinical, radiological, and histopathological findings, we diagnosed it as a second branchial cleft cyst in the neck and obtained results as follows: 1. In clinical examination, there was a 10×15㎝ sized, fluctuant painful mass in the left neck and parotid area. 2. In radiographic examination, a low echogenic mass with internal cystic change in the inferior parotid gland area was noted sonographically. Computed tomograph showed a 3×4㎝ sized, well-defined cystic mass with heterogenous solid component in the anterior border of sternocleidomastoid muscle. MRI revealed 5×6㎝ sized, well-marginated multi separated mass in the same area. 3. In histopathological examination, lining of cyst was stratified squamous epithelium with typical lymph node pattern and inflammatory cell infiltration.

• 대한두개안면성형외과학회지
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• 제15권2호
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• pp.82-88
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• 2014

Background: The chin shape and position is important in determining the general shape of the face, and augmentation genioplasty is performed alone or in combination with other aesthetic procedures. However, augmentation genioplasty using osteotomy is an invasive and complex procedure with the potential to damage mentalis muscle and mental nerve, to affect chin growth, and prolonged recovery. Our aim was to present our experience with a modified augmentation genioplasty procedure for hypoplastic chins using a Gore-Tex implant. Methods: Two vertical slit incisions were made at the canine level to create a supra-periosteal pocket between the incisions, preserving the periosteum and mentalis muscle. Minimal sub-periosteal dissection was performed lateral to the incisions along the mandibular border. The both wings of implant were inserted under the periosteum to achieve a stable dual plane implantation. Results: In total, 47 patients underwent dual plane chin augmentation using a Gore- Tex implant between January 2008 and May 2013. The mean age at operation was 25.77 years (range, 15-55 years). There were 3 cases of infection; one patient was treated with antibiotics, the others underwent implant removal. Additionally, two patients complained of postoperative parasthesia that spontaneously improved without any additional treatment. Most patients were satisfied with the postoperative outcomes, and no chin growth problems were observed among the younger patients. Conclusion: Dual plane Gore-Tex chin augmentation is a minimally-invasive operation that is simple and safe. All implants yielded satisfactory results with no significant complications such as mental nerve injury, lower lip incompetence, or chin growth limitation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.12.1-12.5
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• 2017

Background: Rehabilitation of normal function and form is essential in cleft lip repair. In 2005, Dr. David M. Fisher introduced an innovative method, named "an anatomical subunit approximation technique" in unilateral cleft lip repair. According to this method, circumferential incision along the columella on cleft side of the medial flap is continued to the planned top of the Cupid's bow in straight manner, which runs parallel to the unaffected philtral ridge. Usually, small inlet incision is needed to lengthen the medial flap. On lateral flap, small triangle just above the cutaneous roll is used to prevent unesthetic shortening of upper lip. This allows better continuity of the Cupid's bow and ideal distribution of tension. Case presentation: As a modification to original method, orbicularis oris muscle overlapping suture is applied to make the elevated philtral ridge. Concomitant primary rhinoplasty also results in good esthetic outcome with symmetric nostrils and correction of alar web. As satisfactory results were obtained in three incomplete and one complete unilateral cleft lip patients, indicating Fisher's method can be useful in cleft lip surgery with functional and esthetic outcome. Conclusions: Clinically applied Fisher's method in unilateral cleft lip patients proved the effectiveness in improving the esthetic results with good symmetry. This method also applied with primary rhinoplasty.

• 근관절건강학회지
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• 제4권1호
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• pp.74-86
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• 1997

This investigation has been conducted based on the medical chart of 344 patients who have been diagnosed of fibromyalgia syndrome during Oct. 9, 1996 through Nov. 20 at the Rheumatism Hospital of H. University located in Seoul. 280 which have been included in the analysis. 1. Only one patient was male in 280 patients, age distribution was from 28 to 76, in which the average age was 52.4. 2. Percentage of treatment duration was 6 months in 46.1%, 3 years in 22.1% and 2 years in 12.5%. Considering these results, it can be predicted that the number of patients might be increased and accumulated in the future. 3. Percentage of patients having primary fibromyalgia syndrome was 39.3%, having combination with osteoarthritis was 36.7% and the rest case have combination with rheumatoid arthritis at the same time. 4. The percentage of cases having patients 10-12 tender points was 37.1%, while the most of cases have pain at 12-19 tender points. The common locations of the tender point were at lateral epicondyle of elbow in 92.0%, at midpoint of upper border Trapezius in 84.8%, at upper part of scapula Supraspinatus in 82.9%, at medial fat pad proximal to the joint line knee in 81.85%, at intertransverse of $C_{5-7}$ Low cervical in 73.4% and at 2nd distal costochondral Junction 2nd rib in 72.0%. And most of the patients had joint functional disability at all in 47.1% with average 2.41 joint functional disability. 5. Age was not a variable influencing the number of tender points and the number of joint functional disability.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.591-596
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• 2009

Purpose: To reconstruct soft tissue defect on lower extremity especially combined with osteomyelitis, free flap with enough blood supplies is required. There are some instance when patients have inadequate recipient vessels for microanastomosis. Anastomosis with harvested vein graft can solve the problem. It may be more problematic or even increase recipient site complication. Cross leg free flaps using contra - lateral vessel can be a solution. Methods: From 2005 to 2008, 12 cases of cross leg free flap were done for 12 patients(male = 9, female = 3). External fixators used in all cases. Free flaps used were laissmus dorsi muscle flap(n=5), anterolateral thigh flap(n=4), gracilis muscle flap(n=2) and medial plantar artery fasciotaneous flap(n=1). In all cases, contralateral posterior tibial artery and vein were used as recipient pedicle. Results: All flaps survived without additional operative procedures. There were no complications such as hematoma or Infection. Sometimes patients needs further therapeutic exercise for fast movement recovery. Conclusion: Although cross leg free flaps require long period of bed resting and rehabilitation after pedicle cutting, It can be practical alternative for soft tissue defect on lower distal extremity with inadequate recipient vessels for free flap on affected leg.