• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.267-269
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• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.557-562
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• 2006

Purpose: Advanced carcinoma of the tongue is a devastating disease which may cause severe speech or swallowing dysfunction. But, none to date has provided all of the complex functions of the tongue. The purpose of this study is to review our experiences with individuals who underwent glossectomy followed by reconstruction using free tissue transfer. Methods: Between February 1998 and February 2005, twenty-four patients underwent glossectomy followed by free tissue transfer reconstruction. The defects of tongue caused by partial or subtotal glossectomy were reconstructed by means of radial forearm or lateral thigh free flap with nerve innervation. Especially for the patients who underwent total glossectomy, we reconstructed deglutition muscles anatomically with nerve reinnervation, a procedure that allows the grafted muscle to maintain good tongue bulk without obvious atrophy. Results: Patients were reviewed to determine their functional outcome as it related to speech, deglutition, and aspiration. All patients achieved oral intake of a soft diet and acceptable speech. Conclusion: Although reconstruction following glossectomy using free tissue transfer is not ideal, this procedure is safe and reliable, and provides predictable results. A future challenge is the development of a surgical procedure for reconstruction of a tongue that maintains mobility and sensation using neurotized flaps.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.131-135
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• 2007

23세 남환에서 발생한 요골 두 급성 전방 탈구를 경험하였기에 이를 보고하고자 한다. 수상 당시 전완부는 회내전, 주관절은 약간 굴곡되어 있었고, 손이 지면에 닿아 체중이 실리면서 주관절의 갑작스런 과도한 회내전이 발생하였다. 요골 두는 상완근의 외측 근육 다발에 의해 감돈 되었고, 윤상인대가 척골의 후방 부착부에서 견열되어 요골 두와 소두 사이에 끼어 정복을 방해하였다. 관혈적 정복을 시행하였다. 12개월간 추시 관찰을 하였으며 요골 두의 정복은 잘 유지되고 있었고 주관절의 운동제한은 없었다.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.146-149
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• 2007

선천성 상위 견갑골은 주로 편측성으로 발생하는 선천성 질환으로 견갑골이 정상적인 위치보다 위에 위치하고 하각은 내측으로 상각은 외측으로 회전되는 변형이 발생한다. 저자들은 3-7세인 수술 적기가 이미 지난 상태였으며 수술적 치료를 시행한 1예를 문헌 고찰과 함께 보고하고자 한다. 환자는 7세 남자로 좌측 견갑-흉곽 운동의 제한을 주소로 내원하였으며 견갑 척추 골 유합과 견갑주위 근육의 발육부전도 동반되어있었고 수술적 교정 후 운동범위 증가와 미용의 개선이 있었다.

• 한국운동역학회지
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• 제16권3호
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• pp.165-172
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• 2006

The purpose of this study was to determine effects of 12-week wearing of unstable shoe on the standing posture and gait mechanics. Nine healthy men were asked to wear the unstable shoes for 12-week and walk for 30 minute everyday. Their standing posture and gait mechanics were measured before and after treatment. Standing posture was measured for each side(anterior, posterior, lateral) for standing position. And gait analysis was measured joint angle of a right lower limb between first right heel contact and second right heel contact. Kinematic data were collected using video camera at 30 frame per seconds. Statistical analysis was paired t-test(p<.05) to compare before training with after that. A head tilt angle was significantly decreased for posterior side(p<.05). The angle of between center of line and surface was significantly decreased at midstance and take off during walking(p<.05). Ankle dorsiflexion significantly increased at heel contact2(p<.05) and ankle plantarflexion significantly increased at midstance and midswing(p<.05). The increase of ankle dorsiflexion showed that our results consisted with previous study. In conclusion, there was not large significant difference in static standing posture but joint angle of lower limb represented many changes with increasing of ankle motion during walking. These were of benefit to body by increasing leg muscle activity but it was necessary for man having a ankle problem to consider. Further studies concerning optimum outsole angle of unstable shoes are necessary.

• Journal of Trauma and Injury
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• 제28권1호
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• pp.39-42
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• 2015

Lat. abdominal wall hematoma with active bleeding is very rare but need prompt bleeding control. We report successful treatment by angiographic embolization of superficial circumflex iliac artery rupture caused by blunt trauma. A 60-year-old woman presented painful, enlarging, lat. abdominal wall mass with ecchymosis caused by blunt abdominal trauma. Contrast leakage of superficial circumflex iliac a. within the lt. ext. oblique m. hematoma was confirmed by abdominal computed tomography. Angiographic embolization was performed successfully. Patient was discharged at 4th day after trauma without complication. Angiographic embolization is important treatment option of lat. abdominal wall hematoma with active bleeding replacing emergency surgery.

• 구강회복응용과학지
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• 제30권3호
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• pp.238-245
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• 2014

무치악 환자에서 기능적으로 우수하고 심미적으로 만족스러운 의치 제작을 위해서는 상, 하악 교합관계, 즉 교합수직 고경과 중심위를 정확하게 결정해야 한다. 수직관계를 결정할 때에는 근육, 상, 하악 치열궁간 거리와 상, 하악 치조제의 평행도 등 여러 요소들이 고려되어야 한다. 또한, 중심위는 모든 하악 운동이 시작되는 재현 가능한 위치로서 기록하는 과정 역시 의치 제작에 매우 중요하다. 만일 이러한 악간관계 채득시 오차가 생기면 결과적으로 제작한 의치가 불편하게 된다. Gothic arch tracer와 같은 트레이싱을 이용하는 방법은 술자가 쉽게 교합수직고경과 중심위를 찾아내고 기록할 수 있는 좋은 방법으로 안정적인 교합수직고경에서 하악의 운동위를 얻기에 유리하다.

• 대한치과교정학회지
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• 제43권5호
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• pp.225-234
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• 2013

Objective: The purpose of this study was to classify Korean young adults into 3 groups on the basis of upper incisor exposure rates (UIERs) and to compare the skeletal, dental, and soft tissue variables. Methods: Samples were obtained from 127 students at the College of Dentistry, Wonkwang University in South Korea. Facial photographs of frontal posed smiles and lateral cephalograms of the subjects were taken. The subjects were divided into 3 groups on the basis of UIERs and 20 measurements were compared among the 3 groups. The correlations between the variables were determined. Results: Male and female subjects showed significant differences in the group distribution. Male subjects showed higher frequencies of low smiles, and female subjects showed higher frequencies of high smiles. The vertical height of the anterior alveolar process of the maxilla directly correlated with the UIER. However, the UIER showed no significant correlation with the vertical height of the anterior basal bone or the inclination of the upper incisor axis. In female subjects, the upper central incisor clinical crown length showed an inverse correlation with the UIER. However, this variable showed no significant correlation with the UIER in male subjects. Conclusions: The UIER was directly correlated with the levator muscle activity of the upper lip and inversely correlated with the upper lip thickness, yet there was no correlation between the UIER and upper lip length at rest.

• 구강회복응용과학지
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• 제21권1호
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• pp.43-57
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• 2005

Temporomandibular disorders have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory nuscles, and associated structures. There have been many different contributing factors of TMDs which were traumatic, occlusal, pathophysiological and psychosocial. Among there factors, the effect of occlusion on TMDs have been a controversy for a long time. The purpose of this study was to investigate the effect of occlusal factors and oral habits on TMDs. In this study, 140 subjects with signs and symptoms of TMDs and diagnosed of TMD in the Orofacial Pain clinic of Yonsei University Dental Hospital though March to July 2004 were selected for the TMDs group and 50 subjects without any signs and symptoms of TMDs as the control group. The subjects were evaluated clinically in TMDs' Occlusal and Prosthodontic Restoration examinations. TMDs' examination was composed of the TMJ pain, sound, locking, temporal or masseter muscle palpation, mandibular movement, oral habits and headache. Occlusal examination was made of overjet, overbite, lost teeth number, nonfunctional interference, midline shift, then pattern of lateral movement and attrition. prosthodontic restoration examination had the existence of restoration, placement, then number of crown or bridge and Satisfiable index which estimated the quality of occlusal state of prosthodontic restorations. Following results were obtained : 1. The prevalence of TMDs was higher in their 20s & 30s, female of the TMD patients group. 2. The clenching frequency in the TMDs group(40.71%) was higher than those in the control group(18.00%), and there was a significant statistical difference(p<0.05). 3. The frequency of Nonfunctional interference in the TMDs group(10.00%) was higher than those in then Control group(2.00%), and there was a significant statistical difference(p<0.05). The result of this study indicated TMDs prevalence was higher in their 20s, 30s, female group of TMDs patients similar to the previous studies. Clenching and nonfunctional interference were estimated as the contributing factors of TMDs.

• 대한한의학회지
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• 제22권2호
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• pp.31-40
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• 2001

This experimental studies was to investigate location of labeled neurons in CNS following injection of pseudorabies virus(PRV), Bartha strain, into the uterus and Sanyinjiao(Sp6) of rats. After survival times of 4-5 days following the injection of PRV, the rats were perfused, and their brain and spinal cord were frozen sectioned($30\mu\textrm{m}$). These sections were stained by PRV immunohistochemical staining methods, and observed with light microscope. The results were as follows: 1. In the spinal cord, overlap areas of PRV labeled neurons projecting to uterus and Sp6 were observed in lamina VII, IX and X areas of cervical segments. In thoracic segments, overlap areas were observed in lamina IV, VII, X and intermediolateral n.. In lumbar segments, overlap area of PRV labeled neurons were observed in lamina I, V-VII, IX, X and intermediolateral n.. In sacral segments, overlap areas of PRY labeled neurons were observed in lamina N, V, VII, X and sacral parasympathetic n.. 2. In the brain, overlap areas of PR V labeled neurons projecting to the uterus and Sp6 were observed in lateral paragigantocellular n., rostroventrolateral reticular n., raphe obscurus n., raphe pallidus n., raphe magnus n., locus coeruleus n., Barrington's n., A5 cell group, central gray n., paraventricular hypothalamic n. and arcuate n. This results suggest that overlap areas of PRV labeled neurons of the spinal cord projecting to the uterus and Sp6 might be the first-order neurons related to the viscera-somatic sensory and sympathetic preganglionic neurons. PRV labeled neurons of the brain may be the second and third-order neurons response to the movement of smooth muscle of uterus. These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitoring the internal environment. These overlap areas of spinal cord and brainmay be related to autonomic centers related to regulation of uterus.