• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.1
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• pp.41-48
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• 2020

Objectives: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. Materials and Methods: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). Results: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). Conclusion: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.84-87
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• 2011

Branchio-otic syndrome(BOS) is a relatively uncommon genetic malformation associated with dysmorphogenesis of the first and second branchial arches and is characterized by branchial fistulae, congenital preauricular fistulae, and anomalies of the pinnae, external, middle, and inner ears, accompanied by hearing loss. Recently, we experienced a case of BOS in a 10 years old female patient and report this case with a review of literature. 10-year-old girl presented with hearing impairment, bilateral preauricular fistula and cervical fistula. The pure tone audiometry revealed that she had 60dB sensorineural hearing loss on right side and 90dB mixed hearing loss on left. Bilateral branchial fistula was found on the neck CT scan and bilateral ossicular and cochlear abnormality combined with enlarged internal auditory canal was noted on the temporal bone CT scan. To investigate the association with EYA1 gene, we performed DNA sequncing with peripheral white blood cell and found the point mutations on Exon 7, 12 and 16 of EYA1 gene. The preauricular fistula and branchial fistula was excised surgically and hearing aid was applied on her left side. There was no sign of fistula recurrence for seven years after the surgery.

• Physical Therapy Korea
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• v.24 no.3
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• pp.10-20
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• 2017

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.

• The Korean Journal of Pain
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• v.32 no.2
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• pp.69-78
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• 2019

Pain therapy often entails gastrointestinal adverse events. While opioids are effective drugs for pain relief, the incidence of opioid-induced constipation (OIC) varies greatly from 15% to as high as 81%. This can lead to a significant impairment in quality of life, often resulting in discontinuation of opioid therapy. In this regard, a good doctor-patient relationship is especially pivotal when initiating opioid therapy. In addition to a detailed history of bowel habits, patient education regarding the possible gastrointestinal side effects of the drugs is crucial. In addition, the bowel function must be regularly evaluated for the entire duration of treatment with opioids. Furthermore, if the patient has preexisting constipation that is well under control, continuation of that treatment is important. In the absence of such history, general recommendations should include sufficient fluid intake, physical activity, and regular intake of dietary fiber. In patients of OIC with ongoing opioid therapy, the necessity of opioid use should be critically reevaluated in terms of an with acceptable quality of life, particularly in cases of non-cancer pain. If opioids must be continued, lowering the dose may help, as well as changing the type of opioid. If these measures do not suffice, the next step for persistent OIC is the administration of laxatives. If these are ineffective as well, treatment with peripherally active ${\mu}$-opioid receptor antagonists should be considered. Enemas and irrigation are emergency measures, often used as a last resort.

• Journal of Korean Neurosurgical Society
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• v.52 no.1
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• pp.58-61
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• 2012

Various surgical procedures for the treatment of post-traumatic syringomyelia have been introduced recently, but most surgical strategies have been unreliable. We introduce the concept and technique of a new shunting procedure, syringo-subarachnoid-peritoneal shunt. A 54-year-old patient presented to our hospital with a progressive impairment of motion and position sense on the right side. Sixteen years before this admission, he had been treated by decompressive laminectomy for a burst fracture of L1. On his recent admission, magnetic resonance (MR) imaging studies of the whole spine revealed the presence of a huge syrinx extending from the medulla to the L1 vertebral level. We performed a syringo-subarachnoid-peritoneal shunt, including insertion of a T-tube into the syrinx, subarachnoid space and peritoneal cavity. Clinical manifestations and radiological findings improved after the operation. The syringo-subarachnoid-peritoneal shunt has several advantages. First, fluid can communicate freely between the syrinx, the subarachnoid space, and the peritoneal cavity. Secondly, we can prevent shunt catheter from migrating because dural anchoring of the T-tube is easy. Finally, we can perform shunt revision easily, because only one arm of the T-tube is inserted into the intraspinal syringx cavity. We think that this procedure is the most beneficial method among the various shunting procedures.

• Animal cells and systems
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• v.12 no.1
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• pp.11-14
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• 2008

Finding a way to strengthen human cognitive functions, such as learning and memory, has been of great concern since the moment people realized that these functions can be affected and even altered by certain chemicals. Since then, plenty of endeavors have been made to look for safe ways of improving cognitive performances without adverse side-effects. Unfortunately, most of these efforts have turned out to be unsuccessful until now. In this study, we examine the effect of a natural compound, idesolide, on hippocampus-dependent recognition memory. We demonstrate that idesolide is effective in the enhancement of recognition memory, as measured by a novel object recognition task. Thus, idesolide might serve as a novel therapeutic medication for the treatment of memoryrelated brain anomalies such as mild cognitive impairment(MCI) and Alzheimer's disease.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.264-266
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• 2012

Injury to the bilateral internal branch of superior laryngeal nerve (ibSLN) brings on an impairment of the laryngeal cough reflex that could potentially result in aspiration pneumonia and other respiratory illnesses. We describe a patient with traumatic cervical injury who underwent bilateral ibSLN palsy after anterior cervical discectomy with fusion (ACDF). An 75-year-old man visited with cervical spine fracture and he underwent ACDF through a right side approach. During the post-operative days, he complained of high pitched tone defect, and occasional coughing during meals. With a suspicion of SLN injury and for the work up for the cause of aspiration, we performed several studies. According to the study results, he was diagnosed as right SLN and left ibSLN palsy. We managed him for protecting from silent aspiration. Swallowing study was repeated and no evidence of aspiration was found. The patient was discharged with incomplete recovery of a high pitched tone and improved state of neurologic status. The SLN is an important structure; therefore, spine surgeons need to be concerned and be cautious about SLN injury during high cervical neck dissection, especially around the level of C3-C4 and a suspicious condition of a contralateral nerve injury.

• PNF and Movement
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• v.3 no.1
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• pp.35-45
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• 2005

Objectives : The purpose of this study was to understanding the constraint induced movement and Self-efficacy with arm training on upper motor function in Stroke Patients. Methods : Stroke, the leading cause of functional disability, causes a variety of impairments that compromise quality of life. Upper limb hemiparesis, a commonly seen impairment, is particularly problematic given its impact on activities of daily living. Because stroke was a disease to correspond to the first during domestic cause of death, and was accompanied by a lot of side aftereffects after a survival, stroke rehabilitation bought a patient and a family and a physical therapist, and it was main concern of. Results : Looks into upper extremity excrise of a subacute stroke patient estranged a acute convalescence later by a rehabilitation treatment in this consideration, and evaluates an effect to wind up constraint induced movement for an early treatment of stroke and Self efficacy, and help is one to an early rehabilitation of an stroke patient. Conclusions : Overuse sound tends after the stroke occurrence in the early stage in order to recompense for stroke, and at the time of a new aspect called learned nonuse syndrome by a movement of a paralysis part dusting off wealth with this step thing later. Constraint induced movement using self efficacy could be an effective for improving function of stroke.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.91-97
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• 1996

Lithium is a widely used important drug in the treatment of manic-depressive illness and its prevention of relapse. However, this drug has a Low therapeutic index, therefore, it has many attendant side effects. The most prevalent renal effect of lithium is impairment of concentrating ability and this defect appeared into overt polyuria. A renal lesion is confined to the collecting tubule and 12-20% of patients taking lithium suffer from nephrogenic diabetes insipidus. This nephrogenic diabetes insipidus causes the states of extracellular fluid depletion, hypernatremia and precipitates lithium intoxication. In such situation, symptoms of nephrogenic diabetes insipidus and lithium intoxication are very similar, so we should be very cautious to discriminate them. We herein report a patient characterized by a prolonged stuporous state, hypernatremia and severe nephrogenic diabetes insipidus during lithium therapy.

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.103-108
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• 2015

Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.