• Journal of Audiology & Otology
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• v.25 no.2
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• pp.89-97
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• 2021

Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

• Korean Journal of Audiology
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• v.25 no.2
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• pp.89-97
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• 2021

Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.373-377
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• 2022

Currently, robot-assisted latissimus dorsi muscle flap (RLDF) surgery is used in treating patients with Poland syndrome and for breast reconstruction. However, conventional RLDF surgery has several inherent issues. We resolved the existing problems of the conventional system by introducing the da Vinci single-port system in patients with Poland syndrome. Overall, three patients underwent RLDF surgery using the da Vinci single-port system with gas insufflation. In the female patient, after performing RLDF with silicone implant, augmentation mammoplasty was also performed on the contralateral side. Both surgeries were performed as single-port robotic-assisted surgery through the transaxillary approach. The mean operating time was 449 (335-480) minutes; 8.67 (4-14) minutes were required for docking and 59 (52-67) minutes for robotic dissection and LD harvesting. No patients had perioperative complication and postoperative problems related to gas inflation. The single-port robot-assisted surgical system overcomes the drawbacks of previous robotic surgery in patients with Poland syndrome, significantly shortens the procedure time of robotic surgery, has superior cosmetic outcomes in a surgical scar, and improves the operator's convenience. Furthermore, concurrent application to another surgery demonstrates the possibility in the broad application of the robotic single-port surgical system.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.80-86
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• 2023

We report two rare cases of extensive bilateral subcutaneous emphysema that occurred during ordinary dental procedures. An air-driven high-speed handpiece, routinely used in dental procedures may cause subcutaneous emphysema when high pressure air is introduced into the loose connective tissues below the dermal layer. The first case occurred with surgical extraction of the lower third molar. The air introduced into the fascial spaces near the surgical field spread to the contralateral spaces, as well as the neck and chest areas. The second case also showed extensive bilateral subcutaneous emphysema caused by the introduction of compressed air from the handpiece during crown preparation without any invasive procedure. Cases where the emphysema extends beyond the treatment site to involve the contralateral cervicofacial areas have been rarely reported. Predicting the occurrence of subcutaneous emphysema is difficult, so it is important to exercise caution during routine dental treatment. If significant bilateral cervicofacial swelling is suspected to be due to subcutaneous emphysema, prompt diagnosis with securing the patient's airway will be necessary.

• Korean Journal of Veterinary Service
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• v.46 no.2
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• pp.175-179
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• 2023

This study was conducted to find out the compensation strategy through kinetic gait analysis by comparing dog with congenital luxation of the shoulder joint and normal dog. Ground reaction forces were recorded for all limbs while normal poodle dog and poodle dog with shoulder joint luxation was allowed to walk on an instrumented platform. The dogs were evaluated for maximal vertical force (MVF), body load distribution (BLD), and symmetry index (SI). The MVF was increased in the contralateral forelimb of luxated shoulder joint. The SI was also increased in a dog with dislocated shoulder joints in the forelimbs. For BLD, the maximum load distribution increased centrally, but the total load distribution decreased in the ipsilateral forelimb paw. In contrast, total load distribution was increased in the contralateral forelimb paw. During forelimb lameness, changes in weight-bearing load showed compensatory load redistribution. These biomechanical changes may lead to changes in the musculoskeletal system in a dog with luxated shoulder.

• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.12-22
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• 2001

Purpose: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. Materials and Methods: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. Results: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). Conclusion: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.155-166
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• 2006

Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.

• PNF and Movement
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• v.19 no.3
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• pp.423-433
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• 2021

Purpose: Proprioceptive neuromuscular facilitation (PNF) is a method for promoting functional movements by facilitating neuromuscular responses through the stimulation of proprioceptors in the body using spiral and diagonal patterns. Irradiation, a basic principle of PNF, is a phenomenon in which the muscle activity of a body part caused by resistance is increased or spread into muscles in other parts via their connected muscles. Resistance training can be divided by body alignment into closed and open chain exercises. Methods: In this study, 19 healthy men in their 20s and 30s were selected as subjects. They performed PNF hip flexion, abduction, and internal rotation motions on their dominant side in an open chain exercise posture in which the nondominant sole was away from the wall, and in a closed chain exercise posture in which the sole was fixed to the wall. The nondominant leg's muscle activity was measured while resistance was maintained with applied pressure at 0%, 25%, 50%, 75%, and 100% of the maximum muscle strength in the last range of motions. A two-way analysis of variance (ANOVA) was conducted for a comparative analysis of the contralateral leg's muscle activity according to the chain exercise postures and the intensity of resistance intensity during PNF hip flexion, abduction, and internal rotation. In addition, an independent sample T-test was conducted for a comparative analysis of each chain exercise posture according to the intensity of resistance. A one-way ANOVA and a Scheffe post-hoc test were also performed to analyze the contralateral leg's muscle activity according to the intensity of resistance in the closed and open chain exercise postures. Results: Results of the two-way ANOVA found that the gluteus medius and the biceps femoris had statistically significant differences in both the chain exercise postures and resistance intensity (p<0.05), and that the vastus medialis and the gastrocnemius did not exhibit statistically significant differences in the chain exercise postures (p>0.05) but showed statistically significant differences in resistance intensity (p<0.05). As a result of the independent sample T-test, the application of the PNF hip flexion-abduction-internal rotation pattern led to a statistically significant difference in the contralateral gluteus medius during the closed chain exercise posture (p<0.05). According to the results of the one-way ANOVA and the Scheffe post-analysis, statistically significant differences were observed in the gluteus medius at 50%, biceps femoris at 75%, vastus medialis at 100%, and gastrocnemius at 100% during the closed chain exercise posture based on a resistance intensity of 0% (p<0.05). In the open chain exercise posture, statistically significant differences were found in the gluteus medius at 50%, biceps femoris at 50%, and vastus medialis at 75% based on the resistance intensity of 0% (p<0.05). In the same posture, there was no significant difference in the gastrocnemius's resistance intensity (p>0.05). Conclusion: When the PNF leg pattern is applied, each muscle requires effective chain exercise postures and resistance intensity to generate the contralateral leg muscle's irradiation.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.225-233
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• 2004

Purpose: The Ideal breast irradiation method should provide an optimal dose distribution In the treated breast volume and a minimum scatter dose to the nearby normal tissue. Physical wedges have been used to Improve the dose distribution In the treated breast, but unfortunately Introduce an Increased scatter dose outside the treatment yield, pavllculariy to the contralateral breast. The typical physical wedge (FW) was compared with 4he virtual wedge (VW) to do)ermine the difference In the dose distribution affecting on the treated breast and the contralateral breast, lung, heart and surrounding perlpheral soft tissue. Methods and Materials: The data collected consisted of a measurement taken with solid water, a Humanoid Alderson Rando phantom and patients. The radiation doses at the ipsllateral breast and skin, contralateral breast and skin, surrounding peripheral soft tissue, and Ipsllateral lung and heart were compared using the physical wedge and virtual wedge and the radiation dose distribution and DVH of the treated breast were compared. The beam-on time of each treatment technique was also compared Furthermore, the doses at treated breast skin, contralateral breast skin and skin 1.5 cm away from 4he field margin were also measured using TLD in 7 patients of tangential breast Irradiation and compared the results with phantom measurements. Results: The virtual wedge showed a decreased peripheral dose than those of a typical physical wedge at 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$, and 60$^{\circ}$. According to the TLD measurements with 15$^{\circ}$ and 30$^{\circ}$ virtual wedge, the Irradiation dose decreased by 1.35$\%$ and 2.55$\%$ In the contralateral breast and by 0.87$\%$ and 1.9$\%$ In the skin of the contralateral breast respectively. Furthermore, the Irradiation dose decreased by 2.7$\%$ and 6.0$\%$ in the Ipsllateral lung and by 0.96$\%$ and 2.5$\%$ in the heart. The VW fields had lower peripheral doses than those of the PW fields by 1.8$\%$ and 2.33$\%$. However the skin dose Increased by 2.4$\%$ and 4.58$\%$ In the Ipsliateral breast. VW fields, In general, use less monitor units than PW fields and shoriened beam-on time about half of PW. The DVH analysis showed that each delivery technique results In comparable dose distribution in treated breast. Conclusion: A modest dose reduction to the surrounding normal tissue and uniform target homogeneity were observed using the VW technique compare to the PW beam in tangential breast Irradiation The VW field is dosmetrically superlor to the PW beam and can be an efficient method for minimizing acute, late radiation morbidity and reduce 4he linear accelerator loading bV decreasing the radiation delivery time.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.370-376
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• 2010

Objective : Although unilateral transforaminal lumbar interbody fusion (TLIF) is widely used because of its benefits, it does have some technical limitations. Removal of disk material and endplate cartilage is difficult, but essential, for proper fusion in unilateral surgery, leading to debate regarding the surgery's limitations in removing the disk material on the contralateral side. Therefore, authors have conducted a randomized, comparative cadaver study in order to evaluate the efficiency of the surgery when using conventional instruments in the preparation of the disk space and when using the recently developed high-pressure water jet system, SpineJet$^{TM}$ XL. Methods : Two spine surgeons performed diskectomies and disk preparations for TLIF in 20 lumbar disks. All cadaver/surgeon/level allocations for preparation using the SpineJet$^{TM}$ XL (HydroCision Inc., Boston, MA, USA) or conventional tools were randomized. All assessments were performed by an independent spine surgeon who was unaware of the randomizations. The authors measured the areas (cm2) and calculated the proportion (%) of the disk surfaces. The duration of the disk preparation and number of instrument insertions and withdrawals required to complete the disk preparation were recorded for all procedures. Results : The proportion of the area of removed disk tissue versus that of potentially removable disk tissue, the proportion of the area of removed endplate cartilage, and the area of removed disk tissue in the contralateral posterior portion showed 74.5 ${\pm}$ 17.2%, 18.5 ${\pm}$ 12.03%, and 67.55 ${\pm}$ 16.10%, respectively, when the SpineJet$^{TM}$ XL was used, and 52.6 ${\pm}$ 16.9%, 22.8 ${\pm}$ 17.84%, and 51.64 ${\pm}$ 19.63%, respectively, when conventional instrumentations were used. The results also showed that when the SpineJet$^{TM}$ XL was used, the proportion of the area of removed disk tissue versus that of potentially removable disk tissue and the area of removed disk tissue in the contralateral posterior portion were statistically significantly high (p < 0.001, p < 0.05, respectively). Also, compared to conventional instrumentations, the duration required to complete disk space preparation was shorter, and the frequency of instrument use and the numbers of insertions/withdrawals were lower when the SpineJet$^{TM}$ XL was used. Conclusion : The present study demonstrates that hydrosurgery using the SpineJet$^{TM}$ XL unit allows for the preparation of a greater portion of disk space and that it is less traumatic and allows for more precise endplate preparation without damage to the bony endplate. Furthermore, the SpineJet$^{TM}$ XL appears to provide tangible benefits in terms of disk space preparation for graft placement, particularly when using the unilateral TLIF approach.