• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.117-123
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• 2006

Objectives : The purpose of this study was conducted to find correct facilitation and clinical facilitation with proprioceptive neuromuscular facilitation (PNF). Methods : This is a literature study with books, articles, seminar note and books for PNF international course. Results : Treatment approach was changed from managements of reflex to facilitation. The facilitation will make passive or active motion. But it can not match with normal functional activities, lack of the active movement, and facilitation of musculoskeletal can interaction with environment. Conclusions : Facilitation of the Functional activities in the main therapy goal. Any necessary information, such as visual and acoustical information must be integrated. Spatial summation and temporal summation integrated also. Integrated information for the facilitation will be increased activity of alpha-motorneurons, activity of interneurons, and muscle fiber structural changes from slow twitch fibers to fast twitch fibers. Suggested facilitate goal-oriented of movements at a functional level and reduce stiffness at structural level.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.1
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• pp.25-34
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• 2010

Purpose : The purpose of this study is to assess the effect for gait, balance, and depression for stroke patients by group task-related program training based motor learning theory. Methods : The subjects of this study were administrated to the 11 stroke patients (9 male, 2 female) by 5 weeks, 3 times per week, 15 times. The group task-related program training were performed gait, balance, treadmill, muscle strengthening, and game program. Each program took 7~10 minutes and total time took 60 minutes including moving time. The difference of program training were compared using the paired t-test. Results : The results of this study revealed that Fugl-Meyer motor assessment, Chedoke-McMaster Stroke assessment of lower extremity and Berg balance scale were significantly correlated. However, impairment item of Chedoke-McMaster Stroke assessment, spatio-temporal gait parameters, Timed up and go test, and depression item of Minnesota Multiphasic Personality Inventory were not significantly correlated. Conclusion : These results support that group task-related program could be a useful treatment to improve the balance skills and motor function of lower extremity for the chronic stroke patients.

• Animal cells and systems
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• v.14 no.2
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• pp.73-81
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• 2010

In this study, monoclonal antibodies against lysosomal acid phosphatase (LAP) of a salamander, Hynobius leechii, were used to determine the spatial and temporal expression of the LAP in the regenerating limbs. The Western blot and immunohistochemical analysis in the limb regeneration revealed that LAP was highly expressed at the dedifferentiation stage, especially in the wound epidermis and dedifferentiating limb tissues such as muscle and cartilage. With RA treatment, the LAP expression became upregulated in terms of both level and duration in the wound epidermis, blastemal cell and dedifferentiating limb tissues. In addition, in situ activity staining of LAP showed a similar result to that of immunohistochemistry. Thus, the activity profile of LAP activity coincides well with the expression profile of LAP during the dedifferentiation period. Furthermore, to examine the effects of lysosomal enzymes including LAP on salamander limb regeneration, lysosome extract was microinjected into limb regenerates. Interestingly, when the lysosome extract was microinjected into limb regenerates with a low dose of RA($50\;{\mu}g/g$ body wt.), skeletal pattern duplication occurred frequently in the proximodistal and transverse axes. Therefore, lysosomal enzymes might cause the regenerative environment and RA plays dual roles in the modification of positional value as well as evocation of extensive dedifferentiation for pattern duplication. In conclusion, these results support the hypothesis that dedifferentiation is a crucial event in the process of limb regeneration and RA-evoked pattern duplication, and lysosomal enzymes may play important role(s) in this process.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.271-274
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• 2018

The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.88-91
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• 2020

Cutaneous squamous cell carcinoma (SCC) is the second most common skin malignancy. This report describes the case of an unusual extensive SCC involving the whole hemiface, which required reconstruction with a combination of a dual vascular free transverse rectus abdominis muscle (TRAM) flap and a skin graft. A 79-year-old woman visited our hospital with multiple large ulcerated erythematous patches on her right hemiface, including the parieto-temporal scalp, bulbar and palpebral conjunctiva, cheek, and lip. A preliminary multifocal biopsy was performed in order to determine the resection margin, and the lesion was resected en bloc. Orbital exenteration was also performed. A free TRAM flap was harvested with preserved bilateral pedicles and was anastomosed with a single superior thyroidal vessel. The entire TRAM flap survived. The final pathological examination of the resected specimen confirmed that there was no regional nodal metastasis, perineural invasion, or lymphovascular involvement. The patient was observed for 6 months, and there was no evidence of local recurrence. Usage of a TRAM flap is appropriate for hemifacial reconstruction because the skin of the abdomen matches the color and pliability of the face. Furthermore, we found that the independent attachment of two extra-flap anastomoses to a single recipient vessel can safely result in survival of the flap.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.215-221
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• 2000

A 69-year-old male pateint was admitted for discomfort on right temporomandibular joint during opening, closing and chewing that started few months ago. The patient had no special medical history except for lung tuberculosis approximately 30 years ago and nothing specific appeared on a physical exam taken 2 months ago. Clinical tests show that mouth opening of 53mm which was normal and no joint sound, deviation, pain during opening. But tenderness to palpation on Rt masseter muscle and pain existed on Rt temporomandibular joint during loading test on the right joint. No pain existed during resistance test and protrusion and range of lateral movement was normal. Rt temporomandibular joint was not swollen and no palpable mass was observed. No previous trauma history to the face existed. On X-ray calcific material existed in the joint cavity and on CT image, approximately 2mm sized calcific material appeared on the Rt temporomandibular joint but no change in bone appeared on the condyle nor the temporal bone. The patient was diagnosed as loose body, and the symptoms were relived after 2 physical therapies and is under regular check ups. The purpose of this case is to review disease that cause loose bodies.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.232-238
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• 2021

Background: Galeal or temporalis muscle flaps have been traditionally used to reconstruct skull base defects after tumor removal. Unfortunately, these flaps do not provide sufficient vascularized tissue for a dural seal in extensive defects. This study describes the successful coverage of large skull base defects using anterolateral thigh (ALT) free flaps. Methods: This retrospective study included five patients who underwent skull base surgery between June 2018 and June 2021. Reconstruction was performed using an ALT free flap to cover defects that included the intracranial space and extended to the frontal sinus and cribriform plate. Results: There were no major complications, such as ascending infections or cerebrospinal leakage. Postoperative magnetic resonance imaging showed that the flaps were well-maintained in all patients. Conclusion: Successful reconstruction was performed using ALT free flaps for large anterior skull base defects. In conclusion, the ALT free flap is an effective option for preventing communication between the nasal cavity and the intracranial space.

• Journal of Rhinology
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• v.25 no.2
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• pp.99-102
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• 2018

Lateral pharyngoplasty is a surgical option for treatment of obstructive sleep apnea (OSA). Here, we present a case involving a 40-year-old healthy man who underwent surgery, including lateral pharyngoplasty and robotic tongue base resection, for OSA. There were no intraoperative or immediate postoperative complications. However, on postoperative day 3, the patient presented with swelling in the temporal and buccal areas and was diagnosed with subcutaneous emphysema, later confirmed by computed tomography. The patient was carefully monitored under conservative care and discharged without complications. Although subcutaneous emphysema following tonsillectomy is a rare complication and usually resolves with conservative management, in certain cases, it might require surgical intervention. Lateral pharyngoplasty involves tonsillectomy and additional incision along the tonsillar fossa, which makes it susceptible to pharyngeal wall defects and, consequently, subcutaneous emphysema. Additionally, lateral pharyngoplasty and robotic tongue base resection cause pain and might thus contribute to the increase in intrapharyngeal pressure, which might aggravate subcutaneous emphysema. Lateral pharyngoplasty should be performed with meticulous dissection of the superior pharyngeal constrictor muscle. Healthcare providers should be aware of these complications and, upon suspicion of the same, place the patient under close observation to prevent life-threatening situations.

• The korean journal of orthodontics
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• v.36 no.3 s.116
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• pp.218-227
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• 2006

Although the submentovertex radiograph and surface EMG are not often used due to the difficulty of interpretation, they are accepted as useful diagnostic and analytic aids for skeletal asymmetry. There have been reports which state that they were also useful for the evaluation of vertical skeletal relations. The purpose of this study was to evaluate the correlations between EMG data, measurements from submentovertex radiographs, facial types and facial asymmetry following examination of 60 asymmetric patients. The radiographic corpus length were greater in the nonaffected sides (p<0.001), gonion to interspinosum axis were greater in the affected sides and the mandibular condyle and gonion were located more anteriorly in the non-affected sides than in the affected sides but not significant (p=0.07). The activity of the anterior temporal muscle in rest position was higher in the affected sides than in the non-affected sides (p<0.01). The activity of the masseter muscle at maximum clenching was found to be nonsignificant but it was higher in the affected sides than in the non-affected sides (p=0.09). There was positive correlation between facial index and the intercondylar axes angle (p<0.01). There was positive correlation between masseter muscle activity in maximum occlusion and facial index in the affected and non-affected sides (p<0.05). The results demonstrate that the submentovertex radiograph and EMG can provide useful information for the evaluation of horizontal and vertical skeletal relations.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.245-257
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• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.