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Arthroscopic supraspinatus advancement for retracted rotator cuff tears: a technical note

  • Chris Hyunchul Jo;Pei Wei Wang
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.328-333
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    • 2022
  • Irreparable rotator cuffs with retracted torn ends remain a significant challenge for most shoulder surgeons. Since repairs are preferable to reconstruction or replacement whenever possible, studies for anatomical reductions with minimal tension and secure fixation are important. In this study, the authors introduce an arthroscopic supraspinatus advancement (ASSA) procedure for retracted rotator cuff tears that could not be adequately reduced to the original footprint. Using modified long, narrow, curved Cobb elevators, procedures can be performed through lateral portals without any additional skin incision. Following meticulous stepwise three-compartment elevation procedures based on the supraspinatus insertion anatomy, the supraspinatus muscle could be safely elevated from the fossa and sufficiently advanced laterally. The authors suggest that ASSA could be a useful procedure for management of challenging retracted rotator cuff tears by maximizing lateral excursions that could convert irreparable tears to reparable tears in select patients.

The Effect of snatch technique improvement for men weightlifter of feedback support through quantity analysis by periods (주기적 정성적분석을 통한 훈련목표 제공이 남자 역도 인상기술 향상에 미치는 영향)

  • Moon, Young-Jin;Ryu, Jung-Hyun;Lee, Soon-Ho
    • Korean Journal of Applied Biomechanics
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    • v.14 no.2
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    • pp.69-83
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    • 2004
  • The purpose of this study is searching for technical merits and demerits of each weight lifting player through qualitative motion analysis system. Moreover, It is also analysis the repeating the establishment of exercise purpose and studying for the effect of the field adaptation. The subject of this study was five male weight lifting players who have been engaged in Korean Delegation Team. The institution of exercise target was made through two times qualitative analysis and the result of studying for the effect of the field adaptation was produced before offering feedback. Moreover, two time analysis added after offering feedback. All analysis was based on 2-D visual analysis. The results of this study are as follows: 1. Maximal barbell moving speed in starting phase was decreased after offering feedback. This result implies advancement of technical skills after offering feedback. 2. From starting posture to 앉아받기, forward and backward moving distance of hip joint was decreased after offering feedback in all subjects. This result represents advancement of technical skills after offering feedback. 3. In terms of pull phase, forward and backward moving distance of hip and shoulder joint was decreased after offering feedback in all subjects. This result represents advancement of technical skills after offering feedback. 4. In terms of pull phase, the difference of horizontal value of coordinates was decreased after offering feedback in all subjects. This result represents advancement of technical skills after offering feedback. 5. In terms of pull phase, the motion range of hip joint was decreased after offering feedback in three of five subjects and this represents advancement of technical skills after offering feedback. However, the rest of them were not variable or narrow decreasing. This result represents that feedback system could not brought tremendous effects. 6. From apex point of barbell to 앉아받기, the difference of barbell height was decreased after offering feedback in three of five subjects and this represents advancement of technical skills after offering feedback. However, the rest of them weren't variable or narrow increasing. This result represents that feedback system could not brought tremendous effects. 7. In terms of last-pull phase, the angular velocity of knee joint was increased after offering feedback in four of five subjects and this represents advancement of technical skills after offering feedback. However, the rest of them, only one subject, decreased. This result represents that feedback system could not brought tremendous effects. 8. In terms of last-pull, the conversional tendency of maximal extension to flextion came out all but simultaneously without offering feedback in four of five subjects. This is well-performed technique. Only one subject, however, could not use power effectively because the fact that his maximal extension came out in serial, from ankle to knee and waist means dispersion of power. In addition to, after offering feedback, only one subject made increasing the maximal extension of knee in last-pull and this result represents advancement of skills after offering feedback. However, the rest of them could not make meaningful development after offering feedback. 9. It might be assumed that searching for technical merits and demerits of each weight lifting player through qualitative motion analysis system could improve player's skill.

Reconstruction of large facial defects using a combination of forehead flap and other procedures

  • Kim, Ryuck Seong;Yi, Changryul;Kim, Hoon Soo;Jeong, Ho Yoon;Bae, Yong Chan
    • Archives of Craniofacial Surgery
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    • v.23 no.1
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    • pp.17-22
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    • 2022
  • Background: Reconstruction of large facial defects is challenging as both functional and cosmetic results must be considered. Reconstruction with forehead flaps on the face is advantageous; nonetheless, reconstruction of large defects with forehead flaps alone results in extensive scarring on the donor site. In our study, the results of reconstruction using a combination of forehead flaps and other techniques for large facial defects were evaluated. Methods: A total of 63 patients underwent reconstructive surgery using forehead flaps between February 2005 and June 2020 at our institution. Reconstruction of a large defect with forehead flaps alone has limitations; because of this, 22 patients underwent a combination of procedures and were selected as the subjects of this study. This study was retrospectively conducted by reviewing the patients' medical records. Additional procedures included orbicularis oculi musculocutaneous (OOMC) V-Y advancement flap, cheek advancement flap, nasolabial V-Y advancement flap, grafting, and simultaneous application of two different techniques. Flap survival, complications, and recurrence of skin cancer were analyzed. Patient satisfaction was evaluated using questionnaires. Results: Along with reconstructive surgery using forehead flaps, nasolabial V-Y advancement flap was performed in nine patients, local advancement flap in three, OOMC V-Y advancement flap in two, grafting in five, and two different techniques in three patients. No patient developed flap loss; however, cancer recurred in two patients. The overall patient satisfaction was high. Conclusion: Reconstruction with a combination of forehead flaps and other techniques for large facial defects can be considered as both functionally and cosmetically reliable.

Muller's Muscle-Levator Aponeurosis Advancement Procedure for Blepharoptosis (뮐러근과 거근건막의 전진술에 의한 안검하수의 교정)

  • Baik, Bong Soo;Kim, Tae Bum;Hong, Wang Kwang;Yang, Wan Suk
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.219-226
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    • 2005
  • Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4 mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4 mm ptosis and more than 5 mm of levator function, but three of the four acquired ptosis cases had more than 4 mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1 mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.

Columellar Lengthening Using V-Y Advancement Flap or Central Lip Flap in Secondary Correction of Bilateral Cleft Lip Nose Deformity (양측 구순비변형 환자의 이차성 교정에 있어서 V-Y 전진 피판술 또는 정중 구순 비판술을 이용한 비주 연장술)

  • Bae, Yong Chan;Moon, Jae Sul;Kim, Sang Ho;Nam, Su Bong;Kang, Young Seok
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.561-566
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    • 2005
  • Even though it is generalized to perform synchronous lip and nasal correction, there are some cases in need of secondary correction of cleft lip nose deformity. In these procedures, the lengthening of columella plays an important role. We performed eighteen cases of the secondary cleft lip nose deformity correction using two different methods from 1997 to 2003. The central lip flap was used in eight patients and V-Y advancement flap in ten patients. Additional procedures including reverse U-incision, interdomal fixation sutures and suspension sutures were used for correction of combined deformity. Silastic nasal retainers were kept in all patients for 6 months. Both of central lip flap and V-Y advancement flap seems to be a good technique for lengthening columellar soft tissue. But new columella after V-Y advancement flap appeared to be too narrow and a bit unnatural looking and central lip flap left additional scar on the upper lip although it was conspicuous. We think that central lip flap is a better technique in a case with wide philtrum and narrow columella and V-Y advancement flap can be another choice in a columella with sufficient width.

The Influence of the Amount of Mandibular Advancement in the Application of Mandibular Advancement Device for Obstructive Sleep Apnea Patients (폐쇄성수면무호흡증 환자의 하악전방이동장치 적용에 있어서 전방이동량이 미치는 영향)

  • Kim, Young-Kyun;Yoon, In-Young;Kim, Jeong-Whun;Lee, Chul-Hee;Yun, Pil-Young
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.29-34
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    • 2011
  • Objectives: The purposes of this study were to estimate the effect of mandibular advancement device (MAD) and to evaluate the influence of the advancement amount of mandible in the application of MAD for obstructive sleep apnea (OSA) patients. Methods: From the patients who were diagnosed as OSA by polysomnographic study at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as treatment option were included in this study. All the patients’ data including clinical records and polysomnographic studies (both pre- and post-treatment) were reviewed and analyzed. Results: Successful results were obtained in 65 patients of 86 patients (75.6%). In the follow-up period, mild discomfort of anterior teeth or temporomandibular joint (TMJ) were described in 28 patients, especially in the cases the amount of mandibular advancement were more than 7.0 mm. There was no direct relationship between the amount of mandibular advancement and clinical outcome. Conclusion: MAD was effective treatment option for the OSA patients regardless of severity. For the prevention of potential dental complications, the amount of mandibular advancement should be considered at the time of MAD treatment.

A COMPARATIVE STUDY ON CRONIN TRIANGULAR FLAP AND ROTATION-ADVANCEMENT REPAIR IN UNILATERAL COMPLETE CLEFT LIP (편측성 완전구순열에서 Cronin 삼각피판법과 회전신전법에 의한 수복의 비교)

  • Ryu, Sun-Youl;Yun, Cheon-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.5
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    • pp.415-421
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    • 2001
  • The present study was carried out to compare the postoperative results of Cronin triangular flap and Millard rotation-advancement repair techniques in repairing the unilateral complete cleft lip. Thirteen patients with unilateral complete cleft lip underwent 6 Cronin triangular flap and 7 Millard rotation-advancement repairs at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital over a period of 6 years (January 1994 to December 1999). The surgical results following the operation were assessed on the basis of scoring, vertical lip length and scar hypertrophy. The mean score was better in Cronin triangular flap group($74.77{\pm}0.86$) than in Millard rotation-advancement group($66.50{\pm}1.14$) for both lip and nose segments. Scar hypertrophy developed in the Millard rotation-advancement repair group with 28.6% incidence but not in the Cronin triangular flap group. No significant difference was found in the ratio of lip length between Millard rotation-advancement repair and Cronin triangular flap groups($0.73{\pm}0.10$ and $0.80{\pm}0.96$). These results suggest that Cronin triangular flap shows better results than Millard rotation-advancement repair in repairing the unilateral complete cleft lip.

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Biocontrol of root diseases of fruit trees with fungal viruses

  • Matsumoto, Naoyuki;Nakamura, Hitoshi;Ikeda, Kenichi;Arakawa, Masao;Uetake, Yukari
    • Proceedings of the Korean Society of Plant Pathology Conference
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    • 2003.10a
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    • pp.19-20
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    • 2003
  • Helicobasidium mompa Tanaka and Resellinia necatrix Prillieux cause violet root rot and white root rot of various crops, respectively. Intensive cultural practices, such as the use of dwarf stock, glasshouse cultivation, etc., predispose plants to the diseases. The diseases can be controlled only by biennial drench of 50100L of chemicals for each tree. Biocontrol with soil microorganisms proved ineffective under field conditions. Long-term control may be hampered by the perennial growth of hosts and by the difficulty in the establishment of antagonists in soil. Crop rotation or soil amendment is not applicable, either. Fungal viruses with dsRNA genome (Buck 1986) are promising against root diseases of fruit trees since they exist within the cytoplasm of fungal hyphae and need no effort to help them persist in the field. The viruses are considered to spread though the network of fungal mycelia in the soil once they enter the fungal cytoplasm. Here, we present preliminary results from a project to control the root diseases of fruit trees with dsRNA.(중략)

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GENIAL ADVANCEMENT, INFRAHYOID MYOTOMY AND SUSPENSION IN TREATMENT OF OBSTRUCTIVE SLEEP APNEA SYNDROME (이부전방이동술, 하설골근절개술 및 설골현수법을 이용한 폐쇄성 수면 무호흡증 환자의 치료:증례보고)

  • Kim, Jae-Jin;Kim, Eun-Seok;Kim, Tae-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.162-166
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    • 2001
  • Obstructive sleep apnea syndrome(OSAS) is a complex sleep disorder characterized by intermittent apnea secondary to sleep-induced obstruction of the upper airway. It occurs because of an airway obstruction anywhere between the trachea and the oronasal apparatus. The hallmark of OSAS is snoring, which is caused by vibration of the tissues of the pharynx as the airway narrows. The consequences of OSAS have focused on excessive daytime sleepiness resulting from sleep fragmentation and the cardiovascular derangements producing hypertension and arrhythmias. The primary method of controlling OSAS has been surgery. The current surgical procedures used for OSAS are tracheostomy, tonsillectomy, nasal septoplasty, uvulopalatopharyngoplasty, anterior mandibular osteotomy with hyoid myotomy and suspension, and maxillary, mandibular and hyoid advancement. We report a case of OSAS that was improved by genial advancement with infrahyoid myotomy and suspension. The patient was objectively documented by polysomnography, cephalometric analysis, and physical examination before the surgical procedure. The patient underwent genial advancement with infrahyoid myotomy and suspension. Patient had a good response from surgery.

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