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Treatment of the Stiffness of the Elbow using Posterior Extensile Approach (광범위 후방 접근법을 이용한 주관절 강직의 치료)

  • Yoo Chong-Il;Kim Hui-Taek;Son Kyo-Min;Ku Jeong-Mo;Jung Chul-Yong
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.49-56
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    • 2005
  • Purpose: To review the surgical results of stiff elbow using the posterior extensile approach which provides a wide surgical view with a single posterior skin incision. Materials and Methods: From February 1999 to May 2002, we performed 6 surgical correction of stiff elbow using posterior extensile approach and followed the patients more than 1 year. In order to get better result, we performed cadaver study (four elbows of two fresh cadavers). Average duration of follow up was 15.7 months $(14{\sim}21)$. Functional results was analyzed using Brobery and Morrey analysis scale. Results: The approach through the plane between the extensor carpi radialis longus and the extensor carpi radialis brevis was ideal, because it preserves normal anatomy and provides a wide surgical view of the anterior joint. The posterior joint could be approached directly between the medial head of the triceps brachii and brachialis medially, the lateral head of triceps brachii and brachioradialis laterally. In all patients, an improved ROM was obtained with intra and extra-articular adhesiolysis: an average $61.7^{\circ}$ improvement $(50{\sim}75)$. Functional results were as follows: five excellent, one good. In addition, the patients' satisfaction was high since the scar from the operation was only a single line at the posterior surface of the elbow. Conclusion: In the treatment of stiff elbow, posterior extensile approach is thought to be useful because this method provides wide anterior and posterior surgical view.

A STUDY ON THE ANTERO-POSTERIOR MORPHOLOGY OF THE UPPER FACE IN ANGLE'S CLASS III MALOCCLUSION PATIENTS (Angle씨 III급 不正交合者(부정교합자) 上顔面(상안면)의 前後方(전후방) 形態(형태)에 관한 硏究(연구))

  • Lee, Jee-Hee;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.24 no.2
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    • pp.395-403
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    • 1994
  • To find out the antero-posterior morphology of the upper face in Angle's class III malocclusion patients, 90 patients, adults in Heilman's Dental age, were used as samples and following results were obtained after the relative comparision of antero-posterior relationship of upper facial structures between Angle's class I malocclusion patients and Angle's class III malocclusion patients and of antero-posterior size of upper facial structures to horizontal and vertical structures in each patients. 1. After comparison of the distance from PMV line to anterior margin of maxillary sinus and cheek, which determines the antero-posterior position of the upper face, upper face in Angle's class III patients are underdeveloped relative to Angle's class I patients. The distance between orbitale and anterior margin of maxillary sinus were greater in Angle's class I patients, whic implies thart the upper face in Angle's class III are depressed. 2. Antero-posterior dimension of anterior cranial base from PMV line and vertical dimension of upper face are statistically insignificant between two groups. After comparing antero-posterior position of upper face to anterior cranial base, the upper face in Angle's class Et patients are depressed antero-posteriorly in relation to anterior cranial base. Following the comparision of antero-posterior position of upper face in relation to vertical dimension of upper face, the upper face in Angle's class III patients seem to be narrow antero-posteriorly

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A Study for Normal Development of the Posterior Cranial Fossa in the Chick Embryos (gestation 14-20 days) with MR Images and Histopathology (정상 닭배자(배양14-20일)의 후두와 발생과정에 대한 연구 : 자기공명영상 및 해부병리학적 소견)

  • Sim Ki Bum;Lee Chang Sub;Shin Tae Kyun
    • Environmental Mutagens and Carcinogens
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    • v.25 no.1
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    • pp.25-31
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    • 2005
  • The objective was to use MR imaging to provide a template of posterior fossa development during the late stages in the chick embryos. The MR findings were then correlated with histological data. Fourteen normal formalin-fixed embryonic specimens with a gestational age of 14 to 20 days were examined with 1.5 Tesla unit MRl using a conventional clinical magnet and pulse sequences. The MR findings were correlated with the whole-mount histological specimens. Resolution of the morphological features of posterior fossa development in embryos greater than 14 days gestational age was possible. Development of cerebellum, brain stem, 4th ventricle and bony posterior fossa was documented. In the 14-day-old embryos, a premordial cerebellum was visualized in the enlarged bony posterior fossa, and it covered the the roof of the primitive fourth ventricle. The bony posterior fossa grows at the same rate along the supratentorial skull. The supratentorial skull and the rostral part of the brain grows at the same rate. The cerebellum begins to grow later than the rostral part of the brain. In the 19- to 20-day-old embryos, MRl revealed the rapid development of the cerebellar hemispheres, along with an increase in volume manifested by the more typical mushroom-shaped configuration observed in the newly hatched. At this stage, the cerebellum almost completely filled the posterior fossa and covered the entire fourth ventricle. The brain stem grew steadily, but the volume change was too subtle to evaluate. Features of cerebellar histogeneis were beyond the resolution of MRl. However, there were lots of artifacts in the features of the bony posterior fossa. An MR template of normal posterior fossa development would be useful to avoid confusion of normal development with abnormal development and to identify the expected developmental features when provided the estimated gestational age of a embryo.

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Comparison of Infraspinatus and Posterior Deltoid Muscle Activities According to Exercise Methods and Forearm Positions During Shoulder External Rotation Exercises (어깨 가쪽돌림 운동 시 운동방법과 아래팔의 자세에 따른 가시아래근과 뒤어깨세모근의 근활성도 비교)

  • Son, Myeong-gi;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.106-116
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    • 2022
  • Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

A STUDY OF THE POSTERIOR SLOPE OF THE ARTICULAR EMINENCE IN PATIENTS WITH INTERNAL DERANGEMENT (악관절 내장증환자에서 관절돌기의 후방경사에 관한 연구)

  • Lee Geon-Ill;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.2
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    • pp.225-234
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    • 1991
  • This study was designed to investigate the effects of the posterior slope of the articular eminence and the condylar angulation to the posterior slope of the articular eminence on internal derangement of TMJ. The materials consisted of 78 transcranial oblique lateral projections of 31 normal subjects and 47 internal derangement patients. The results were as follows: 1. The posterior slope of the articular eminences in normal group were larger than that in abnormal group, but there were not significant differences between each group about the condylar angulation to the posterior slope of the articular eminences. 2. The differences between in the right and left sides in patients who were affected unilaterally and bilaterally were larger than that in normal groups. 3, In patients affected unilaterally, there were not significant differences between affected joints and unaffected joints about the posterior slope of the articular eminence and the condylar angulation to the posterior slope of the articular eminence. 4. In abnormal group, there were significant differences between each group about condylar angulation to the post, slope of the articular eminence (ant. disk displacement without reduction > fibrous adhesion > ant. disk displacement with reduction), but not about the post, slope of the articular eminence.

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The Result of Posterior Microforaminotomy for Posterolateral Herniation of Cervical Discs (후측방으로 탈출된 경추 디스크의 후방 미세간공천개절제술의 치료결과)

  • Kim, Young Soo;Kuh, Sung Uk;Jin, Byung Ho;Cho, Young Eun;Chin, Dong Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.743-748
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    • 2001
  • Objective : To evaluate the effectiveness of posterior microforaminotomy in treatment of posterolateral cervical disc herniation, the authors retrospectively analyzed the result of posterior microforaminotomy in our institute. Patients and Methods : Ten patients with radiculopathy due to posterolateral cervical disc herniation have been treated with posterior microforaminotomy from August 1996 to July 2000. We analyzed clinical results in all patients who were followed up for an average of 10 months. Results : The mean age was 47.2 years and all patients were treated with posterior microforaminotomy as primary treatment. one patient was received anterior cervical interbody fusion with iliac bone 12 years before. Clinical improvement in the last follow-up were seen in all patients and there were no complications. Conclusion : Microcervical foraminotomy is considered useful operative method for posterolateral soft disc herniation. We conclude that the posterior microforaminotomy for radiculopathy due to soft posterolateral cervical disc herniation seems to be safe and effective in selective patients.

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The Immediate Effects of Posterior Pelvic Tilt with Taping on Pelvic Inclination, Gait Function and Balance in Chronic Stroke Patients

  • Wu, Yang-Ting;Choe, Yu-Won;Peng, Cheng;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.3
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    • pp.11-21
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    • 2017
  • PURPOSE: The purpose of this study is to identify the immediate effect of posterior pelvic tilt taping on anterior pelvic inclination, gait function, and balance in chronic stroke patients. METHODS: Fourteen chronic stroke subjects were enrolled in this study. Subjects who consented to participate in this cross-over experiment were assigned three interventions: posterior pelvic tilt taping, placebo taping, and no taping, in random order. After tape application, subjects were asked to complete: 1) Anterior pelvic tilt measurement, 2) 10-Meter Walk test, and 3) Limits of stability (LOS) test. To eliminate the learning effect of the tape after tearing off the tape, a 10 minute break was given between posterior pelvic tilt taping intervention and placebo taping intervention. RESULTS: Significant decreases were observed for the anterior pelvic inclination on both sides after posterior pelvic tilt taping application compared with placebo taping and no taping application (p<.05). Post hoc test results differed significantly in the 10-meter walk test after intervention (p<.05). However, there were no significant differences in limits of stability test after intervention (p>.05). CONCLUSION: Posterior pelvic tilt taping in chronic stroke patients decreases the inappropriate anterior pelvic inclination immediately and improves gait function, but it has little effect on balance.

Iliac Bone Graft for Recurrent Posterior Shoulder Instability with Glenoid Bone Defect

  • Ko, Sang-Hun;Cho, Yun-Jae
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.190-193
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    • 2014
  • Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.

TREATMENT OF FUNCTIONAL POSTERIOR CROSSBITES IN THE PRIMARY AND EARLY MIXED DENTITIONS : CASE REPORT (유치열 및 초기 혼합치열기에서 기능성 구치부 반대교합의 치료증례)

  • Lee, In-Jeong;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.547-554
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    • 1994
  • Posterior crossbites are abnormal buccal, or lingual relationship of a tooth or teeth of the maxilla, the mandible, or both when the teeth of the two arches are in occlusion and involve the molars and premolars. Posterior crossbites are classified as dental, muscular(functional), or skeletal. In an effort to avoid occlusal interferences caused by the inadequate arch width, the patient deviates the mandible laterally upon closure to achieve maximum intercuspation. This is described as functional posterior crossbite. Correction of functional posterior crossbites in the primary & early mixed dentition as early as possible after diagnosis has been recommended, because crossbites do not automatically improve with the eruption of the permanent teeth. Functional posterior crossbites, if left untreated, may have deleterious effects on the development and function of the TMJ. The diagnosis and management of three cases is presented. Each patient with functional posterior crossbites is treated using the bilateral maxillary expansion appliance.

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Primary Leiomyosarcoma of the Left Lower Posterior Chest wall with Lung Metastasis - One Case Report - (폐 전이를 동반한 원발성 흉벽 평활근육종 - 1례 보고 -)

  • 김대현;김범식;박주철;조규석
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.764-767
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    • 2002
  • An unusual case of primary leiomyosarcoma at the left lower posterior chest wall with metastasis to the right lung parenchyme is presented. The patient was a 43-year-old man who was asymptomatic but a slow growing hard mass was noted at the left lower posterior chest wall. The chest computed tomography showed a tumor at the left lower posterior chest wall with multiple metastasis to the right lung. The left lower posterior chest wall mass was examined by percutaneous needle aspiration and it was revealed as rhabdomyosarcoma histologically. En bloc resection to the left lower posterior chest wall tumor and metastasectomy to the multiple nodules in the right lung were done and pathological examination finally revealed primary leiomyosarcoma at the left lower posterior chest wall with multiple metastasis to the right lung. Chemotherapy was scheduled as adjunctive measure.