• Journal of Korean Neurosurgical Society
• /
• v.48 no.5
• /
• pp.406-411
• /
• 2010

Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

• Journal of Korean Physical Therapy Science
• /
• v.5 no.4
• /
• pp.785-794
• /
• 1998

We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

• Transactions of the Korean Society of Automotive Engineers
• /
• v.18 no.2
• /
• pp.1-6
• /
• 2010

This study presents the practical design modification to improve the retracting performance of the pyro-typed high power pretensioner. 3 components of the pretensioner are redesigned and the usefulness of the design modification is verified by the experiment. During the pretensioning process, the gas blast generated from the gunpowder is transferred to the rack-pinion gear through the manifold. The rack-pinion gear is connected with the spool where the webbing is rolled up. According to the rotation of the pinion, the spool is turned and the webbing is winded. To help the gas blast flow well, the shape of the inner cross section of the manifold is changed. The spur gear design program is developed and used to find the best combination of the rack-pinion gear pair to increase the power transmission efficiency. The pinion guide is installed on the spool to prevent the vibration of the pinion. As a result of the experiment, the amount of the web retraction length is increased when every single design modification is applied. Therefore, the retracting performance of the pretensioner is considered to be improved if the presented design modifications are applied.

• Archives of Plastic Surgery
• /
• v.34 no.3
• /
• pp.330-335
• /
• 2007

Purpose: The purpose of this study is to evaluate the functional outcome and donor site morbidity of anterolateral thigh free flap(ALT) compared to Radial forearm free flap(RFFF) for the reconstruction of partial glossectomy defect. Methods: 5 ALT free flap (group I) were attempted for partial glossectomy patients. We compared patients undergone ALT flap with those(n=11) of similar size defect reconstructed with RFFF (Group II). Rating scales for articulation and swallowing function were applied and donor site morbidity have been evaluated. Results: The scales for speech function showed no difference between the two groups (average score; group I - 6.4, group II - 6.45). Swallowing function also showed no difference between the two groups(average score; Group I - 6.6, Group II - 6.27). ALT group had one patient with donor site morbidity(numbness). All of the RFFF patients(11/11) complained and suffered from hypertrophic scar, retraction, numbness or hyperpigmentation on forearm donor site. Based on our study, ALT free flap is comparable to that of RFFF in terms of functional assessment in tongue reconstruction. Conclusion: Considering the donor site morbidity, ALT flap is to be valuable to reconstruct partial glossectomy defect.

• Clinics in Shoulder and Elbow
• /
• v.4 no.2
• /
• pp.181-185
• /
• 2001

Purpose: We reviewed the bilateral anterior shoulder instability to evaluate the final outcomes and influencing factors that had effect on the final outcomes. Materials and Methods: Sixteen patients of the bilateral shoulder instability underwent the operative treatment and 15 patients could be followed up average 29 months. There were Bankart lesions in 28 cases and 46% retracted markedly onto the medial side of the glenoid neck. Capsular redundancy could be seen in 50%, but the generalized ligamentous laxity in only two patients. We performed open Bankart repair in 21 cases and arthroscopic repair in 9 cases. Inferior capsular shift was performed in 12 cases of 15 cases in patients who was shown the capular redundancy. Results: The average increment of the forward flexion was 4° postoperatively but the average decrement of the external rotation was 6° postoperatively. After the inferior capsular shift surgery, there were significantly the decrement in external rotation by 13° even though the forward flexion was at the same level comparing with preoperative motion. There were 13 cases(43%) in excellent result, 14 cases(47%) in good and 3 case(l0%) in poor. Rowe score improved from 53 to 87.3 postoperatively. Conclusion : Re-establishing a proper capsular tensioning in a bilateral anterior shoulder instability is critical to ultimate success because there was a redundant laxity in a half and majority of them had marked retraction of an anteroinferior glenohumeral ligament complex. Especially, it should be considered that an unexpected limitation of external rotation could be occurred in the inferior capsular shift surgery.

• Childhood Kidney Diseases
• /
• v.8 no.1
• /
• pp.57-62
• /
• 2004

Schinzel-Giedion syndrome is a rare, distinct dysmorphic syndrome characterized by congenital hydronephrosis, skeletal dysplasia, and severe developmental retardation, likely to be inherited as an autosomal recessive trait, but not yet confirmed. This syndrome is characterized by coarse facial features such as midfacial retraction, bulging forehead, short nose with anteverted nostrils, low-set malformed ears, protruding large tongue, and hypertelorism. Skeletal and limb defects, choanal stenosis, simian creases, hypospadias, microphallus, hypertrichosis, and intractable seizures are the frequently associated clinical findings. Urogenital involvement is a major component of the syndrome, and this problem sometimes is associated with nephrocalcinosis and urinary tract infection in the clinical course of the disease. We report a 22 month-old girl with Schinzel-Giedion syndrome complicated by medullary nephrocalcinosis and urinary tract infection due to Klebsiella pneumoniae. This patient had also been suffering from postnatal growth deficiency, intractable seizure, spastic tetraplegia, delayed development and severe mental retardation.

• Archives of Plastic Surgery
• /
• v.35 no.4
• /
• pp.471-479
• /
• 2008

Purpose: Sunken eyelid is a deformity of upper eyelid due to atrophy of periocular fat tissue, loss of skin elasticity. It causes the skin retraction of eyelid and unfavorable fold. Sunken eyelid occurs from the results of natural aging process, facial trauma, complication of previous periocular surgery, etc. We acquired a satisfied correction of sunken eyelid and unfavorable fold using autologous fat injection only. The aim of this study is a assessment of autologous fat injection for correction of sunken eyelid accompanied with unfavorable fold. Methods: From August 2002 to March 2006, we performed 37 cases of correction of sunken eyelid with unfavorable fold using autologous fat injection. They were all females with ages ranged from 23 to 63. Fat was harvested from lower abdomen and centrifuged with Coleman system. Multi-layered injection of purified fat was done from orbital fat layer to orbicularis oculi muscle. Results: Overall, improvement of sunken eye and unfavorable fold was observed in the majority of the patients. Discomfort of eye opening was improved in 24 patients. The average injection volume was 1.33 mL in right eyelid, 1.31 mL in left eyelid at first injection. Second injection was done in patients who absorption of injected fat was noted with. No specific complications were observed. Conclusion: Natural and attractive upper eyelid was acquired from fat injection only in sunken eyelid with unfavorable fold. To the authors' knowledge, it is desirable for sunken eyelid accompanied with unfavorable fold to be treated with autologous fat injection at first. Although some shortcomings are substantial, autologous fat injection is easy and effective method for correction of unfavorable fold in sunken eyelid without specific complication.

• Journal of Biosystems Engineering
• /
• v.18 no.4
• /
• pp.344-350
• /
• 1993

The purpose of this study is to develop design equations to calculate optimum specifications and dimensions such as weight, engine horsepower, etc. of the tractor necessary to perform stable rotary tillage. The main results of this study are as follows. 1. A wheel-lug ought to receive a special resistance in downward direction which resists the lug's upward motion on wet sticky soil surface. The authors introduce a new academic name of the "lift resistance(上昇抵抗力, 상승저항력)" for such a force which resists retraction of a wheel lug from the soil in the upward trochoidal motion. This force is composed of the frictional force acting on the trailing and the leading lug side, and the "perpendicular adhesion(鉛直付着力, 연직부착력)" acting on the lug face and the undertread face on adhesive soil. 2. The "lift resistance ratio(上昇抵抗力係數, 상승저항력계수)" and the "perpendicular adhesion ratio(鉛直付着力係數, 연직부착력계수)" were defined, which are something similar to the definition of the motion resistance ratio, the traction coefficient, etc. 3. The design equation of the optimum weight of a rotary tiller mounted on the tractor derived by calaulating the forces acting on the rotary blades. 4. The design equations to calculate optimum specifications and dimensions such as weight, engine horsepower, etc. of the tractor necessary to perform stable rotary tillage were derived. It becomes clear that the optimum weight of a rotary tiller and a tractor can be estimated in planning design by means of putting about 21 design factors of the target into the equation. These equations are useful for planning design to estimate the optimum dimensions and specifications of a rotary tiller as well as a tractor by the use of known and/or unknown design parameters.

• Clinics in Shoulder and Elbow
• /
• v.23 no.3
• /
• pp.144-151
• /
• 2020

Background: This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40. Methods: From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation. Results: Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event. This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Conclusions: Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.20 no.1
• /
• pp.9-14
• /
• 2014

Background: Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of manual therapy on pain, ROM, disability in a patient experiencing cervical radiculopathy. Methods: In this study, 30 participants who met the diagnostic criteria for cervical radiculopathy were randomized into two groups: group I (nerve mobilization group) & group II (Mckenzie exercise group). The experimental group was performed manual cervical traction and neural mobilization technique. The control group was performed manual cervical traction and cervical retraction, extension exercise. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were pain intensity (PI), cervical rotation ROM (CR) and neck disability index (NDI). Results: After 4 weeks therapy, PI, CR and NDI were significantly reduced in both groups (p<.01). The PI, CR and NDI were no significantly reduced between group I and group II (p>.01). Conclusions: Manual therapy could reduce the symptoms of cervical radiculotpathy.