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IMMOBILIZATION OF LOWER MANDIBULAR ALVEOLAR BONE FRACTURE USING RESIN-WIRE OPEN CAP SPLINT (하악 유전치부 치조골 골절시 resin-wire open cap splint를 이용한 고정)

  • Kwon, Joung-Hyun;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.175-180
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    • 2008
  • Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

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A Clinical Analysis on the Restoration of Sinus Rhythm Following Mitral Valve Surgery (승모판 수술 후 동율동 회복에 관한 임상분석)

  • 백완기;심상석;김현태;조상록;진성훈
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.347-352
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    • 1999
  • Background: The atrial fibrillation in patients with mitral valvular heart disease is frequently converted to sinus rhythm after the mitral valve surgery. This sinus restoration implies an important meaning in that it not only helps postoperative convalescence in patients with unstable hemodynamics but also reduces the rate of postoperative thromboembolism. Material and Method: We retrospectively analyzed 184 patients who received mitral valve surgery from June 1986 to December 1996 to investigate the trend of rhythm change following mitral valve surgery and thus to clarify the predisposing factors of postoperative sinus rhythm conversion and its maintenance. Result: The sinus rhythm was restored after the operation in 54 out of 139 patients with atrial fibrillation preoperatively(38.8%). However, the atrial fibrillation recurred in 41 patients at the time of discharge showing a recurrence rate of 75.9 percent. The mean duration of sinus rhythm in patients with eventual atrial fibrillation recurrence was 8.2${\pm}$5.9 days. Only 15 patients were in sinus rhythm at the time of late follow-up with the mean follow-up period of 84.4${\pm}$34.7 months. While the age, duration of symptoms, duration of atrial fibrillation, left atral size, and pulmonary artery pressure were thought to be the predisposing factors for sinus conversion after the operation, only the duration of atrial fibrillation and ejection fraction were considered risk factors for the recurrence of the atrial fibrillation following sinus conversion. Conclusion: This study suggests that the early operation is mandatory for the satisfactory result regarding postoperative rhythm. Moreover, additional operative measure in adjunct to the intervention of mitral valve should be considered for the maintenance of restored sinus rhythm as reflected by high postoperative recurrence rate of atrial fibrillation.

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Clinical Experiences of redo-CABG (관상동맥우회 재수술의 임상적 고찰)

  • Lim, Sang-Hyun;Kwak, Young-Tae;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick;Cho, Bum-Koo;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.779-784
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    • 2002
  • Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F=12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

THE ANTERIOR-POSTERIOR AND VERTICAL RELATIONSHIP OF THE GROWING CHILDREN WITH CLASS III MALOCCLUSION BY LATERAL CEPHALOMETRIC MEASUREMENT (측모두부방사선 사진을 이용한 성장기 III급 부정교합아동의 전후방적, 수직적 악골관계에 대한 연구)

  • Yang, Ku-Ho;Choi, Nam-Ki;Kim, Seong-Nam
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.291-297
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    • 2003
  • While making diagnosis and the treatment plan for the growing children who visited at Chonnam National University Hospital for orthodontic treatment, authors obtained 8 lateral cephalometric measurements in antero-posterior and vertical relationship such as APDI, WITS, ANB, SN-MP, ODI, PFH/AFH, Y-axis, SUM for children aged 7 to 9 with class III malocclusion and compared them with these of 73 children of elementary school aged 7 to 9 with proper profile and normal occlusion in Gwangju. The results were as follows: 1. Between normal occlusion and class III malocclusion, ANB, SN-MP, ODI, SUM, except PFH/AFH and Y-axis showed statistically significant differences(p<0.05). 2. Between mesurements to describe skeletal disorder of antero-posterior relationship such as APDI, WITS, ANB and skeletal disorder of vertical relationship such as SN-MP, ODI, PFH/AFH, Y-axis, SUM, all of them in both normal occlusion and Class III malocclusion showed significant correlation, except Y-axis, SUM correlation(p<0.01). 3. Wald' statistics of WITS, ANB and APDI expressing skeletal disorder of antero-posterior relationship showed 7.118, 5.148, 0.741, respectively and Wald' statistics of ODI, Y-axis, PFH/AFH, SN-MP, SUM were presented 28.348, 2.238, 1.376, 0.090, 0.089, respectively. Therefore, WITS and ODI could be considered as useful diagnotic measurements for class III malocclusion.

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Intraoperative and Postoperative Complications After Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft (자가 골-슬개건-골을 이용한 관절경적 전방십자인대 재건술의 수술 중 및 수술 후 합병증)

  • Kim, Kyung-Tae;Lee, Song;Jeong, Soon-Young;Kim, Hyun-Soo;Park, Jun-Seong
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.1-6
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    • 2002
  • Purpose : Evaluation and analysis of the incidence and causes of intraoperative and postoperative complications after arthoscopic anterior cruciate ligament(ACL) reconstruction using bone-patella. tendon-bone (BPTB) auto graft. Materials and Methods : We reviewed 85 cases of arthroscopic ACL reconstruction using BPTB autograft which had been followed up for more than 1 year. Intraoperative complications had been recorded and corrected during the operation. Postoperative complications were analyzed and compared between 3 groups which were classified by the last follow-up period after the operation. Results : There were a few intraoperative complications including patellar fracture(1 case), contamination of harvested graft(1 case), impingement of graft(2 cases), blow-out of tile posterior wall of the femoral tunnel(1 case) and intraarticular retraction of the screw(1 case). The result of the comparison of postoperative complications among the groups shows that the incidence of anterior knee pain, donor site pain and patellofemoral crepitation were significantly decreased after 2 years. But there was no significant decrease in these complications after 3 years. Conclusion : Intraoperative complications after arthroscopic ACL reconstruction using BPTB autograft were due to incorrect technique and carelessness of the operation team, and can be prevented by improvement of surgical technique and accumulation of experience. Postoperative complication were somewhat unavoidable but gradually improved with time; hence, we should consider it for the selection of graft donor.

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Comparison to Contrast Sensitivity of Male and Female Adults in Their 20s (20대 성인 남녀의 대비감도 비교)

  • Choi, Soon-Lyoung;Han, Kwang-Lae;Shim, Hyun-Suk
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.1
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    • pp.87-92
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    • 2014
  • Purpose: Comparison with contrast sensitivity between binocular and monocular of 20s adult was measured by spatial frequency 3.0, 6.0, 12.0 and 18.0 cpd and compares difference between monocular and binocular and difference between male and female. Methods: Topcon CV-3000 Phoroptor was used for full correction of 99 ophthalmic optics students and contrast sensitivity were measured by using Vector Vision CSV-1000E at 2.5 m in photopic condition (100 $cd/m^2$). Results: Photopic condition at 2.5 m, average contrast sensitivity of entire subject was 52.54, 80.40, 36.79 and 13.56 with right eye and 52.33, 81.29, 41.73 and 14.22 with left eye in 3, 6, 12 and 18 cpd. For both eye 65.46, 113.69, 52.04 and 19.44 were measured. The contrast sensitivity of male was 58.22, 83.52, 37.89 and 13.82 with right eye and 56.03, 46.68 and 15.67 with left eye in spatial frequency of 3, 6, 12 and 18 cpd. Both eyes were measured to 70.89, 120.96, 56.56 and 19.89. The contrast sensitivity of female was 46.50, 77.09, 35.61 and 13.28 with left eye and 48.40, 70.43, 36.47 and 12.68 with left eye in spatial frequency of 3, 6, 12, 18 cpd. Both eyes were 59.68, 105.97, 47.23 and 18.95. Conclusions: Contrast sensitivity value of binocular shows higher than monocular to both male and female. Contrast sensitivity of difference between male and female were statistically remarkably higher to male in right eye 3 cpd, left eye 6 cpd, 12 cpd and both eye 3 cpd. In other frequency, there was no statistical significance but male shows higher.

A Study on the Factors Causing Analytical Errors through the Estimation of Uncertainty for Cadmium and Lead Analysis in Tomato Paste (불확도 추정을 통한 토마토 페이스트에서 카드뮴 및 납 분석의 오차 발생 요인 규명)

  • Kim, Ji-Young;Kim, Young-Jun;Yoo, Ji-Hyock;Lee, Ji-Ho;Kim, Min-Ji;Kang, Dae-Won;Im, Geon-Jae;Hong, Moo-Ki;Shin, Young-Jae;Kim, Won-Il
    • Korean Journal of Environmental Agriculture
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    • v.30 no.2
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    • pp.169-178
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    • 2011
  • BACKGROUND: This study aimed to estimate the measurement uncertainty associated with determination of cadmium and lead from tomato paste by ICP/MS. The sources of measurement uncertainty (i.e. sample weight, final volume, standard weight, purity, molecular weight, working standard solution, calibration curve, recovery and repeatability) in associated with the analysis of cadmium and lead were evaluated. METHODS AND RESULTS: The guide to the expression of uncertainty was used for the GUM (Guide to the expression of Uncertainty in Measurement) and Draft EURACHEM/CITAC (EURACHEM: A network of organization for analytical chemistry in Europe/Co-Operation on International Traceability in Analytical Chemistry) Guide with mathematical calculation and statistical analysis. The uncertainty components were evaluated by either Type A or Type B methods and the combined standard uncertainty were calculated by statistical analysis using several factors. Expected uncertainty of cadmium and lead was $0.106{\pm}0.015$ mg/kg (k=2.09) and $0.302{\pm}0.029$ mg/kg (k=2.16), on basis of 95% confidence of Certified Reference Material (CRM) which was within certification range of $0.112{\pm}0.007$ mg/kg for cadmium (k=2.03) and $0.316{\pm}0.021$ mg/kg for lead (k=2.01), respectively. CONCLUSION(s): The most influential components in the uncertainty of heavy metals analysis were confirmed as recovery, standard calibration curve and standard solution were identified as the most influential components causing uncertainty of heavy metal analysis. Therefore, more careful consideration is required in these steps to reduce uncertainty of heavy metals analysis in tomato paste.

Dosimetric Characteristics of Dual Photon Energy Using Independent Collimator Jaws (고에너지 선형가속기의 Independent Collimator를 이용한 비대칭 방사선 조사시 방사선량 결정에 미치는 요인에 관한 연구)

  • Kim Jeung-kee;Choi Young-Min;Lee Hyung-Sik;Hur Won-Joo
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.237-244
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    • 1996
  • Purpose : The accurate dosimetry of independent collimator equipped for 6MV and 15MV X-ray beam was investigated to search for the optimal correction factor. Materials and Methods : The field size factors, beam quality and dose distribution were measured by using 6MV, 15MV X-ray Field size factors were measured from $3{\times}3cm^2$ to $35{\times}35cm^2$ by using 0.6cc ion chamber (NE 2571) at Dmax. Beam qualities were measured at different field sizes, off-axis distances and depths. Isodose distributions at different off-axis distance using $10\times10cm^2$ field were also investigated and compared with symmetric field. Result: 1) Relative field size factors was different along lateral distance with maximum changes in $3.1\%$ for 6MV and $5\%$ for 15MV. But the field size factors of asymmetric fields were identical to the modified central-axis values in symmetric field, which corrected by off-axis ratio at Dmax. 2) The HVL and PDD was decreased by increasing off-axis distance. PDD was also decreased by increasing depth For field size more than $5{\times}cm^2$ and depth less than 15cm, PDD of asymmetric field differs from that of symmetric one ($0.5\~2\%$ for 6MV and $0.4\~1.4\%$ for 15MV). 3) The measured isodose curves demonstrate divergence effects and reduced doses adjacent to the edge close to the flattening filter center was also observed. Conclusion . When asymmetric collimator is used, calculation of MU must be corrected with off-axis and PDD with a caution of underdose in central axis.

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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Quantifying Uncertainty of Calcium Determination in Infant Formula by AAS and ICP-AES (AAS 및 ICP-AES에 의한 조제분유 중 칼슘 함량 분석의 측정불확도 산정)

  • Jun, Jang-Young;Kwak, Byung-Man;Ahn, Jang-Hyuk;Kong, Un-Young
    • Korean Journal of Food Science and Technology
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    • v.36 no.5
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    • pp.701-710
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    • 2004
  • Uncertainty was quantified to evaluate calcium determination result in infant formula with AAS (Atomic Absorption Spectrometry) and ICP-AES (Inductively Coupled Plasma-Atomic Emission Spectrometry). Uncertainty sources in measurand, such as sample weight, final volume of sample, sample dilution and the instrumental result were identified and used as parameters for combined standard uncertainty based on the GUM (Guide to the expression of uncertainty in measurement) and Draft EURACHEM/CITAC Guide. Uncertainty components of each sources in measurand were identified as resolution, reproducibility and stability of chemical balance, standard material purity, standard material molecular weight, standard solution concentration, standard solution dilution factor, sample dilution factor, calibration curve, recovery, instrumental precision, reproducibility, and stability, Each uncertainty components were evaluated by uncertainty types and included to calculate combined uncertainty. The kinds of uncertainty sources and components in the analytical method by AAS and ICP-AES were same except sample dilution factor for AAS. The analytical results and combined standard uncertainties of calcium content were estimated within the certification range $(367{\pm}20\;mg/100g)$ of CRM (Certified Reference Material) and were not significantly different between method by AAS followed by ashing and method by ICP-AES followed by acid digestion as $359.52{\pm}23.61\;mg/100g\;and\;354.75{\pm}16.16\;mg/100g$, respectively. Identifying uncertainty sources related with precision, repeatability, stability, and maintaining proper instrumental conditions as well as personal proficiency was needed to reduce analytical error.