• Archives of Plastic Surgery
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• 제38권2호
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• pp.143-147
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• 2011

Purpose: A Tessier classification number 7 cleft is an uncommon malformation that results from a failure of mesenchymal fusion within the maxillary and mandibular prominences of the 1st pharyngeal arch. Many operative techniques of the number 7 cleft repair have been proposed to restore function and improve aesthetics. Fifteen patients underwent repair of a number 7 cleft over 13 years by a modification of the surgical Technique, and an appraisal of the operative outcome is reported herein. Methods: A retrospective review was conducted involving 15 patients with number 7 clefts who underwent surgery from 1996 to 2009. The changes in surgical technique included skin closure, attachment of the orbicularis oris muscle, and position of the repaired commissure; the changes were analysed with a review of the medical records and the outcomes of surgery were analysed via photographs. Specifically, the technique of skin closure was changed from the a Z-plasty to a linear closure, the orbicularis oris muscle overlapped attachment was replaced by a side-to-side approximation with horizontal mattress sutures, and the position of the repaired commissure was changed from 1 mm laterally to 1 mm medially in reference to the non-cleft side. Results: A Z-plasty caused additional cutaneous scarring, an overlapped attachment of the orbicularis oris muscle caused a thick oral commissure, and the repaired commissure migrated to the lateral side, so a 1 mm, laterally-positioned commissure caused asymmetry. The altered procedure included a linear skin closure, a side-to-side orbicularis oris muscle approximation, and a 1 mm, medially-positioned commissure, which together resulted in a good outcome. Conclusion: The altered procedure for repair of a number 7 cleft as described herein, yields a short scar, no functional problems with the orbicularis oris muscle, a thin oral commissure, and symmetry of the repaired commissure.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.11-21
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• 2005

The purpose of this study was to investigate how COP displacement of a hemiplegic foot in stance phase during gait is related to clinical balance measures and the recovery stage in hemiplegic stroke patients. Twenty-eight functionally ambulant hemiplegic patients who had suffered from strokes and thirty age-matched healthy subjects participated in this study. COP parameters were calculated. Clinical balance was measured using the Functional Reach Test (FRT) and Timed Up and Go Test (TUGT). The recovery stage, proprioception, and clonus of the ankles or lower extremities were also measured for physical impairment status. The COPx max-displacement in the medial-lateral side of the stroke patients was significantly longer than that of the normal group (p=.038). The COPy max-displacement in the anterior-posterior side of the stroke patients was significantly shorter than that of normal group (p<.001). Significant differences in the COPx and COPy displacement asymmetry index were found between the two groups (p<.01). The FRT was correlated with the COPx displacement (r=.552) and COPy displacement (r=.765). The TUGT was correlated with the COPy displacement (r=-.588) only. The recovery stage of the lower extremities was correlated with COPy displacement (r=.438). The results of the study indicate that the characteristic of COP displacement in hemiplegic feet in stance phase during gait is related to balance ability and recovery in stroke patients. COP parameters acquired by the mapping of foot pressure in stance phase during gait will provide additional useful clinical information. This information can be used by clinicians to assess objectively the pathologic gait with other diseases and to evaluate the therapeutic effects on gait in stroke patients.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.9-19
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• 1993

The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).

• 대한지리학회지
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• 제33권3호
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• pp.355-364
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• 1998

하천 합류점의 하노형상을 파악하고 하도형상에 영향을 미치는 요소를 조사하기 위해 소형 수로실험을 실시했다. 합류하는 두 수류리 모삔트가 동일하면 할류후 하도는 합류각도를 이분하는 방향으로 늘어서기 때문에 초기하도의 배열에 따라 하도의 측방이동이 일어난다. 그 결과 합류후 하도의 형상은 합류의 평면형태 즉 대칭형, 점이형. 비대칭형에 따라 달라진다. 합류에 기인하는 가장 특징적인 하도혈상으로 하상 세굴부를 들 수 있다. 급경사의 양벽으로 둘러싸인 합류점의 세굴부는 기본적으로 합류각도에 의해 지배된다. 하천합류는 전통적으로 협화적이라고 표현되어 왔지만 불협화적 합류도 빈번하게 발생한다. 합류의 불협화에는 합류하천의 유량비뿐만 아니라 유사농도비도 관여한다. 따라서 불협화를 일으키는 최대요소로는 두 비를 고려한 수면폭당 단위유량비를 들 수 있다.

• 대한치과교정학회지
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• 제43권1호
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• pp.42-52
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• 2013

The aim of this paper was to propose a new method of bimaxillary orthognathic surgery planning and model surgery based on the concept of 6 degrees of freedom (DOF). A 22-year-old man with Class III malocclusion was referred to our clinic with complaints of facial deformity and chewing difficulty. To correct a prognathic mandible, facial asymmetry, flat occlusal plane angle, labioversion of the maxillary central incisors, and concavity of the facial profile, bimaxillary orthognathic surgery was planned. After preoperative orthodontic treatment, surgical planning based on the concept of 6 DOF was performed on a surgical treatment objective drawing, and a Jeon's model surgery chart (JMSC) was prepared. Model surgery was performed with Jeon's orthognathic surgery simulator (JOSS) using the JMSC, and an interim wafer was fabricated. Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, and malar augmentation were performed. The patient received lateral cephalometric and posteroanterior cephalometric analysis in postretention for 1 year. The follow-up results were determined to be satisfactory, and skeletal relapse did not occur after 1.5 years of surgery. When maxillary and mandibular models are considered as rigid bodies, and their state of motion is described in a quantitative manner based on 6 DOF, sharing of exact information on locational movement in 3-dimensional space is possible. The use of JMSC and JOSS will actualize accurate communication and performance of model surgery among clinicians based on objective measurements.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.77-84
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• 2024

Background: The facial artery is an important blood vessel responsible for supplying the anterior face. Understanding the branching patterns of the facial artery plays a crucial role in various medical specialties such as plastic surgery, dermatology, and oncology. This knowledge contributes to improving the success rate of facial reconstruction and aesthetic procedures. However, debate continues regarding the classification of facial artery branching patterns in the existing literature. Methods: We conducted a comprehensive anatomical study, in which we dissected 102 facial arteries from 52 embalmed and formaldehyde-fixed Vietnamese cadavers at the Anatomy Department, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Results: Our investigation revealed eight distinct termination points and identified 35 combinations of branching patterns, including seven arterial branching patterns. These termination points included the inferior labial artery, superior labial artery, inferior alar artery, lateral nasal artery, angular artery typical, angular artery running along the lower border of the orbicularis oculi muscle, forehead branch, duplex, and short course (hypoplastic). Notably, the branching patterns of the facial artery displayed marked asymmetry between the left and right sides within the same cadaver. Conclusion: The considerable variation observed in the branching pattern and termination points of the facial artery makes it challenging to establish a definitive classification system for this vessel. Therefore, it is imperative to develop an anatomical map summarizing the major measurements and geometric features of the facial artery. Surgeons and medical professionals involved in facial surgery and procedures must consider the detailed anatomy and relative positioning of the facial artery to minimize the risk of unexpected complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권4호
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• pp.321-329
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• 2001

안면 비대칭이나 반안면 왜소증등과 같은 악변형증 환자의 진단 및 치료계획을 수립함에 있어서 종합적이고도 3차원적인 접근을 하는 것이 중요하다. 최근 3차원 CT가 개발되었으나 이 경우 계측점의 정확성이 아직 확립되어 있지 않다. 최근들어 두부 위치를 보정하여 다른 시기에 촬영된 방사선 사진을 3차원적으로 비교할수 있도록 하는 방법이 소개되었다. 이러한 방법을 이용하여 얻어진 3차원 좌표값 자동적으로 계산한 후 3차원적 구조 분석 및 계측을 할 수 있는 컴퓨터 프로그램을 개발하였다. 이 프로그램은 정중면을 설정하는 개념에 입각하여 안면구조물의 변형정도를 다양한 방법으로 나타낼수 있으며 이러한 기능은 특히 안면 비대칭의 분석과 술전, 후 비대칭의 정도를 파악하는데 유용한 것으로 보인다.

• 대한소아치과학회지
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• 제38권3호
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• pp.270-275
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• 2011

섬유성이형성증은 골격 계통의 국소화된 양성 발육장애로서 해면골 내에서 섬유조직이 증식되며 불규칙한 골소주가 형성되는 질환이다. 섬유성이형성증의 두개안면부 병소는 안면동통, 두통, 두개비대칭, 안면기형, 치아이동, 부정교합, 시각이상, 청각이상 등의 증상이 나타날 수 있다. 본 증례는 섬유성이형성증으로 진단된 혼합치열기 환아로서 이환 부위에서 영구치의 맹출지연이 관찰되었다. 병소에 이환되지 않은 환아의 하악 좌측 측방 치열군은 교합위까지 맹출을 완료하였으나 병소에 이환된 하악 우측 측방 치열군은 현재 치조골 내에서 느린 속도로 맹출 중이며 치근 형성이 완료되지 않아 계속 경과 관찰 중이다. 맹출이 정지되었다고 판단될 시 상부 치조골 제거를 통한 맹출유도나 교정적 정출을 고려할 수 있을 것이다.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.28-36
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• 2012

This study used an unstable platform to change the support surface type and position of both lower limbs in order to determine changes in weight distribution and muscle including the vastus medialis, tibialis anterior, lateral hamstring, and lateral gastrocnemius of both lower limbs were evaluated during knee joint flexing and extending in a semi-squat movement in 32 hemiplegic patients. The support surface conditions applied to the lower limbs were divided into four categories: condition 1 had a stable platform for both lower limbs; condition 2 had an unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side; condition 3 had a stable platform for the non-hemiplegic side and an unstable platform for the hemiplegic side; and condition 4 had an unstable platform for both sides. The normalized EMG activity levels of muscles and weight bearing ratio of both sides in the four surface conditions were compared using repeated measures ANOVA. A significant increase was found in the weight support distribution for the hemiplegic side in flexing and extending sessions in condition 2 compared to the other conditions (p<.05). A statistically significant decrease in significant decrease in asymmetrical weight bearing in flexing and extending sessions was observed for condition 2 compared to the other conditions (p<.05). A similar significant decrease was found in differences in muscular activity for both lower limbs in condition 2 (p<.05). The muscular activity of the hemiplegic side, based on the support surface for each muscle showed a significantly greater increase in condition 2 (p<.05). An unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side therefore increased symmetry in terms of the weight support distribution rate and muscle activity of lower limbs in hemiplegic patients. The problem of postural control due to asymmetry in hemiplegic patients should be further studied with the aim of developing continuous effects of functional training based on the type and position of the support surfaces and functional improvement.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.431-438
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• 2008

Purpose: The common deformity after the correction of unilateral cleft lip nasal deformity is nasal asymmetry, and it is caused by the hypoplasia of the pyriform aperture. To correct this, many procedures have been applied, but still many problems are present. Authors performed the inlay and onlay insertion of porous high density polyethylene sheet(1 mm thickness $Medpor{(R)}$ sheet) in the hypoplastic pyriform margin of cleft side and obtained satisfactory results. Methods: 11 cases were performed and the mean follow up period was 15.1 months. Their mean age was 23.6 years. Under general anesthesia, bilateral pyriform margin was exposed. $Medpor{(R)}$ sheets in "match stick" like shaped were inlay inserted, and kidney shaped were onlay inserted fixating with two 6 mm titanium screws. After the surgery, the results was evaluated by photogrammetric analysis. On the basal view, the distance from the subalare and labiale superius' to the transverse baseline connecting the both cheilions was measured from the cleft side and the non-cleft side. Then, the postoperative symmetry was assessed by obtaining the cleft side against the non-cleft side as proportion index, defined as lateral and medial upper lip contour index. Results: There were 2 infections. The cause was because the inserted implant was too long and thus protruded to the base of nasal cavity. The lateral upper lip contour index was from 95.49 to 103.27, and medial upper lip contour index was from 90.92 to 100.49, it was statistically increased, and thus the symmetry was improved. However clinically mild depression remained at nostril floor. Conclusion: Authors performed porous high density polyethylene sheet inlay and onlay insertion for the hypoplasia of the pyriform margin in unilateral cleft lip nasal deformity. It was found that depressed pyriform margin and upper lip were corrected effectively except for the nostril floor, for which an additional soft tissue augmentation would be necessary. The inlay insertion has risk of protrusion, thus the guideline of the use of artificial prosthesis should be observed strictly.