Unilateral Ankle Force Control With and Without Chronic Ankle Instability

PURPOSE Repetitive lateral ankle sprains often cause chronic ankle instability (CAI) leading to various sensorimotor deficits. This study aimed to investigate altered ankle dorsiflexion force control capabilities in individuals with CAI. METHODS Ten young adults with unilateral CAI performed isometric ankle dorsiflexion force control at 20% of the maximum voluntary contraction under vision and no-vision conditions. Participants executed submaximal force control tasks with their impaired and non-impaired ankles. To evaluate the force control capabilities, we estimated the force trend, accuracy, and variability. Two-way repeated-measures ANOVAs (ankle×vision, 2×2) for each force control variable were used for statistical analyses. RESULTS When the visual information was removed, a declining force trend was observed in the impaired ankle (p<.001), whereas no differences were observed in the non-impaired ankle (p=.096). In the no-vision condition, the impaired ankle showed a lower mean force (p=.035) and force accuracy (p=.009) and greater force variability (p=.004) than the non-impaired ankle. CONCLUSIONS These findings suggest that CAI interferes with ankle dorsiflexion force control without visual information, indicating sensorimotor impairment

측두골에 발생한 콜레스테롤 육아종의 임상적 양상

Cholesterol granuloma is not a clinically or pathologically independent entity. It may develop in any portion of the pneumatic system of the temporal bone and can be associated with a variety of middle ear disorders. Three factors are considered to play an important role in its development；1) interference with drainage 2) hemorrhage and 3) obstruction of ventilation. We reviewed 20 cases of cholesterol granuloma in the temporal bone by analysing findings of myringoscopy, temporal bone CT and/or MRI and operation, and concluded that cholesterol granuloma appeared clinically in three forms；1) in association with chronic otitis media, especially cholesteatoma 2) idiopathic blue eardrum 3) localized lesion in the middle ear, mastoid antrum, external auditory canal and petrous apex

후두전적출술을 시행받은 환자의 인두 및 상부식도괄약근 내압검사 소견

Background and Objectibes: Total laryngectomy is usually used for patients with advanced laryngeal cancer, and causes injuries to hypopharyngeal mucosa, cricopharyngeal muscle, pharyngeal constrictor muscle. These damages induce postoperative swallowing difficulties, although accurate and objective data have not been reported. The purpose of this study is to evaluate the changes and functional difficulties of swallowing mechanism in patients with total laryngectomy by manometric analysis. Material and Methods: We used station pull-through technique in two groups. The study group consisted of 11 total laryngectomized patients, and the control group consisted of 10 cases. We measured resting pressure, length, pressure after relaxation of UES (upper esophageal sphincter), and pharyngeal pressure. And 5 parameters were analyzed for coordination of hypopharynx and UES during swallowing. Results: In the study group, the resting pressure, the maximal pressure after relaxation, and the length of UES was 36.3+/-10.5 mmHg, 149.8+/-14.6 mmHg, and 3.4+/-0.8 cm respectively. In the control group, the results was 34.9+/-9.6 mmHg, 85.5+/-12.3 mmHg, 2.2+/-0.6 cm respectively. The pharyngeal pressure was 81.8+/-10.1 mmHg in the study group, and 67.1+/-12.3 mmHg in the control group. The interval of pharyngeal constriction was 3.0+/-0.23 sec in the study group and 0.49+/-0.04 sec in the control group. The interval of UES relaxation was 2.43+/-0.14 sec in the study group and 0.99+/-0.03 sec in the control group. Conclusion: Manometric analysis showed higher pressure of the pharynx and UES in the total laryngectomized patients than in the normal adults. And there was a failure in the coordination between pharyngeal constriction and UES relaxation

포괄적 경부곽청술, 대흉근피판술과 술후 방사선 치료후 발생한 쇄골골절 3예

The treatment of head and neck cancer with radiotherapy and radical neck dissection has many well recognized complications. Radiotherapy in therapeutic doses can produce devascularization and weakening of bone. Radical neck dissection results in altered mechanics of the shoulder girdle and a normally balanced forces acting on the clavicle. However, there are no reports elaborating on the unusual case of clavicle fracture which is considered to have resulted from pectoralis major myocutaneous flap (PMMCF). We reviewed 169 cases treated with radical neck dissection and 45 patients treated with PMMCF between 1992 and 1998, retrospectively. We could find three cases of clavicle fracture all of whom underwent radical neck dissection, PMMCF and postoperative radiotherapy on the side of fracture. The type of PMMCF was island PMMCF. Fractures were noted 1-3 years postoperatively and all fractures were noted on medial portion of the clavicle. Island type PMMCF was considered as one of the predisposing factors of clavicular fracture. Devascularization after stripping of periosteum and altered mechanics of the clavicle following resection of clavicular head of pectoralis major muscle may contribute to developing a rare complication in addition to the effect of radiotherapy and radical neck dissection

부분무치악을 가진 하악전돌증 환자에서 악교정수술과 임프란트 식립을 통한 교합의 회복; 증례보고

Partially edentulous patient with an mandibular prognathism, as diagnosed by orofacial examination and radiographic finding visited in our hospital. This patient needed orthognathic surgery for correction of jaw relationship and alveolar bone augmentation before implant treatment for severely atrophic edentulous mandible. After 9 months of preoperative orthodontic treatment, sagittal split ramus osteotomy was performed and autogenous bone graft was performed using cortical bone gained from osteotomy. Grafted bone was protected with titanium mesh and fixed with micro screw. Post operative orthodontic treatment was performed for 9 momths. Titanium mesh was removed and implant fixture installation was performed .Prosthodontic treatment was carried out 5-6 months after implant placement. Oral function and facial esthetics were improved after total treatment, so we report this case with literature review

광범위 후외측 경부곽청술을 이용한 두피의 재발성 편평세포암종 치험 1례

The metastasis of nodal pattern of malignant scalp tumors of the posterior half of the scalp including the occipital area and the nape of the neck takes place primarily in the retro-auricular and suboccipital area, and secondarily in the posterior triangle of the neck. The regional node dissection that includes the removal of the retro-auricular and suboccipital nodes in continuity with the posterior triangle and jugular chain of lymph nodes is called the posterolateral neck dissection. Recently, we experienced a case of an extended posterolateral neck dissection for recurred squamous cell carcinoma on scalp. We hereby present this case with the operative technique and surgical anatomy

두경부암에서 감마카메라를 이용한 FDG영상의 임상적 유용성

BACKGROUND AND OBJECTIVES: An accurate, preoperative assessment of tumor extent and lymph node involvement is necessary to plan and tailor therapy for patients with head and neck cancer. Metabolic imaging with tluorine-18-fluorodeoxyglucose (FDG) is a good method to detect primary cancers in the head and neck and to assess the involvement of lymph nodes, but it is not widely available because of high cost of positron emission tomography (PET). Recently, an alternative method for using FDG was developed: the coincidence detection PET (CoDe PET) using a gamma camera. The aim of this study was to evaluate the clinical utility of FDG CoDe PET using a gamma camera in patients with head and neck cancer. MATERIALS AND METHODS: Thirty FDG CoDe PET studies were performed in 7 patients before therapy and 19 patients after therapy with various head and neck cancers (Age : 25- 79 years, mean age : 50+/-13 years, 18 men, 8 women). All patients had fasted for 6 to 12 hours and were injected 1 1 l to 370 MRq of F-18-FDG 1 hour before imaging. With the exception of the physiological FDG uptake, all visually detectable focal FDC uptake in the primary cancer site or in the neck was considered positive. FDG CoDe PET studies were correlated with CT/MRI. The standard procedure for detecting the presence of disease was the combinations of repeated MRIs, 3 months of follow-up clinical evaluation and the result of a needle aspiration cytology or biopsy. RESULTS: FDG CoDe PET had a detcction rate that was comparable to that of CT/MRI in the pre-therapy group. However, in the post-therapy group, FDG CoDe PET could differentiate residual/recurrence of tumor from radiation change more accurately than could MRI. But, it had a less accurate detection rate for cervical metastases because of asymmetric neck muscle uptake. CONCLUSION: FDG CoDe PET is a sensitive and cost-effective method to detect primary tumor and lymph node involvement in primary head and neck cancers. It is also useful in differentiating residual tumor or tumor recurrence from post-therapy changes in patients with head and neck cancers

지르코니아제 지대주를 이용한 임프란트 심미수복

Anterior maxillary area is called “esthetic zone”. Sometimes in implant restoration, metal abutments can make tissue discoloration on the cervical area. Zirconia abutment is an alternative for the use in esthetic zone because it doesn't cause tissue discoloration. This article describes four cases where zirconia abutments were used in anterior maxillary area with allceramic restorations. Though one case suffered the fracture of all-ceramic restoration, three of the four cases had good esthetic and functional results

골밀도 평가방법과 임플란트 안정성 변화의 관찰

Purpose: The aim of this study was to examine the correlation of the subjective and the objective evaluation of edentulous ridge bone quality, and to evaluate the change of the dental implant stability in each bone density group for early healing period after implant installation. Methods: Sixty-seven implants(Osstem implant, Seoul, Korea) were included in this study. We evaluated the bone density by 2 methods. The one was the subjective method which was determined by practitioner s tactile sense, the other was the objective bone type was based on Hounsfield units. The implant stability in each bone type group was assessed by resonance frequency analyzer(Osstell mentor). Data were analyzed for the change of the implant stability, and they were compared to verify the difference of groups at the time of installation, 2, 6, 10, 14 weeks postoperatively. Spearman’s correlation was used to demonstrate the correlation between the subjective and the objective evaluation of the bone density, and analysis of variance(ANOVA) was used to analyze the differences of implant stability at each time point. Results: There was no close relation between the subjective and the objective evaluation of the bone density(r=0.57). In the subjective groups, there was statistically significant difference between the type 1 and 3 at 10 weeks and between the type 2 and 3 at 14 weeks. In the objective groups, there was no statistically significant difference between the D 1, 2, 3, 4, and 5 group with regard to RFA from baseline to 14 weeks(P>0.1). Conclusions: The implant stability increased over time during the study, and it was improved with bone density proportionally after 2weeks postoperatively. It is recommended that the decision of bone density is base on Hounsfield unit for implant loading time

On the Orthography of North Korea during the 19451954 Period

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