• Journal of Dental Rehabilitation and Applied Science
• /
• v.32 no.1
• /
• pp.70-79
• /
• 2016

Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.

• Clinics in Shoulder and Elbow
• /
• v.11 no.1
• /
• pp.6-12
• /
• 2008

With the increasing use of arthroscopy and MRI for the diagnosis of shoulder problems, SLAP (superior labrum from anterior to posterior) lesions are more commonly diagnosed, and the incidence of SLAP repair surgery is increasing. Clinical diagnosis of SLAP is difficult to achieve, and many specific physical exam maneuvers have been described. However, neither these exam maneuvers nor history can provide a definitive diagnosis of a SLAP lesion. Despite this limitation, it is helpful to establish a more precise and accurate examination and to construct a preoperative plan. The purpose of this article is to review the original descriptions for specific physical exam maneuvers in SLAP, along with statistical analysis where available. This will help clinicians in deciding which tests are useful, how they should be implemented, and how to interpret the results.

• Journal of Korean Society of Spine Surgery
• /
• v.25 no.4
• /
• pp.160-168
• /
• 2018

Study Design: Retrospective study of prospectively-collected data. Objectives: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. Summary of Literature Review: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. Materials and Methods: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. Results: The average area of the spinal canal was $81.40{\pm}53.61mm^2$ in the surgical group, compared to $127.75{\pm}82.55mm^2$ in the nonsurgical group (p=0.042). The muscle area in the spinal canal was $5.17{\pm}1.30cm^2$ in the surgical group, whereas it was $6.40{\pm}1.56cm^2$ in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). Conclusions: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

• The korean journal of orthodontics
• /
• v.26 no.1 s.54
• /
• pp.1-16
• /
• 1996

The purpose of this study was to evaluate the amount and interrelationship of the soft and hard tissue changes after simultaneous maxillary advancement and mandibular setback surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patients(13 males and 12 females) who had severe anteroposterior skeletal discrepancy. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of simultaneous Le Fort I or Le Fort II osteotomy and bilateral sagittal split ramus osteotomy. The presurgical and postsurgical lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/$PC^+$ program. The results were as follows. 1. The correlation of maxillary hard and soft tissue horizontal changes were high and the ratios for soft tissue to A point were $71\%$ at Sn, $67\%$ at SLS and $37\%$ at LS. 2. The correlation of mandibular hard and soft tissue horizontal changes were very high and the ratios were $84\%$ at LI, $107\%$ at ILS, $96\%$ at Pog' and $97\%$ at Gn'. 3. The correlation of mandibular hard tissue horizontal changes and soft tissue vertical changes were moderate. 4. The upper to lower lip length were increased(P<0.001). 5. The soft tissue thickness were decreased in upper lip and increased in lower lip(P<0.001). The postsurgical changes were reversely correlated with initial thickness in upper lip.

• Clinical and Experimental Reproductive Medicine
• /
• v.35 no.2
• /
• pp.155-162
• /
• 2008

Objectives: The aim of this study was to assess the change of ovarian reserve after removal of ovarian tumor using basal FSH, $E_2$, clomiphene citrate challenge test and ovarian volume. Methods: Twenty two patients with unilateral ovarian tumor, ${\leq}35$ years old, regular menstrual cycle were collected prospectively and divided into endometrioma or non-endometrioma group. We measured the ovarian volume with transvaginal ultrasonography on the day 3 of menstrual cycle within one month before and 3 months after surgery. Basal (cycle day 3) FSH, $E_2$ and CCCT were checked before surgery and repeated at least 2 spontaneous cycles later after surgery. Three patients that had been pregnant within 3 months after surgery were excluded in analysis. Results: The ovarian volume was reduced significantly after surgery in endometrioma and non-endometrioma ${\geq}10\;cm$ group ($4.79{\pm}2.57\;cm^3$ and $5.21{\pm}1.33\;cm^3$, respectively), but not in the non-endometrioma <10 cm group ($6.18{\pm}2.85\;cm^3$). After surgery, basal FSH and cycle day 10 FSH on CCCT in endometrioma and non-endometrioma were $4.25{\pm}0.20\;mIU/ml$ and $3.79{\pm}0.80\;mIU/ml$, $4.24{\pm}0.85\;mIU/ml$ and $4.28{\pm}0.92\;mIU/ml$, respectively. There were neither significant difference in comparison with the preoperative results nor between two groups. Conclusions: Enucleation of ovarian mass was associated with a significant reduction in ovarian volume in endometrioma and non-endometrioma larger than 10cm in diameter. Hormonal markers for evaluation of ovarian reserve, such as basal and cycle day 10 FSH on CCCT, were not changed significantly in each group. In reproductive age women, conservative enucleation or cystectomy rather than oophorectomy should be considered even in a large benign tumor and ovarian function could be reserved by meticulous operative technique.

• Journal of Yeungnam Medical Science
• /
• v.14 no.1
• /
• pp.197-208
• /
• 1997

The purpose of this study was to evaluate the amount and interrelationship of the soft and hard tissue change after mandibular setback surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patient (12 male and 13 female) who had severe anteropostrior skeletal discepancy. These patient had received presurgical orthodontic treatment and surgical treatment which is bilateral sagittal split ramus osteotomy. The presurgical and postsurgical lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/PC program. The result were as follows: 1. After mandibular bilateral sagittal split ramus osteotomy, lower facial soft. tissue horizontal posterior changes were high significance value. but vertical soft tissue changes were low significance value. 2. After mandibular bilateral sagittal split ramus osteotomy, relative upper lip protrusion increased(p<0.01) and relative lower lip protrusion decreased(p<0.01) and lower facial soft tissue thickness increased(p<0.01).

• Progress in Medical Physics
• /
• v.23 no.3
• /
• pp.127-137
• /
• 2012

A conversing beam is firstly designed for radiosurgery by a neurosugern Lars Leksell in 1949 with orthogonal x-rays tube moving through horizontal moving arc to focusing the beam at target center. After 2 decades he composits 201 source of the Co-60 for gamma knife which beams focused at locus. Sveral linac-based stereotactic radiosurgery using the circular collimated beam which size range for 0.4~4.0 cm in a diameter by non-coplanar multiarc have been developed over the decades. The irregular lesions can be treated by superimposing with several spherical shots of radiation over the tumour volume. Linac based techniques include the use of between 4 and 11 non-co-planar arcs and a dynamic rotation technique and use photon beam energies in the range of 6~10 MV. Reviews of the characteristics of several treatment techniques can be found in the literature (Podgorsak 1989, Schell 1991). More in recent, static conformal beams defined by custom shaped collimators or a mini- or micro-multileaf collimator (mMLC) have been used in SRS. Finally, in the last few years, intensity-modulated mMLC SRS has also been introduced. Today, many commercial and in-house SRS programs have also introduced non-invasive immobilization systems include the cyberknife and tomotherapy and proton beam. This document will be compared the characteristics of dose distribution of radiosurgery as introduced gamma knife, BrainLab include photon knife in-house SRS program and cyberknife in currently wide used for a cranial SRS.

• Journal of Chest Surgery
• /
• v.31 no.2
• /
• pp.108-112
• /
• 1998

Experimental trials of unilateral lung transplantation in dogs have been attempted and satisfactory results were obtained without any noticeable difficulty in surgical techniques. Fourteen dogs with the body weight of around 25 kg were anesthesized by 20~30 mg/kg of intravenous Entobar,; one was sacrificed to make available blood for use during transplantation for the recipient dog. A mid-sternotomy incision was performed and 20 mg/kg of Prostaglandin E1 was infused through the pulmonary artery and Euro-Collin's(E-C) preservation solution, cooled down to 4$^{\circ}C$, was perfused at the rate of 70cc/kg by a pressure of 30 cmH2O. The heart-lung block was then resected out and promptly immersed in the prepared preservation solution at 4$^{\circ}C$. One lung preserved in the EC solution at 4$^{\circ}C$ was anastomosed to the recipient dog in the order of the pulmonary vein, bronchus then pulmomary artery and the thoracotomy incision was closed after the bleeding control and tube thoracostomy. Then the pneumonectomy in the opposite side was perfomed in the same manner and the tailored lung was transplanted in the order of the pulmonary vein, bronchus, then pulmonary artery. We conclude that in the bilateral sequential lung transplantation, the right lung transplantation should precede to better expose the operative field and to prevent reperfusion injury; also, the cardiopulmonary bypass should be consider for certain appropriate cases.

• Journal of Korean Society of Spine Surgery
• /
• v.25 no.4
• /
• pp.180-184
• /
• 2018

Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

• Proceedings of the Korea Water Resources Association Conference
• /
• 2004.05b
• /
• pp.1310-1315
• /
• 2004

용수수요 추정의 기본은 수도계획에 사용할 수 있는 실사용량에 대한 조사로 이에 대한 자료가 거의 없기 때문에 각 수도사업별로 제시되는 추정방법이 조금씩 상이하며, 추정방법의 진위를 가릴 수 없이 수요추정의 악순환을 초래하고 있는 실정이다. 기존 물사용량 예측은 급수량 기준의 도시 전체에 내한 평균 LPCD를 이용함에 따라 물사용 특성을 충분히 고려찬 수 없어 지역별 실제 물사용량과 큰 오차가 유발되었다. 그러므로 수도계획 및 설계에 사용할 수 있는 신뢰성 있는 설계인자를 도출하기가 불가능하여 물수요 관리정책 수립, 수도요금체계 조정 및 누수방지계획 수립 등 경제적인 수도시설의 건설에 애로를 겪고 있다. 본 연구에서는 생활용수 중 가정용수에 대하여 세탁기, 변기, 싱크대 등 수도전에 유량계를 설치 실제 가정에서 사용하고 있는 용도별 사용량을 실측, 파악하였으며, 이로부터 얻은 용도별 사용량에 대한 기간별 소비특성을 분석하였다. 이로부터 생활용수 사용량의 소비패턴 및 시간대별 부하율 산정이 가능하며, 각종 용도별 사용수량의 소비형태를 찾아낼 수 있었다. 또한 가정용수 중 용도별 물 사용비율은 세탁용수, 변기, 주방, 목욕용수의 순으로 나타났으며 주택유형별로는 아파트 연립주택, 다세대 주택, 단독주택의 순으로 단독주택에서의 물사용량이 가장 적게 나타났다. 생활용수 공급량에 내해서는 시간별, 주별, 월별 그리고 계절변동 총량을 파악하였으며 시간대별로는 오후 3시경이 최대 소비량을 보였고, 주별로는 월요일 그리고 월별로는 7월의 용수사용량이 가장 큰 것으로 조사 되었다. 본 연구로부터 도출된 용도별 실측 물사용량 자료 및 분석결과로부터, 지금까지 공급량 기준의 계획수립이 이루어져왔던 파종 수도시설 규모결정시 합리적인 용수수요예측 및 수요관리가 이루어질 수 있을 것으로 판단되며, 용수수요의 과다예측 오해 해소 등 경제적, 과학적 물관리 정책수립을 위한 기초자료를 제공할 수 있을 것으로 기대된다.는 경제적인 방법이 될 수 있다. 하천수 등의 상호 관계 분석을 통해 장기간의 유역 물순환체계 변화를 분석할 수 있었다.골풀과, 닭의장풀과가 각 1종씩으로, 조사지점( I )보다 좀 더 많은 종이 분포하는 것으로 조사되었다. 또한 어류는 조사지점( I )에서 3회에 걸쳐 총 396개체가 채집되어 3목 8과 21종이었다. 이 중 한국 고유종은 11종이었고, 외래 어종은 검정우럭과 2종이 조사되었으며, Zacco platypus(피라미), Zacco temmincki(갈겨니), Acheilongnathus koreanus(칼납자루), Odontobutis platycephala(동사리), Coreoleuciscus splendidus(쉬리) 순으로 분포하고 있었고, Acheilognathus signifer(묵납자루)는 댐 건설 전에는 많이 분포하였으나 현장조사에서 서식을 확인 할 수 언어 개체수의 큰 감소내지 멸종된 것으로 추정되었다.에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와 carriage rat