• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.265-269
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• 2019

Congenital hypoplasia of the depressor anguli oris muscle is a rare cause of asymmetrical crying facies in newborns. The clinical manifestations range from mild to severe asymmetry and may persist up to adulthood. In the current case, the patient did not exhibit other congenital anomalies or paralysis of other branches of the facial nerve. This adult patient presented with severe asymmetrical lower lip deformity during full mouth opening since birth. A chromosomal study for the detection of 22q gene deletion yielded negative results. The electromyography findings of the lower lip were insignificant. Depressor labii inferioris muscle resection was not effective, but bidirectional (horizontal and vertical) fascia lata grafting improved the aesthetic appearance of the asymmetrical lower lip. The patient showed improved lower lip symmetry during full mouth opening at 1 year after the surgery. Therefore, the details of this rare case are reported herein.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.135-139
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• 2018

Background Static reconstruction surgery that tightens the tension of the inferior tarsus, thereby raising the lax lower eyelid, is a common treatment for paralytic ectropion of the lower eyelid. We present one such operative procedure, in which an orbicularis oculi muscle flap was used. Methods The surgical technique involves partial resection of the tarsus and the skin, as well as a superior-based orbicularis oculi muscle flap that is sutured to the firm tissue present on the Whitnall tubercle. The muscle flap is approximately 7 mm in width and 15 mm in length, with a superior pedicle that is attached to the tarsus at the medial point of the resected tarsus. The procedure results in contact between the ocular surface and the lower eyelid. Results The procedure was performed in 11 patients with lower eyelid ectropion due to facial paralysis. Ten cases showed a favorable outcome following surgery, with stable results seen over an average follow-up period of 4.5 years. In one case, recurrence of ectropion was observed 2 months after surgery due to an insufficient correction, and the patient required repeat surgery. Conclusions The orbicularis oculi muscle flap was an effective means of suspension and was able to maintain long-term traction tension. This procedure can therefore be considered a favorable treatment option for lower eyelid ectropion due to facial paralysis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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• pp.256-259
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• 2013

Botulinum toxin type A (BTX-A) inhibits muscle contraction, which leads to reversible muscle atrophy and paralysis. Therefore, BTX-A injection can be an effective treatment of facial asymmetry that originated from the uncoordinated muscle movement. A 52-year-old patient was referred from another hospital for the correction of post-traumatic sequelae. The patient had prominent scar in the mandibular symphysis area with asymmetric lower lip movement. The reason for this asymmetric lower lip movement was due to damage in the lower lip depressor muscle. After the injection of BTX-A on the lower lip depressors, asymmetric lip movement has been improved.

• Clinical and Experimental Pediatrics
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• 제53권10호
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• pp.909-912
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• 2010

Familial hypokalemic periodic paralysis is an autosomal-dominant channelopathy characterized by episodic muscle weakness with hypokalemia. The respiratory and cardiac muscles typically remain unaffected, but we report an atypical case of a family with hypokalemic periodic paralysis in which the affected members presented with frequent respiratory insufficiency during severe attacks. Molecular analysis revealed a heterozygous c.664 C>T transition in the sodium channel gene $SCN4A$, leading to an Arg222Trp mutation in the channel protein. The patients described here presented unusual clinical characteristics that included a severe respiratory phenotype, an incomplete penetrance in female carriers, and a different response to medications.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.351-356
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• 2020

Background: We have devised a novel surgical method, termed as temporalis muscle tendonperiosteum (T-P) compound surgical method, by modifying pre-existing techniques. Our method is characterized by elevation of temporalis muscle tendon and the periosteum of the mandibular ramus as a single compound. Here, we describe the concept and clinical outcomes of our method. Methods: We conducted both a cadaveric study and a clinical study. First, we used four human cadavers (two males and two females) to confirm the anatomy of the temporalis muscle tendon and availability of sufficient length extension through the elevation of the T-P compound. Moreover, we obtained measurements of the mouth angle and the philtrum angle from a total of six patients (two males and four females) and compared them between preoperatively and postoperatively. Results: The mean length of the periosteal portion was measured as 2.43± 0.15 cm (range, 2.2-2.6 cm). There was an improvement in the mouth angle postoperatively as compared with preoperatively (7.2°± 3.0° vs. 14.5°± 4.7°, respectively). Moreover, there was also an improvement in the philtrum angle postoperatively as compared with preoperatively (7.2°± 3.4° vs. 17.2°± 6.5°, respectively). Conclusion: Our method is a simple, minimally-invasive modality that is effective in achieving good clinical outcomes. Its advantages include an ability to achieve a firm extension of the temporalis muscle tendon as well as a lack of requirement for a donor site that may cause complications.

• 제어로봇시스템학회논문지
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• 제16권10호
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• pp.919-926
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• 2010

This paper proposes a wearable hand rehabilitation device, DULEX, for persons with functional paralysis of upper-limbs after stoke. DULEX has three degrees of freedom for rehabilitation exercises for wrist and fingers except the thumb. The main function of DULEX is to extend the range of motions of finger and wrist being contracture. DULEX is designed by using a parallel mechanism, and its parameters such as length and location of links are determined by kinematic analysis. The motion trajectory of the designed DULEX is aligned to human hand to prevent a slip. To reduce total weight of DULEX, artificial air muscles are used for actuating each joint motion. In feedback control, each joint angle is indirectly estimated from the relations of the input air pressure and the output muscle length. Experimental results show that DULEX is feasible in hand rehabilitation for stroke survivals.

• 동의생리병리학회지
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• 제20권3호
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• pp.748-752
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• 2006

Wei symptom(?證) is symptom that reveals muscle relaxation without contraction and muscle relaxation occurs in the lower or upper limb, in severe case, leads to death. This is the clinical report about the Wei symptom(?證)-patient doubt as Transverse Myelitis and Conversion Disorder. The patient was treated by acupuncture, moxibustion, herb medication(十全大補湯), electriccal stimulation theraphy, Bee Venom acupuncture, and had significant improvement in Wei symptom(?證). these results suggest the surface temperature differ remarkably from before being treated. The temperature is measured by using Digital Infrared Thermal Imaging(DITI). The results suggest that oriental medicare is an effective treatment for Wei symptom. We expected that therapeutic value of treatment of both leg Paralysis in the oriental medicine will be higher if more clinical studies and researches are accomplished.

• Journal of Acupuncture Research
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• 제40권2호
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• pp.156-161
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• 2023

Herein, we report the effectiveness of Korean medicine for the treatment of postherpetic upper limb weakness and pain. The patient received a combination of Korean medicine treatment modalities, including electroacupuncture, pharmacopuncture, and herbal medicine. Muscle strength and pain were evaluated using a manual muscle test (MMT) and a Numerical Rating Scale (NRS), respectively. The overall MMT score improved after hospitalization, and elbow extension improved from 3+ at admission to 5 at discharge. The NRS score improved to 2 at discharge. This study suggests the effectiveness of a combination of Korean medicine modalities in treating postherpetic motor nerve paralysis.

• Journal of Chest Surgery
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• 제15권3호
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• pp.290-294
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• 1982

Diaphragmatic eventration is a rare disease, congenital or acquired, high or elevated position of one leaf of the diaphragm muscle, as a result of paralysis, aplasia or atrophy of varying degree of the muscle fibers of the affected side but with no break in the continuity of the muscle. We experienced 3 cases of the diaphragmetic eventration at the department of thoracic surgery, C.A.F.G.H., from 1980 to 1982, which were treated successfully. Among three cases, one case combinded with hamartoma of the ipsilateral lung. Specific complications were not noticed after surgical repair of diaphramatic eventration with good result.

• Clinical and Experimental Pediatrics
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• 제57권10호
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• pp.445-450
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• 2014

Purpose: Familial hypokalemic periodic paralysis (HOKPP) is an autosomal dominant channelopathy characterized by episodic attacks of muscle weakness and hypokalemia. Mutations in the calcium channel gene, CACNA1S, or the sodium channel gene, SCN4A, have been found to be responsible for HOKPP; however, the mechanism that causes hypokalemia remains to be determined. The aim of this study was to improve the understanding of this mechanism by investigating the expression of calcium-activated potassium ($K_{Ca}$) channel genes in HOKPP patients. Methods: We measured the intracellular calcium concentration with fura-2-acetoxymethyl ester in skeletal muscle cells of HOKPP patients and healthy individuals. We examined the mRNA and protein expression of KCa channel genes (KCNMA1, KCNN1, KCNN2, KCNN3, and KCNN4) in both cell types. Results: Patient cells exhibited higher cytosolic calcium levels than normal cells. Quantitative reverse transcription polymerase chain reaction analysis showed that the mRNA levels of the $K_{Ca}$ channel genes did not significantly differ between patient and normal cells. However, western blot analysis showed that protein levels of the KCNMA1 gene, which encodes $K_{Ca}$1.1 channels (also called big potassium channels), were significantly lower in the membrane fraction and higher in the cytosolic fraction of patient cells than normal cells. When patient cells were exposed to 50 mM potassium buffer, which was used to induce depolarization, the altered subcellular distribution of BK channels remained unchanged. Conclusion: These findings suggest a novel mechanism for the development of hypokalemia and paralysis in HOKPP and demonstrate a connection between disease-associated mutations in calcium/sodium channels and pathogenic changes in nonmutant potassium channels.