• Title/Summary/Keyword: 성형수술

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The Vertical Changes of Lip and Perioral Soft Tissue Following Orthognathic Surgery in Skeletal Class III Patients by a Cephalometric Analysis of Cone Beam Computed Tomography (Cone Beam Computed Tomography의 두부계측분석을 통한 골격성 제3급 부정교합 환자에서 악교정 수술 후 입술과 주위 연조직의 수직적 변화)

  • Lee, Jong-Min;Kang, Joo-Wan;Lee, Jong-Ho;Kim, Chang-Hyen;Park, Je Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.311-319
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    • 2012
  • Purpose: The aim of this study is to evaluate the vertical changes of the lip and perioral soft tissue, following orthognathic surgery in skeletal class III patients by a cephalometric analysis of a cone beam computed tomography (CBCT). Methods: A total of 20 skeletal class III patients, who had bimaxillary surgery with Le Fort 1 osteotomy and bilateral sagittal split ramus osteotomy, were included in this study. The surgical plan for maxilla was posterosuperior impaction with the anterior nasal spine, as the rotation center. Further, the surgical plan for mandible was also posterosuperior movement. The soft tissue changes between lateral cephalogram and CBCT were compared. And the correlations between independent variables and dependent variables were evaluated. Results: There were no significant differences of the soft tissues changes between lateral cephalogram and CBCT. Upper lip philtrum length (SnLs), nasolabial angle increased and upper lip vermilion length (LsStms), lower lip length (StmiB'), lower lip vermilion length (StmiLi), lower lip philtrum length (LiB') and soft tissue lower facial height (SnMe') decreased after surgery. Change of SnLs (${\Delta}$SnLs) was influenced by vertical change of menton (${\Delta}$MeV), and change of LsStms (${\Delta}$LsStms) was influenced by upper lip thickness (ULT). Change of StmiLi' (${\Delta}$StmiLi') were influenced by preoperative overjet. Change of StmiB' (${\Delta}$StmiB') were influenced by preoperative overjet, vertical change of lower incisor (${\Delta}$L1V) and horizontal change of posterior nasal spine (${\Delta}$PNSH). Change of LiB' (${\Delta}$LiB') was influenced by ${\Delta}$L1V and ${\Delta}$PNSH. Change of SnMe' (${\Delta}$SnMe') was influenced by ${\Delta}$MeV, horizontal change of upper incisor (${\Delta}$U1H) and horizontal change of lower incisor (${\Delta}$L1H). ${\Delta}$Nasolabial angle was influenced by change of ULT (${\Delta}$ULT). Conclusion: Both soft tissues and hard tissues can be evaluated by CBCT. Posterosuperior rotation of maxillomandibular complex resulted in increase of upper lip philtrum length and nasolabial angle, while the upper lip vermilion length, lower lip philtrum length, lower lip vermilion length, and soft tissue lower facial height showed a decrease.

Transplantation of an Extremely Oversized Heart after. Prolonged Extracorporeal Membrane Oxygenation Assistance in a 3-month-old Infant with Congenital Heart Disease (선천성 심질환을 가진 3개월 소아에서 장기간의 체외 막형 산소화 보조 후 몸무게 차이가 큰 공여자-수용자간 심장 이식)

  • Cho, Hyun-Jin;Seo, Dong-Man;Jhang, Won-Kyoung;Park, Chun-Soo;Kim, Young-Hwee
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.630-634
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    • 2009
  • According to the 2007 International Society for Heart and Lung Transplantation (ISHLT) report, a congenital diagnosis, infantile transplantation and being on extracorporeal membrane oxygenation (ECMO) at the time of transplant are risk factors for mortality for the patients who undergo a heart transplant, and a large body weight ratio also increases the risk of mortality. The patient of this case underwent a Ross operation and mitral valve repair due to left ventricle outflow track obstruction and mitral regurgitation. But the baby was treated with ECMO due to heart failure after the operation. When he was 3-months-old and had been. on 30 days of ECMO, he underwent a heart transplant with a heart that had a high donor-recipient weight ratio (4.42). We present this case from a technical standpoint and we include a review of the relevant literature.

SOFT TISSUE CHANGES FOLLOWING BIMAXILLARY SURGERY IN SKELETAL CLASS III MALOCCLUSION PATIENTS (골격성 III급 부정교합 환자에서 양악 수술후 연조직 변화에 대한 연구)

  • Park, Hong-Ju;Choi, Hong-Ran;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.284-290
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    • 1998
  • The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

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CORRECTIVE RHINOPLASTY OF THE POST-TRAUMATIC RESIDUAL NASAL DEFORMITIES (외상성 비변형의 이차적 정비술)

  • Choung, Pill-Hoon;Kim, Chang-Soo;Chae, Yun-Pill;Ann, Heui-Young;Chung, Sang-Chul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.1-10
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    • 1989
  • The major causes of the facial bone fractures are fractures are automobile collision or other accident, and fights. Of the facial bone fractures, the nasal bone fractures are monst common. According to Schroeder et al., 50% of facial bone fractures are isolated fractures of the nasal pyramid. But the fractured nasal bone is not immediately treated as other facial bone fractures. And it is necessary to delay the treatment of the combined nasal bone fractures with other jaw bone fractures because of the difficult anesthetic techniques. Therefore there are many residual nasal deformities following a fracture; nasal hump, saddle nose and alar rim defect. Many authors have suggested the methods to correct the post-traumatic nasal deformities. We have treated several patients with several methods and this paper presents the operating methods and results.

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A Micro Finite Element Analysis on Effects of Altering Monomer-to-Powder ]Ratio of Bone Cement During Vertebroplasty (골 시멘트 중합 비율 변경이 척추성형술 치료에 미치는 영향에 대한 비교 분석)

  • 김형도;탁계래;김한성
    • Journal of Biomedical Engineering Research
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    • v.23 no.6
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    • pp.451-458
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    • 2002
  • Osteoporosis is a systemic skeletal disease caused by low bone mass and the decrease of bone density in the microstructure of trabecular bone. Drug therapy(PTH Parathyroid hormone) may increase the trabecular thickness and thus bone strength. Vertebroplasty is a minimally invasive surgery foy the treatment of osteoporotic vertebral compression fracture. This Procedure includes Puncturing vertebrae and filling with Polymethylmethacrylate(PMMA). Although altering recommended monomer-to-Powder ratio affects material properties of bone cement, clinicians commonly alter the mixture ratio to decrease viscosity and increase the working time. The Purposes of this study were to analyze the effect of 4he monomer-to-powder ratio on the mechanical characteristics of trabecular. In this paper, the finite element model of human vertebral trabecualr bone was developed by modified Voronoi diagram, to analyze the relative effect of hormone therapy and vertebroplasty at the treatment of osteoporotic vertebrae. Trabeuclar bone models for vertebroplasty with varied monomer-to-Powder ratio(0.40∼1.07 ㎖/g) were analyzed. Effective modulus and strength of bone cement-treated models were approximately 60% of those of intact models and these are almost twice the values of hormone-treated models. The bone cement models with the ratio of 0.53㎖/g have the maximum modulus and strength. For the ratio of 1.07㎖/g, the modulus and strength were minimum(42% and 49% respectively) but these were greater than those for drug therapy. This study shows that bone cement treatment is more effective than drug therapy. It is found that in vertebroplasty, using a monomer-to-powder ratio different from that recommended by manufacturer nay significantly not only reduce the cement's material Properties but also deteriorate the mechanical characteristics of osteoporotic vertebrae.

Hormonal Analysis of Female Transgender Patients Performed Gender Reassignment Operation (여성 성전환수술을 받은 환자의 호르몬 정량분석)

  • Park, Jung Min;Kwon, Yong Seok;Lee, Keun Cheol;Kim, Seok Kwun;Kwak, Hyun;Kim, Sang Beom
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.699-705
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    • 2005
  • Transgender is the severe type of gender identity disorder. The prevalence rate of transgender is reported to occur to about 1 out of 50,000 men, and about 1 out of 10,000 women. As for Korea, it is estimated to have about 1400 transgender patients. Lately, not only the numbers of them are increasing but also they are influencing our society increasingly. As for female transgender patients, they take female hormone for a long term before and even after the operation to maintain their physical identity of female. We have analyzed insulin like growth factor-1(IGF-1), insulin like growth factor protein binding-3(IGFBP-3), female hormone, male hormone and thyroid hormone in female transgender patients who have undergone the gender reassignment operation. We examined the changes of hormone level due to having female hormone steadily, and also examined how the steady use of the hormone could affect body organs. As for IGF-1, it showed significantly low in the female transgender group compared to control ($319.30{\pm}37.4$ vs $539{\pm}55.0$, p<0.05). As for IGFBP-3, there was no significant difference ($2859{\pm}200.3$ vs $2607{\pm}262.5$, p>0.05). As for female hormone, there was no significant differences in FSH($13.42{\pm}13.8$ vs $8.95{\pm}3.5$, p>0.05), estradiol($104.41{\pm}97.1$ vs $121.68{\pm}60.2$, p>0.05), and LH($7.62{\pm}5.6$ vs $7.4{\pm}3.3$, p>0.05). Even in comparison of testosterone, there was no significant differences($0.23{\pm}0.09$ vs $0.33{\pm}1.33$, p>0.05). As for thyroid hormone, there was no significant differences in TSH and free T4($1.34{\pm}0.94$ vs $1.71{\pm}0.12$, $1.4{\pm}0.37$ vs $1.46{\pm}0.17$, p>0.05). Therefore, this study concludes that apart from the decreased level of IGF-1, the possible endocrine side-effect problem due to female hormone seems to be low because there was no differences of female, male, and thyroid hormone level compared with normal female. Further study will be required in metabolic change including bone metabolism occurred by decrease level of IGF-I.

Repair of Unilateral Cleft Lip and Nose: Mulliken's Modification of Rotation Advancement (편측 구순열비의 교정술: Rotation Advancement 원칙에 근거한 Mulliken의 방법)

  • Jung, Young-Soo;Lee, Gyu-Tae;Jung, Hwi-Dong;Mulliken, John B.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.133-139
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    • 2012
  • This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

Regenerative Endodontic Treatment of Infected Immature Permanent Teeth with Dens Invaginatus : A Report of Two Cases (치내치를 동반한 감염된 미성숙 영구치의 재생형 근관치료)

  • Shin, Gayoung;Lee, Kwanghee;An, Soyoun;Song, Jihyun;Heo, Narang;Ra, Jiyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.188-196
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    • 2015
  • Endodontic management of an immature permanent tooth with dens invaginatus poses a challenge to efficient treatment planning for the clinicians. Because it is difficult to shape, disinfect, and seal the canal space effectively, teeth with complex root canal structures often require particularly extensive and thorough treatment approaches. The purpose of this case report was to share clinical insight from the results of short-term follow-ups after regenerative endodontic treatment with a dens invaginatus. Two immature maxillary lateral incisors with Oehlers type I and III dens invaginatus and infected necrotic pulp were treated using regenerative endodontic procedures. For the type III dens invaginatus case, an unusual approach toward redesigning the complex internal structure was taken, in order to have sufficient infection control and sealing. Cone-beam computed tomography (CBCT) and a surgical operating microscope were used to aid visualization and treatment. As a result, regenerative endodontic treatment appears to be effective for managing immature permanent teeth with complex dens invaginatus, and can lead not only to clinical and radiographic resolution, but also increased thickness of the dentinal walls.

Stress Distribution in Microvascular Anastomotic Coupler (AnaFix®) Micropins with Respect to the Fillet Radius (필렛효과에 따른 미세혈관 문합커플러(AnaFix®) 마이크로핀의 응력분포)

  • Jee, Dae-Won;Kim, Cheol-Woong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.11
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    • pp.1139-1145
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    • 2011
  • An automated anastomotic ring-pin system consisting of both the anastomotic ring-pin system and the coupler device has eliminated the drawbacks of the suture method. High density polyethylene (HDPE), a material with outstanding biocompatibility and injection molding capability, was used in the ring. SUS316 stainless steel, Ti-6Al-4Nb, Ti-6Al-4V, and unalloyed titanium were used in FEM simulations of the micropin. The authors categorized the microvascular anastomotic ring micropins into short neck (SN) and long neck (LN) groups in order to evaluate the effect of the micropin's fillet radius and neck length on the von Mises stress. The micropins were further divided into those with and without fillet. On the basis of the fillet radius rate (FRR), which represents the rate of change in the von Mises stress with respect to the availability and shape of the fillet, and the neck length rate (NLR), which represents the rate of change in the von Mises stress with respect to changes in the length of the neck within the fillet shape, it can be concluded that the SN-3 neck design is the most stable.

MICRONEUROSURGICAL RECONSTRUCTION OF THE ORAL AND MAXILLOFACIAL REGION USING THE SURAL NERVE;HISTOLOGIC STUDY (비복신경을 이용한 구강 및 악안면 영역의 신경재건;해부학적 특성에 관한 연구)

  • Kim, Myung-Jin;Kim, Byeong-Rin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.30-36
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    • 1991
  • Various nerves from many areas of body can be used as a donor of autogenous nerve graft in the microneurosurgical repair of the oral and maxillofacial region. In the grafting procedure of nerve repair, the best results will be achieved with a maximum approximation of fascicular surface at both the porximal and the distal stumps. Therefore, appropriate selection of donor nerve will bring out the best results. The sural nerve has been used as one of the most popular donor nerve in the microneurosurgical repair of the oral and maxillofacial region. The authors examined the fascicular characteristics of the human sural nerve microscopically and compare this results with our previous report of the greater auricular nerve and that of the inferior alveolar nerve.

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