• Archives of Plastic Surgery
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• 제49권1호
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• pp.39-42
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• 2022

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.

• 한국전문물리치료학회지
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• 제20권1호
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• pp.47-54
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• 2013

The purpose of this study was to compare the immediate effects of upper trapezius muscle stretching in more tensed position (MTP) and less tensed position (LTP) on the change of range of motion (ROM) for neck rotation, and the ROM for conjunct neck motions at end-range of neck rotation toward the painful side in patients with unilateral neck pain. Eighteen patients with unilateral neck pain were recruited for the study's MTP group, and 18 age-, weight- and gender-matched patients with unilateral neck pain were recruited for LTP group. The ROM changes in active neck primary and conjunct motions were measured using a cervical ROM inclinometer in the sitting position. Our results showed that both upper trapezius stretching method in MTP and LTP were significantly effective in increasing the ROM of neck rotation toward painful side in patients with unilateral neck pain. However, a significantly greater increase in the ROM for neck rotation and a further decrease in conjunct neck extension during neck rotation toward the painful side were shown in MTP group, compared to LTP group. The upper trapezius stretching in MTP is useful in increasing the ROM of neck rotation and decreasing the range of conjunct neck extension during neck rotation toward the painful side in patients with unilateral neck pain.

• 간호행정학회지
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• 제5권2호
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• pp.225-235
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• 1999

This study was conducted to offer a basic material for effective human resource management of nurses by studying correlations among inter-department rotation, job motivation and organizational commitment. For this study 159 nurses in a medical college hospital were surveyed. Organization Assessment Instrument(Van de Ven. 1980) and Organizational Commitment Questionnaire (Mowday, 1979) were used. SPSS was used to analyze the data. The results of this study are as follows : 1. Nurses who had been rotated to other departments showed higher motivation scores than those who had not. 2. Nurses who had been rotated also indicated higher organizational commitment scores than those who had not. 3. There was significant positive correlations among nurse's age, job motivation and organizational commitment of nurses. 4. There was significant positive correlations among nurse's experience, job motivation and organizational commitment of nurses. 5. Inter-department rotation times were significant positive correlation with job motivation. 6. "The sense of achievement perceived form performing one's duty" was the most important criteria that nurses consider in measuring their job motivation. As to the criteria for inter-department rotation, some respondents stated that it is needed when "current assignments are not suited for particular individuals" and such rotations would job motivation and elevate the morale of nurses involved." Many opposed using the rotations as a "means of reprimanding individuals." In conclusion, inter-department rotation has a positve effect on the nurse's job motivation and organizational commitment, so regular inter-department rotation have to be recommended to nurses who want rotation.

• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.59-71
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• 2024

Background: Restoration of external (ER) and internal rotation (IR) after Grammont-style reverse shoulder arthroplasty (RSA) is often unreliable. The purpose of this systematic review was to evaluate the influence of RSA medio-lateral offset and subscapularis repair on axial rotation after RSA. Methods: We conducted a systematic review of studies evaluating axial rotation (ER, IR, or both) after RSA with a defined implant design. Medio-lateral implant classification was adopted from Werthel et al. Meta-analysis was conducted using a random-effects model. Results: Thirty-two studies reporting 2,233 RSAs were included (mean patient age, 72.5 years; follow-up, 43 months; 64% female). The subscapularis was repaired in 91% (n=2,032) of shoulders and did not differ based on global implant lateralization (91% for both, P=0.602). On meta-analysis, globally lateralized implants achieved greater postoperative ER (40° [36°-44°] vs. 27° [22°-32°], P<0.001) and postoperative improvement in ER (20° [15°-26°] vs. 10° [5°-15°], P<0.001). Lateralized implants with subscapularis repair or medialized implants without subscapularis repair had significantly greater postoperative ER and postoperative improvement in ER compared to globally medialized implants with subscapularis repair (P<0.001 for both). Mean postoperative IR was reported in 56% (n=18) of studies and achieved the minimum necessary IR in 51% of lateralized (n=325, 5 cohorts) versus 36% (n=177, 5 cohorts) of medialized implants. Conclusions: Lateralized RSA produces superior axial rotation compared to medialized RSA. Lateralized RSA with subscapularis repair and medialized RSA without subscapularis repair provide greater axial rotation compared to medialized RSA with subscapularis repair. Level of evidence: 2A.

• 한국운동역학회지
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• 제29권2호
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• pp.61-70
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• 2019

Objective: This study aimed to investigate the characteristics of the declination of the subtalar joint rotation axis and the structural features of the ankle joint complex such as rear-foot angle alignment and ligament laxity test between chronic ankle instability (CAI) patients and healthy control. Method: A total of 76 subjects and CAI group (N=38, age: $23.11{\pm}7.63yrs$, height: $165.67{\pm}9.54cm$, weight: $60.13{\pm}11.71kg$) and healthy control (N=38, age: $23.55{\pm}7.03yrs$, height: $167.92{\pm}9.22cm$, weight: $64.58{\pm}13.40kg$) participated in this study. Results: The declination of the subtalar joint rotation axis of the CAI group was statistically different from healthy control in both sagittal slope and transverse slope. The rear-foot angle of CAI group was different from a healthy control. Compared to healthy control, they had the structure of rear-foot varus that could have a high occurrence rate of ankle varus sprain. CAI group had loose ATFL and CFL compared to the healthy control. Conclusion: The results of this study showed that the deviation of the subtalar joint rotation axis and the structural features of the ankle joint complex were different between the CAI group and the healthy control and this difference is a meaningful factor in the occurrence of lateral ankle sprains.

• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.191-196
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• 2020

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R². Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.

• 대한물리치료과학회지
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• 제10권2호
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• pp.53-61
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• 2003

The purposes of this study were to describe and compare pint moments according to 6 types of gait methods during free speed. 15 volunteers(7 male, 8 female: mean age = 23.33 yrs.) participated and performed 6 types of gait methods. From the 3 types of pint moments of lower extremities(hip, knee, ankle and foot), the following results were made: 1. In left hip pint, the flexion-extension moment was not significantly different, but the adduction-abduction moment and rotation moment were showed different curves during stance phase. 2. In left knee pint, the flexion-extension moment was not significantly different, but the varus-valgus moment and rotation moment were showed different curves during stance phase. 3. In left ankle and foot the dorsiflexion-plantarflexion moment was not significantly different but the varus-valgus moment and rotation moment were showed different curves during stance phase. In conclusion, because weight loading gait with 10-20% of body weight were normal gait patterns, It was inferred that all weight loading gaits did not indicate noxious reactions of human body.

• 대한치과의사협회지
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• 제16권11호통권114호
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• pp.849-856
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• 1978

Relapse following rotational movement of the tooth is a common problem in orthodontic practice. To overcome such relapse, many procedures have been advocated: prolonged retention, permanent retention, over-rotation, rotation of teeth at an early age, surgical procedures such as gingivectomy, redressement force, septotomy, et cetra. A 23-year-old woman presented with Angle's Class I malocclusion and extreme rotation of maxillary central incisors. After 15 months' active therapy, septotomy was performed on maxillary central incisors and Howley retainer was applicated for the purpose of overcoming rotational relapse. During the 1 year post-operative observation, negligible, if any, rotational relapse occurred.

• 대한치과교정학회지
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• 제15권1호
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• pp.123-140
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• 1985

Variation in the facial pattern and effect of the rotational jaw growth on the facial proportion were studied in serial cephalometric radiographs of 40 Korean children (25 boys, 15 girls) ranging in age from 6 to 13 years. According to Y-axis (N-S-Gn) growth change during the 7 years of period, the subject who had exhibited 'wave-like' manner of Y-axis growth change within ${\pm}\;2^{\circ}$ was classified to the Parallelwise group and the subject who had exhibited Y-axis increase more than $+2^{\circ}$ was classified to the Clockwise rotation group and the subject who had exhibited Y-axis decrease more than $-2^{\circ}$ was classified to the Counterclockwise rotation group. For the comparison of each group, a total of 22 morphologic variables were employed and the data were analyzed by means of computer morphometrics and statistical methods. On the basis of the finding of this study, the following trends were established. 1. The Parallelwise group was $75\%$, the Clockwise rotation group was $12.5\%$ and the Counter-clockwise rotation group was $12.5\%$. 2. The growth pattern of cranial base was related to the rotation of mandible. 9. Maxillary prognathism was occured in the Counterclockwise rotation group and the rotation of palatal plane was occured in the Clockwise rotation group. 4. Mandibular prognathism was occured in the Parallelwise and the Counterclockwise rotation groups, especially in the Counterclockwise rotation group. 5. The degree of maxillo-mandibular divergency was constant in the Clockwise rotation group but decreased in the Counterclockwise rotation and the Parallelwise groups, especially in the Counterclockwise group. 6. There were no differences in the size of the anterior upper facial height (N-ANS) and the posterior lower facial height ((Go-Me)-PNS) but there were differences in the size of the anterior lower facial height (ANS-Me) and the posterior upper facial height ((S-N)-PNS) between each group. 7. The growth increment and the size of the facial depth was not related to the growth pattern of the face but the growth increment and the size of the facial height was related to the growth pattern of the face. 8. Proportional change due to the facial growth rotation was concentrated in the anterior lower face. 9. The most apparent difference between each group was happened in the size of the posterior cranial base (S-Ba) and the facial length (S-Gn).

• 한국임상보건과학회지
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• 제1권1호
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• pp.29-34
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• 2013

Purpose : This study was to investigate that tongue positions have effect on the cervical range of motion (ROM). Methods : 18 subjects, 20 to 25 years of age, were participated in this study. The tongue positions were neutral position, anterior protrusion, posterior protrusion, superior protrusion, inferior protrusion, left side protrusion and right side protrusion. The neck movements were right side flexion, left side flexion, right rotation and left rotation. The cervical range of motion measured by cervical range of motion instrument (CROM, C9266-49, USA). The changes were analyzed using the paired t-test. SPSSWIN (ver. 20.0) was used for data analysis and the significance level was chosen as ${\alpha}$=0.05. Results : In the lateral flexion, the angle of left lateral flexion increased in anterior protrusion(p<0.05) and right side protrusion(p<0.05) significantly. In the rotation, the angle of right rotation increased in anterior protrusion(p<0.05), posterior protrusion (p<0.05), superior protrusion(p<0.05), inferior protrusion(p<0.05), and left side protrusion (p<0.05) significantly. Conclusions : In conclusion, we found that the tongue positions affected some cervical movements.