• Title/Summary/Keyword: Unaffected Side

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Evaluation of soft tissue asymmetry using cone-beam computed tomography after open reduction and internal fixation of zygomaticomaxillary complex fracture

  • Kim, Dong Hyuck;Kim, Rae Hyong;Lee, Jun;Chee, Young Deok;Kwon, Kyoung-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.3
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    • pp.103-110
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    • 2014
  • Objectives: In this study, we assessed soft tissue asymmetry that occurred after open reduction of unilateral zygomaticomaxillary complex (ZMC) fractures. We proposed a simple method to assess soft tissue asymmetry after reduction surgery by evaluating the symmetry between the affected and the unaffected sides. The factors affecting soft tissue contour after surgery were also analyzed. Materials and Methods: Subjects included patients admitted to Wonkwang University Dental Hospital from 2008 to 2013. Cone-beam computed tomography (CBCT) images of asymmetric patients who underwent open reduction at least 3 months prior were compared with healthy patients. Results: The degree of asymmetry was measured in both the open reduction and control groups. Landmarks that showed a statistically significant difference between the two groups were zygion ($1.73{\pm}0.24mm$), bucclae ($1.08{\pm}0.26mm$), point of cheek ($2.05{\pm}0.33mm$) and frontozygomatic point ($1.30{\pm}0.31mm$). Conclusion: When compared with the normal group, asymmetry can occur in the affected side, which usually shows depression of overlying soft tissue and is statistically significantly different. Evaluation of soft tissue asymmetry with CBCT images after open reduction of ZMC fracture is useful.

Effect of Chronic Foot Disease to Bone Mineral Density of the Affected Lower Limb (만성 족부 질환이 환측 하지의 골밀도에 미치는 영향)

  • Chu, In-Tak;Yoo, Jong-Min;Kang, Min-Gu;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.165-168
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    • 2010
  • Purpose: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. Materials and Methods: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. Results: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p <0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p <0.05). Conclusion: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.

The Effect of Balance Training With Upper Extremity Exercise on the Improvement of Balance Performance After Stroke

  • Song, Ju-Min;Kim, Soo-Min;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.14 no.4
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    • pp.75-83
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    • 2007
  • The purpose of this study was to investigate the effect of balance training with upper extremity exercise on the improvement of balance performance in people who have had a stroke. Eighteen candidates who have all experienced a stroke, were living in Dong-Gu, Ulsan and were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 7 consecutive weeks. Subjects were tested with 7 m and 100 m Timed Gait Test (sec), Timed Get Up and Go Test (sec), Functional Reach Test (cm) and 5 items of Berg's Balance Test at pre-training and post-training. Total balance index and balance ratios were measured by K.A.T. 3000. The balance training program performed by sitting on a chair and gymnastic ball and standing on stable and unstable surfaces during upper extremity exercises such as Proprioceptive Neuromuscular Facilitation (PNF) upper extremity pattern, picking a ball up from floor, throwing and catching it. After seven weekends of balance training, subjects showed a significant difference in balance test results. The exceptions were three items of Berg's Balance Test (p<.05). Balance index score and affected and unaffected side balance ratio had a larger improvement than pre-training (p<.05). The result of this study showed that intervention of this balance training program could improve the balance performance in people who have had a stroke.

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Results of Operative Treatment for Large Osteochondral Lesion of Medial Talar Dome (내측 거골 체에 발생한 비교적 큰 골연골 병변에 대한 수술적 치료 결과)

  • Jeong, Un-Seob;Park, Yong-Wook;Lee, Jae-Hyung
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.150-155
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting harvested from medial side of talus for relatively large osteochondral lesion of the medial talar dome. Materials and Methods: From October 2004 to September 2005, 12 patients with osteochondral lesion measured more than 10 mm in axial MRI who were followed up more than 1 year after operation were analyzed. We evaluated postoperative symptoms by Mann and Reynolds scale, morbidity of donor site, and compared the range of both ankle motion. We also evaluated the union at the medial malleolar osteotomy site, trabecular connection between the grafted osteochondral mass and talus, irregularity of the articular surface in lesion. Results: Clinical results were rated as excellent in 4, good in 7, fair in 1. The mean angle of the total range of motion in affected ankle was decreased by 3 degrees compared to that in unaffected ankle. We did not observe abnormal findings at donor site. The osteotomized bone was united at mean 9 weeks (range, 8-12 weeks). We observed trabecular connection between grafted osteochondral mass and talus at mean 14 weeks (range, 12-16 weeks). We also observed irregular articular surface in osteochondral lesions in 6, smooth articular surface in 6. Conclusion: The local autologous osteochondral graft for relatively large osteochondral lesion of the medial talar dome is useful operative method with advantages of wide operative field, low morbidity of donor site, and high satisfaction rate.

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Craniofacial Deformity in a Patient with Dyke-Davidoff-Masson Syndrome: A Case Report (Dyke-Davidoff-Masson 증후군 환자의 두개골 변형: 증례보고)

  • Lee, Seung-Hyun;Lee, Hye-Kyung;Jeong, Hii-Sun
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.50-53
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    • 2012
  • Purpose: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. Methods: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. Results: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. Conclusion: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.

Modified Fisher method for unilateral cleft lip-report of cases

  • Kim, Hui Young;Park, Joonhyoung;Chang, Ming-Chih;Song, In Seok;Seo, Byoung Moo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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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.

Upper extremity exercise training effects on motor activity, ADL and health related QOL of hemiplegic patients (상지운동훈련이 편마비 환자의 상지활동, 일상생활활동 및 건강관련 삶의 질에 미치는 효과)

  • Kim, Keum-Soon;Kang, Ji-Yeon
    • The Korean Journal of Rehabilitation Nursing
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    • v.5 no.2
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    • pp.134-144
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    • 2002
  • Purpose: The purpose of this study was to investigate the effects of upper extremity exercise training on the motor activity, the ADL and the health related quality of life. Method: A non-equivalent pretest-posttest design was used. Study subjects were conveniently selected 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who had been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of motor activity(amount, quality) of plegic side, ADL(ADL, IADL) and health related QOL(SF-36). Results: 1. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group. 2. There were no significant differences in ADL and IADL between experimental and control groups. 3. After 2 weeks of treatment, the health related QOL was significantly higher in subjects who participated in exercise training than in subjects in the control group. Conclusion: The above results state that the U/E exercise training could be an effective intervention for improving the motor activity and the health related QOL of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

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Comparison of Asymmetries on Masseter Muscle Thickness and Range of Motion in Subject With and Without Temporomandibular Disorders (턱관절 장애 유무에 따른 깨물근의 두께와 턱관절 가동범위의 비대칭성 비교)

  • Lee, Ji-won;Yang, Yeon-ju;Won, Jong-im
    • Physical Therapy Korea
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    • v.26 no.1
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    • pp.28-36
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    • 2019
  • Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation

  • Cho, Nam Su;Bae, Sung Ju;Lee, Joong Won;Seo, Jeung Hwan;Rhee, Yong Girl
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.93-99
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    • 2019
  • Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was $164.6^{\circ}$, external rotation at the side was $61.2^{\circ}$ and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

Occlusal Analysis of the Patients with Temporomandibular Disorders Using T-Scan II System (T-Scan II 시스템을 이용한 측두하악장애 환자의 교합 분석)

  • Yang, Dong-Hyo;Lee, Won-Seop;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.105-111
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    • 2007
  • Correlation between occlusal contact pattern and TMD have been hypothesized and partially investigated but results are controversial and not conclusive. The purposes of this study were to compare right-to-left difference of occlusal contact pattern, through contact points, contact force and occlusal balance, in the patients with unilateral TMD and also to evaluate its change related with TMD treatment. 36 patients with unilateral TMD from Department of Oral Medicine in Dankook University Dental Hospital were selected in this study (M:F=7:29, mean age of $29.2{\pm}14.8$ years). A computerized T-Scan II system (Tekscan, INC., USA) was employed for occlusal analysis and the simultaneity and occlusal balance through the number of tooth contact and magnitude of contact force were determined before and after TMD treatment. The number of contact points and contact force was more on the unaffected side than the affected side before treatment (p=0.056 and p=0.060, respectively) while significant difference between both sides was not found after treatment. The number of contact points and contact force on the affected sides significantly increased after treatment (p=0.038 and p=0.052), but the unaffected sides exhibited no significant difference between before and after treatment. In addition, sides difference in relative contact force decreased from about 27% to about 12% after TMD treatment (p=0.001). According to the results of this study, it is likely that unilateral TMD impairs right-to-left occlusal balance and that conservative TMD treatment alleviates the imbalance, subsequently leading to more symmetrical occlusal condition with increased contact points and force.