A two-year-old pointer dog showed a liver failure for long duration. By radiographic examination, barium or gas filled intestine was detected in the pericardium. Although liver function was bad, surgery was tried to repair hernia due to the poor prognosis. Intestine, omentum, and liver with gall bladder were dislocated in the pericadial sac by peritoneopericardial diaphragmatic hernia (PPDH). Intestine was easily removed from pericardial sac but omentum and liver were not because of strong adhesion to the pericardial sac. Postmortem examination was performed because the patient was died after surgery. Grossly, herniated liver whose right medial lobe was strongly adhered to the pericardial sac was severely congested with fibrin adhesion on the surface. Hypoplastic abnormally up-located heart had a fissure in the outside of lower right venticulum bordered apex and depressed large vessels including vena cava and aortic arch into the base of heart. It was suggested that formation of a fissure and depression of vessels might be due to the pressure of herniated organs. In the veterinary literature as far as we knew, PPDH associated with liver failure due to adhesion of liver to the pericardial sac has not been reported.
It has been reported that tight sportswear could have complicated influence on physiological function of human body. The purpose of this present study was to investigate the effect of wearing gradient compression tights (GCT) on muscle strength and EMG activity during repeated isokinetic muscle contractions. Four healthy male undergraduate students performed maximal voluntary isokinetic concentric muscle contractions on biomechanical test and training systems with GCT and loose pants as control (Cont) respectively. During each test, the peak torque of extensor and flexor contractions and the surface electromyography (sEMG) of the rectus femoris and medial gastrocnemius was recorded simultaneously, the peak torque was recorded as an indicator of muscle strength, and the average amplitude and mean power frequency of sEMG were calculated as indicators of EMG activity. The results showed that: the peak torque decreased gradually during continuous muscle contractions both when the Cont and GCT were worn, average sEMG and mean power frequency declined along with the repetitions of muscle contractions for both wearing conditions, and the change tendency was consistence with that of peak torque. There was no obvious difference between the peak torque recorded wearing the Cont or wearing GCT, but when GCT were worn, average sEMG was lower and mean power frequency was higher than the Cont condition. In 24 samples obtained from four subjects, 80% of results showed the same trend. So we could make a conclusion that wearing GCT had no obvious effect on the improvement of muscle strength, but it would affect the EMG activity positivly.
Purpose: To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibular disorder (TMD) patients. Materials and Methods: 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra- and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Results: Osteophyte (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior and medial surfaces of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78-0.84), but interobserver agreement was fair (k=0.45). Conclusion: CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.
Purpose: To investigate the relationship between 3D bone architectural parameters and direction-related elastic moduli of cancellous bone of mandibular condyle. Materials and Methods: Two micro-pigs (Micro-$pig^R$, PWG Genetics Korea) were used. Each pig was about 12 months old and weighing around 44 kg. 31 cylindrical bone specimen were obtained from cancellous bone of condyles for 3D analysis and measured by micro-computed tomography. Six parameters were trabecular thickness (Tb. Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI), degree of anisotropy (DA) and 3-dimensional fractal dimension (3DFD). Elastic moduli of three orthogonal directions (superior-inferior (SI), medial-lateral (ML), andterior-posterior (AP) direction) were calculated through finite element analysis. Results: Elastic modulus of superior-inferior direction was higher than those of other directions. Elastic moduli of 3 orthogonal directions showed different correlation with 3D architectural parameters. Elastic moduli of SI and ML directions showed significant strong to moderate correlation with BV/TV, SMI and 3DFD. Conclusion: Elastic modulus of cancellous bone of pig mandibular condyle was highest in the SI direction and it was supposed that the change into plate-like structure of trabeculae was mainly affected by increase of trabeculae of SI and ML directions.
Purpose: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results. Methods: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl. Results: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained. Conclusion: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.
Purpose: The importance of the deformities in alar - columellar complex has been underestimated in Asian ethnic groups for the last decades. Fortunately, with increasing familiarity of the open rhinoplasty techniques, the anatomic details of the nasal tip have been pointed up. Definitely, having an interest and demand for improving the sub - normal relationship between the alar rim and columella are indebted for such growing of knowledge about nasal tip anatomy. However, it is true that any single procedure is not settled as versatile and fully confident modality to correct the retracted notching of the alar rim. With this article, I should like to propose another useful option for treating retracted ala. Methods: The author has tried to correct alar rim retraction by means of: (1) Triangular onlay septal cartilage graft on the lower lateral cartilage with the medial end fixed to the anterior surface of the lateral crus(Alar extension graft), (2) Inserting lateral end of the alar extension graft to the vestibular skin pocket in the form of a finger - in - groove, (3) using the vestibular skin in the form of an advancement flap, and (4) using the soft shield graft to prevent possible visible step - off of the alar margin. Results: The author applied an alar extension graft to 16 patients in order to correct a retracted ala for the last 27 months (August, 2003 - October, 2005). The distances from alar rim to long axis of nostril were improved to be within 2 mm in all of the cases, and also the shape of the alar rim changed to a round form. Nostril asymmetry (6%) in one case, temporary palpable step - off (18%) in three cases, temporary visible step - off (6%) in one case, and temporary paresthesia of the tip (25%) in four cases were observed. Conclusion: The alar extension graft is simple and efficacious. It does not need donor sites other than the operative field, and its results are predictable. In particular, since it may give structural intensity to a weak lower lateral cartilage, it may be preferentially used for the correction of a retracted ala that arises from hypoplastic lower lateral cartilage. Moreover intensified lower lateral cartilage also improves the esthetic shape of lobule.
The purpose of this study was to evaluate the effects of forefoot rocker shoes equipped with a metatarsal bar on lower extremity muscle activity and plantar pressure distribution. Ten healthy women in the age of twenties were participated in this study as the subjects. All subjects walked on a treadmill(Gait Trainer, BIODEX, USA) wearing normal shoes and metatarsal bar shoes, during which the plantar pressure distribution and muscle activity were measured. Using Pedar-X system(Novel Gmbh, Germany), the plantar pressure was measured for six regions of the foot: forefoot, midfoot, rearfoot, 1st metatarsal, 2-3th metatarsal, and 4-5th metatarsal, and for each sub-region, 4 features such as maximum force, contact area, peak pressure, and mean pressure were analyzed based on the plantar pressure. EMG(Electromyography) activity was measured by attaching surface electrodes to the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medial head, and magnitude of muscle contraction was analyzed in IEMG(Integrated EMG) value. The results show that the maximum force, contact area, peak pressure, and mean pressure in the midfoot all increased while maximum force, peak pressure, contact area, mean pressure in the 1st metatarsal and 2-3th metatarsal all decreased when wearing functional shoes. Also, muscle activities in the four muscles were all decreased when wearing the functional shoes. This paper suggests that forfoot rocker shoes equipped with a metatarsal bar can help disperse the high pressure and absorb the shock to the foot as well as give positive influence on gait pattern and postural stability by reducing muscle fatigue during walking.
This study was carried out to identify the gross anatomical and radiographic characteristics of the nasolacrimal system of the Korean native goat. The results were as follows : The nasolacrimal system are composed of two lacrimal ducts, two lacrimal, canaliculus, one lacrimal sac and one nasolacrimal duct. The nasolacrimal duct was divided into proximal, middle and distal portion. The nasolacrimal duct took a straight course to be paralleled with nasal bones and opened close to the nostril on the medial surface of the alar fold. The diameter of lacrimal punctum, the length of eyelid margin to lacrimal punctum, the length of canaliculus and the diameter of lacrimal sac were 0.82~0.90mm, 1.06~1.54mm, 5.65~6.30mm and 1.77~2.06mm, respectively. The length of proximal, middle and distal nasolacrimal duct were 36.84~40.00mm, 23.53~24.31mm and 14.55~14.73mm, respectively. The diameter of the orifice of nasolacrimal duct, the length of lateral margin of nostril to orifice of nasolacrimal duct and the length of dorsum to orifice of nasolacrimal duct were 1.29~1.33mm, 12.97~12.53mm and 15.24~16.11mm. The skull index of Korean native goat was not significantly different from the length of nasolacrimal duct.
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.
Purpose : Average humeral head retroversion was showed significant wide range from literatures based on variable measuring technique, We performed computed tomography(CT) study in an effort to define the specific anatomy relationships and evaluate their use. Materials and Methods : Two hundreds shoulders and distal humeri CT scan with no known pathology were examined. The study population was divided to 10 groups by gender and age (from third to seventh decade). The number of each group was twenty. Retroversion of proximal humerus and glenoid were measured using the lines that were connected the central axis of humeral head, central points of the humeral epicondyles paralleling to the trochlea, paralled to the glenoid surface, midpoint between the transverse glenoid diameter and medial edge of the scapular. We also measured the bicipital groove distance from the humeral central axis and scapulothoracic angle. Results: Retroversion of proximal humerus was highly variable, ranging in this study from 13 to 58 degrees(mean 28.73) These values correlated with sex, not age, height or hand dominance. Glenoid retroversion at the inferior sections showed average 1.3 degree, did not signigicant differences. The central axis was an average of l0mm(5-15mm) posterior to the posterior margin of the bicipital groove. Scapulothoracic angle was average 43 degrees(25-53 degrees) Conclusion: Anatomical reconstruction of retroversion angle should be individualized and bicipital groove could be useful as landmark for the lateral fin of the prosthesis to be positioned an average of 10mm posteriorly.
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