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Outcomes of Primary Unilateral Cheiloplasty in Same-Day Surgical Settings

  • Khan, Mansoor;Ullah, Hidayat;Aziz, Asif;Tahir, Muhammad
    • Archives of Plastic Surgery
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    • v.43 no.3
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    • pp.248-253
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    • 2016
  • Background Financial, clinical, and psychological considerations have made same-day surgery an attractive option for a variety of procedures. This article aimed to analyse the postoperative results of same-day primary unilateral cleft nasolabial repair. Methods This study was performed from 2011 to 2014. Unilateral cleft lip patients fulfilling the inclusion criteria were preoperatively classified as mild, moderate, and severe. All patients underwent same-day surgery and were discharged after satisfying the appropriate clinical criteria, receiving thorough counselling, and the establishment of a means of communication by phone. Postoperative outcomes were assessed and stratified according to preoperative severity and the type of repair. Results A total of 423 primary unilateral cleft lip patients were included. Fisher's anatomical subunit approximation technique was the most common procedure, followed by Noordhoff's technique. The postoperative outcome was good in 89.8% of cases, fair in 9.9% of cases, and poor in 0.2% of cases. The complication rate was 1.18% (n=5), and no instances of mortality were observed. The average hospital stay was 7.5 hours, leading to a cost reduction of 19% in comparison with patients who stayed overnight for observation. Conclusions Mild unilateral cleft lip was the most common deformity for which Fisher's anatomical subunit approximation technique was performed in most of the cases, with satisfactory postoperative outcomes. Refinements in the cleft rhinoplasty techniques over the course of the study improved the results regarding cleft nasal symmetry. Single-day primary unilateral cleft cheiloplasty was found to be a cost-effective procedure that did not pose an additional risk of complications.

The Effects of Mental Practice for Performing of Functional Activities to Unilateral Neglect and ADL in Person With Stroke (기능적 활동의 수행에 대한 상상연습이 뇌졸중 환자의 편측무시와 일상생활활동에 미치는 효과)

  • Choi, Yoo-Im
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3879-3887
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    • 2009
  • The purpose of this study was to investigate the effect of mental practice about functional performance of affected limb to unilateral neglect and ADL(Activities of Daily Living) in person with stroke. A single subject experimental research with ABA design was employed in this study. The experiment formed 18 sessions in total: 5 sessions for baseline, 10 sessions for mental practice treatment, and 3 sessions for the second baseline. Mental practice was composed of performing 3 functional activities(dressing clothes, make-up with materials and arrangement, folding clothes). It took 5 minutes at once and 15 minutes in total daily. The unilateral neglect was measured by reading test, writing test, and Baking Tray Task. ADL was assessed by COPM. The results indicated that unilateral neglect test scores were all reduced, and the score of COPM was clinically significant. Mental practice for performing of functional activities was effective method to reduce unilateral neglect and improve ADL in person with stroke.

The Effects of Gluteal Taping on Pelvic Alignment, Trunk Stability, and Balance during Sitting in Children with Unilateral Cerebral Palsy (편측 뇌성마비아의 볼기 테이핑이 앉은 자세에서 골반경사 및 몸통 안정성과 균형에 미치는 영향)

  • Seo, Hye-Jung;Kim, Joong-Hwi;Choi, Myung-Jin;Jeong, Hye-Su
    • The Journal of Korean Physical Therapy
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    • v.26 no.5
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    • pp.308-314
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    • 2014
  • Purpose: The aim of this study was to investigate the effects of gluteal taping on pelvic alignment, trunk stability, and balance during sitting posture in children with unilateral cerebral palsy (CP). Methods: Thirteen children with unilateral cerebral palsy (six females. seven males; mean age 8.5) participated in this study. All participants were evaluated before and after gluteal taping using an Inclinometer for pelvic lateral inclination, trunk impairment scale (TIS) for trunk stability, and modified functional reaching test for balance during sitting. The collected data were analyzed using a paired t-test. Results: The results of this study were as follows: 1) Statistically significant decreases in the angle of pelvic lateral inclination were observed after gluteal taping in children with unilateral CP (p<.05). 2) Statistically significant increases in TIS score were observed after gluteal taping (p<.05). 3) Statistically significant increases in the range of reaching during sitting were observed after gluteal taping (p<.05). Conclusion: : In conclusion, this study showed that gluteal taping improves pelvic alignment, trunk stability, and balance during sitting in children with unilateral cerebral palsy. Further studies will be required to determine the short- and long-term effects of gluteal taping on improving postural symmetry, trunk stability, and balance.

Efficacy of Unilateral Laminectomy for Bilateral Decompression in Elderly Lumbar Spinal Stenosis

  • Ji, Yong-Cheol;Kim, Young-Baeg;Hwang, Sung-Nam;Park, Seung-Won;Kwon, Jeong-Taik;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.410-415
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    • 2005
  • Objective: The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique. Methods: Thirty-four patients over 65years of age who underwent unilateral partial laminectomy for bilateral decompression from January 2000 to October 2003 were analyzed. These patients were studied for preoperative co-morbid condition and physical status according to the American Society of Anesthesiologists(ASA) classification, postoperative morphometrical change, and clinical outcomes, including visual analogue scale(VAS) score. The mean follow-up was 23months (range 6 - 48months). Results: A patient's physical status was recorded as class I, II, or III by ASA classification, which correlated to 41.2%, 44.1%, and 14.7% of patients, respectively. The cross-sectional area of the pre- and postoperative dural sac at the level of the stenosis was $52.5{\pm}19.9mm^2$ and $110.6{\pm}18.2mm^2$, respectively. The outcome was excellent in 8.8%, good in 58.8%, fair in 23.6%, and poor in 8.8% of the patients. The VAS was changed postoperatively to $3.1{\pm}1.2$. There was no operation-related transfusion yet there was no evidence of postoperative instability at the follow-up examination. Conclusion: Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

Profiles of Spinal Cord Tumors Removed through a Unilateral Hemilaminectomy

  • Yeo, Dong-Kyu;Im, Soo-Bin;Park, Kwan-Woong;Shin, Dong-Seong;Kim, Bum-Tae;Shin, Won-Han
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.195-200
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    • 2011
  • Objective : To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. Methods : From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. Results : The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. Conclusion : Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.

Effects of the Support Surface Condition on Muscle Activity of Abdominalis and Erector Spinae During Bridging Exercises

  • Hong, Young-Ju;Kwon, Oh-Yun;Yi, Chung-Hwi;Jeon, Hye-Seon;Weon, Jong-Hyuck;Park, Kyue-Nam
    • Physical Therapy Korea
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    • v.17 no.4
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    • pp.16-25
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    • 2010
  • The aim of this study was to determine the muscle activity of the abdominalis and erector spinae during bridging and unilateral bridging exercises on the firm surface, the sir-fit, and the foam roll. Eighteen healthy young subjects were recruited for this study. Surface electromyographic (EMG) activities were recorded from the both sides of the rectus abdominalis, external obliques, internal obliques, and erector spinae muscles during bridging and unilateral bridging-exercises. A one-way repeated analysis of variance was used to compare the EMG activity of each muscle according to the support surface condition. Differences in the EMG activities between the bridging and unilateral bridging exercises, and between the right and left side were assessed using a paired t-test. The study showed that the EMG activities of all of the muscles were significantly higher when the bridging exercise was performed using the foam roll or sit-fit than on the firm surface. The EMG activities of the right rectus abdominis, right external obliques, the right internal oblique, and both erector spinae were significantly higher during unilateral bridging ex exercise using the foam roll or the sit-fit than on the firm surface. The EMG activities of all of the muscles were significantly higher during the unilateral bridging exercise than during the bridging exercise. Based on these finding, performing the unilateral bridging exercise using the sit-fit or the foam roll is a useful method for facilitating trunk muscle strength and lumbar stability.

Analysis of Judgements on the validity of selective/unilateral Arbitration Agreement - In case of the Supreme Court's Judgements - (선택적 중재합의의 유효성에 대한 판례분석 - 대법원 판례를 중심으로 -)

  • Chung, Young-Hwan
    • Journal of Arbitration Studies
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    • v.19 no.3
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    • pp.3-24
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    • 2009
  • This article discusses the validity of selective/unilateral arbitration agreement that provides arbitration as one of several dispute resolution methods. The Supreme Court has held selective/unilateral arbitration agreement that is conditional invalidity since the judgement of 2003Da318 decided on Aug. 22, 2003: In the following judgements of 2004Da42166 decided on Nov. 11, 2004 and 2005Da12452 decided on May 27, 2005, the Court stated that the selective/unilateral arbitration agreement that stipulates to resolve a dispute through arbitration or mediation would be valid as an effective arbitration agreement only if a party elects and proceeds an arbitration proceeding and another party responses to the arbitration proceeding without any objection. The definition of arbitration agreement, the formation of selective/unilateral arbitration agreement, the summary of relative judgements and academic theories will be reviewed in order to examine the appropriateness of the series of judgements of the Supreme Court. Based on such reviews, this article will investigate the adequacy of the Supreme Court judgements from the perspectives of i) the principle of party autonomy, ii) the structure of dispute resolution methods, iii) legal provisions of Arbitration Act, iv) legal stability, and v) the policy to revitalize the use of arbitration. At conclusion, this article will suggest the change of precedents of the Supreme Court's judgements with regard to the selective arbitral agreement.

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A Case of Type I Vitamin D-dependent Rickets with Unilateral Aplasia of Kidney (일측성 신장 무형성을 동반한 제 1형 비타민 D 의존성 구룻병 1례)

  • Lim, Dong-Hee;Jung, Ji-In;Yim, Hyung-Eun;Eun, Baik-Lin;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.111-115
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    • 2008
  • Vitamin D-dependent rickets(VDDR) is a rare autosomal disorder, characterized by hypocalcemia, hypophosphatemia, increased alkaline phosphatase, secondary hyperparathyroidism and many other clinical features. Type I VDDR is due to congenital defects of renal 1${\alpha}$-hydroxylase, the enzyme responsible for the conversion of 25-(OH)D3 to 1,25-$(OH)_2D3$. Type II VDDR arise from target organ resistance to 1,25-$(OH)_2D3$. Unilateral renal aplasia is generally thought to result from a lack of induction of the metanephric blastema from the ureteral bud, which may be secondary to ureteral bud maldevelopment and/or to a problem with the formation of the mesonephric duct. The incidence of unilateral renal aplasia is approximately 1/500-3,200. Type 1 VDDR associated with unilateral renal aplasia has not been reported yet. Thus we report a case of a 3 month old female infant diagnosed as type 1 VDDR with unilateral aplasia of kidney.

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The Comparison Between CBS and Pencil and Paper Test in Patients With Unilateral Neglect (편측무시 환자에서 관찰을 통한 Catherine Bergego Scale과 지필 검사 간 비교)

  • Heo, Eun-Young;Kwon, Hyuk-Cheol;Hwang, Ki-Cheol
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.48-56
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    • 2013
  • Purpose : To identify the correlation between CBS and pencil and paper test, and to test the sensitivity of above tests about unilateral neglect. Mostly used tool of pencil and paper test is line bisection and albert test. CBS is behavioral neglect test. Methods : The subjects of study were 44 stroke patients with left hemiplegia. Data were analyzed for Pearson correlation, paired t-test and ANOVA using SPSS program. The significance level was ${\alpha}<.01$. Results : The results of the study was as follow: 1. CBS had a significant correlation of line bisection and Albert test. 2. CBS was more sensitive than the pencil and paper in unilateral neglect. 3. CBS had high correlations with ADL than the pencil and paper test. Conclusion : The result showed that CBS was more useful than a pencil and paper test to distinguish unilateral neglect and available to diagnose anosognosia. Therefore, it should be considered applying CBS to inspect and cure unilateral neglect.

Efficacy of Thalamotomy and Thalamic Deep Brain Stimulation for the Treatment of Head Tremor

  • Choi, Seung-Jin;Lee, Kyung-Jin;Ji, Cheol;Ahn, Jae-Geun;Choi, Hyun-Chul;Kim, Moon-Chan
    • Journal of Korean Neurosurgical Society
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    • v.37 no.5
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    • pp.325-328
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    • 2005
  • Objective: Stereotactic thalamic procedure is well known to be a effective treatment for disabling upper limb tremor of essential tremor. However, the effect of this procedure for head tremor, which is midline symptom of that disease entity, has not been sufficiently established. The authors discuss the result of stereotactic thalamic operations for head tremor of their patients who suffered from essential tremor. Methods: We evaluated 4 patients of essential tremor who had head tremor combined with both upper limb tremor. One patient underwent unilateral ventralis intermedius thalamotomy, two patients had unilateral Vim deep brain stimulation(DBS) and one patient had unilateral Vim thalamotomy and contralateral DBS. Postoperative results of tremor were evaluated using our proposed scale. Results: Contralateral upper limb tremors to surgical side were markedly resolved in all patients but there was no meaningful effect for head tremor in 3 patients who underwent unilateral thalamic surgery. In a patient having simultaneously unilateral thalamotomy and contralateral DBS, remarkable improvement of head tremor was observed. Conclusion: Although it is difficult to evaluate the efficacy of thalamic surgery for axial symptom of essential tremor with a few cases, simultaneous unilateral thalamotomy and contralateral DBS would be expected to induce favorable outcomes for head tremor with significant economical advantages.