• Journal of Korean Academy of Nursing
• /
• v.4 no.3
• /
• pp.93-104
• /
• 1974

Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many-patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intervals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of valiance-to obtain the following findings: 1. There was no significantly different changes of skin over the sanctum or the trochanter in each group using get pad, sheepskin or sponge. It means that we may substitute sponge for expensive gel pad or sheepskin. 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's akin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility, 6. Sheepskin and sponge had meaningfully totter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.4
• /
• pp.311-316
• /
• 2007

Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

• Archives of Plastic Surgery
• /
• v.35 no.2
• /
• pp.139-146
• /
• 2008

Purpose: The objective of this study is anthropometric analysis of mouth and lower face of Korean. The relationship of soft-tissue to underlying bony structures determine the overall aesthetics of the face. The goal of aesthetic surgery of the face is to achieve the ideal normal and enhance the aging face. The purpose of present study was to determine the change of the morphology of the mouth and lower face based on soft-tissue landmarks according to age group to facilitate prediction during aesthetic surgery. Methods: The standardized photographs of 2,018 healthy volunteers(18 to 79 years of age; 1,070 males, 948 females) were investigated. Age groups were classified into young, middle-aged, and elderly groups. Five and seven items were measured on frontal and lateral view photographs, respectively. Individual dimensions were compared in the three age groups and between males and females. Results: The width of mouth is 4.5 times larger than that of philtrum. Most of measured data decreased with age. However, woman's lip width of the mouth somewhat increased from the young to elderly. The width of lower face is 2.5 times larger than mouth in young age group and increased slightly from the young to middle-aged and thereafter slightly decreased to elderly group. Upper lip was more higher than lower lip and male lip was more higher than female. But male and female lip height is similar at old age. Conclusion: Most of Koreans showed prominent lower face because of the development or protrusion of the mandible. And the descent of soft-tissue around the mouth was one of the significant characteristics of senile change. The posterior retrusion of the subnasal was an another characteristic. This study will help to elucidate the age-related dimensional differences of the human being and to provide useful information for clinical applications in oral and aesthetic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.3
• /
• pp.278-290
• /
• 1991

Prediction of the sop tissue changes following hard tissue movements is very important in the preoperative analysis of surgical changes of the patient who have orthognathic surgery. This study examined post operative changes of the mid-facial sop tissues in Koreans depending upon two major positional changes of the maxilla following Le Fort - I type osteotomy for orthognathic purposes. Sixty patients(41 males and 19 females) of Koreans were selected and divided into two groups according to directional change of movement of anterior bony structures of the Maxilla as follows : Group I (44 patients) was mooed anteriorly and/or inferiorly, and Group II (16 patients) was mooed posteriorly and/or superioly. Postoperative changes of the sop tissue measurements following hard tissue changes were examined on pre - and post - operative cephalometrics by means of computerized digitation methods and the ratios of changes were analysed. The results were obtained as follows : 1. In Group I, all of the sop tissue measures except the Pn was closely followed by the changes of the hard tissue measures in the horizontal plane, but the Sn and the Cm were only correlated to the vertical changes(p<0.001). In group II, all of the sop tissue measures excluding of the N' and the Pn were significantly correlated to the hard tissue measures in horizontal plane(p<0.001), but the Ls and Stm were only correlated relatively to the vertical changes of the ANS(p<0.01). 2. Predictable ratio of the Sn was 66% of the ANS or 56% of the A in the horizontal plane and 89% of the A in the vertical plane in Group I. In Group II, the Sn was predictable as 85% of the ANS or 70% of the A in the horizontal plane but was not predictable in vertical plane. 3. Predictable ratio of the Cm was 28% of the ANS or 50% of the A in the horizontal plane and 56% of the ANS or 36% of the A in the vertical plane in Group I. In Group II, the Cm was predictable horizontally as 74% of the A. Predictable ratio of the Pn was 30% of the ANS or 38% of the A in horizontal plane in Group I, but it was not predictable both horizontally and vertically in Group II. 4. Predictable ratio of the Ls was 52% of the Pr in Group I and 77% in Group II in the horizontal plane. The Stm was predictable as 34% of the pr or 22% of the I in the horizontal plane in Group I, and was also predictable as 55% of the pr or 68% of the I horizontally and 21% of the pr or 65% of the I vertically in Group II. 5. All ratios of change in the thickness. length and area of the upper lip following maxillary movement were statiscally correlated, however, mangitudes of them were meaningful clinically.

• The Journal of Korean Academy of Prosthodontics
• /
• v.45 no.2
• /
• pp.263-273
• /
• 2007

Statement of problem: Alteration of tooth function is assumed to be changed by stress/strain on the adjacent alveolar bone, producing changes in morphology similar to those described for other load-bearing bones. When teeth are removed, opposing teeth will not be functioned. When edentulous area is restored by implant prostheses, opposing teeth will be received physiologic mechanical stimuli. Purpose: The aim of this study was to evaluate the bone changes around the teeth opposing implant restoration installed mandibular posterior area. Material and method: Eight patients who had mandibular posterior edentulous area were treated with implants. Radiographs of the opposing teeth were taken at implant prostheses delivery(baseline), 3 months, and 6 months later. Customized film holding device was fabricated to standardize the projection geometry for serial radiographs of opposing teeth. Direct digital image was obtained. Gray values of region of interest at each digital image were measured and compared according to time lapse. Repeated measured analysis of variance and post-hoc Scheffe's test were performed at the 95% significance level. Results: Alveolar bone changes around the natural teeth opposing the posterior implant in mandible showed statistically significant difference compared to control group(P<0.05). And gray values of alveolar bone around the teeth opposing implants were increased. There were no statistically significant differences of alveolar bone changes between crestal group and middle group and between mesial group and distal group according to time lapse(P>0.05). There were no statistically significant differences of alveolar bone changes among mesial-crestal group, mesial-middle group, distal-crestal group, distal-middle group, and control group(P>0.05). Conclusion: Alveolar bone around the natural teeth opposing the implant prosthesis showed gradual bony apposition.

• The Journal of Korean Academy of Prosthodontics
• /
• v.36 no.6
• /
• pp.900-913
• /
• 1998

Despite of technical difficulties, the combination of occlusal projection and densitometric digital analysis may ultimately provide a means of detection of subtle bone loss at the facial and lingual side of dental implant (Oblique occlusal view is more useful for $ITI^{(R)}$ dental implant due to its contour of shoulder as like tulip flower). In this study, conventional periapical projections of x-ray beam had shown more high sensitivity to detect the bony defects than oblique occlusal projections in alveolar crest obscured by dental implants or not, even if the difference was not statistically significant. Unlike conventional periapical projections. occusal projections combined with densitometric digital analysis technique may provide a means for detection of subtle bone change at the all around of implants without obscuring effect by implant itself. Although the results from this in vitro study were performed under limited circumstances, these results might afford more possibility and versatile modality of diagnosis options to clinician in the implant practice.

• Journal of Oral Medicine and Pain
• /
• v.20 no.1
• /
• pp.141-158
• /
• 1995

This study was performed to invetigate the relationship between clinical manifestations related to temporomandibular joint sounds and temporomandibular joint vibrations that occurred synchronously with sounds. There have been reported in many articles that joint sounds indicate internal joint pathology. Therefore, it is necessary to evaluate type and patterns of joint sounds, and radiographic changes of temporomandibular joint(TMJ) in order to diagnose and deal with the Temporomandibular Disorders(TMD). For this study 142 patients with TMDs were collected and they were examined by routine diagnostic procedure for TMDs. The author classified TMJ sounds clinically into 3 types : click, popping, and crepitus. Transcranial and panoramic radiographs were taken for observein bony changes of TMJ, and for observing vibrations of TMJ Sonopak of Biopak system was used. The obtained results were as follows : 1. Female subjects with crepitus were older than those with click or popping and their mean ages were about 45 years old. But in male subjects, there was no age difference. 2. For all subjects, mean value of maximal mouth opening were above 40mm, which are lower limit of normal vertical opening. But in subjects with L-type opening deviation, mouth opening capacity were about 36mm of range. 3. Symptom duration stated when patient presented first were slightly longer in subjects with crepitus but there were no statistical differences. And there were also no radiographic differences among 3 types of joint sounds in regard to symptom duration. 4. In subjects wih click, it might have been interpreted that 12% had closed lock, 12% had degenerative joint disease, and about 17% of he subjects had normal joints by Sonopak. 5. There were no significant relationships between subjective loudness of joint sounds and magnitude of joint vibrations. 6. The highest value of Integral and peak amplitude were observed in popping sounds and though it was not significant, value of peak frequency was highest in crepitus. 7. Amount of mandibular positional change were differed between click and crepitus on frontal plane, between click, crepitus and popping on horizontal plane in rotational movement, respectively. However, there no difference among them in translational movements.

• Journal of Periodontal and Implant Science
• /
• v.33 no.2
• /
• pp.301-310
• /
• 2003

The purpose of this study is to evaluate the biocompatibility and the biorsorbability of several types of calcium polyphosphate made through change of manufacturing process for 12 month. To solve limitation of calcium phosphate, we developed a new ceramic, Calcium Polyphosphate(CPP), and report the biologic response to CPP in extraction sites of beagle dog. Porous CPP blocks were prepared by condensation of anhydrous $Ca(H_2PO_4)_2$ to form non-crystalline $Ca(PO_3)_2$ and then milled to produce CPP powder. CPP powder, CPP block, and CPP granules added with $Na_2O$ were implanted in extraction sockets and histologic observation were performed at 12 months later. Like 3 months results, histologic observation at 12 months revealed that CPP matrix were mingled with and directly apposed to new bone without any adverse tissue reaction, CPP powder show direct bony contact, but new bone formation and fibrous tissue encapsulation showed in CPP block. 10% $Na_2O$ CPP granules show more inflammatory cells infiltration around graft materials compared at 3 month, but 15% $Na_2O$ CPP granules show less. This result revealed that regardless of addition of $Na_2O$, CPP had a high affinity for bone and had been resorbed slowly. From this results, it was suggested that CPP is promising ceramic as a bone substitute and addition of $Na_2O$ help biodegradation but optimal concentration of $Na_2O$ and other additive component to increase degradation rate should be determined in further study.

• The Journal of Korean Academy of Prosthodontics
• /
• v.45 no.1
• /
• pp.131-143
• /
• 2007

Statement of the problem: In case of poor bone quality or immediately loaded implant, various strategies have been developed focusing on the surface of materials to improve direct implant fixation to the bone. The microscopic properties of implant surfaces play a major role in the osseous healing of dental implant. Purpose of study: This study was undertaken to evaluate bone response of ion beam-assisted deposition(IBAD) of hydroxyapatite(HA) on the anodized surface of subperiosteal titanium implants. Material and methods: Two half doughnut shape subperiosteal titanium implants were made. The control group was treated with Anodized surface treatment and the test group was treated with IBAD of HA on control surface. Then two implants inserted together into the subperiosteum of the skull of 30 rats and histological response around implant was observed under LM(light microscope) and TEM(transmission electron microscope) on 4th, 6th and 8th week. Results: Many subperiosteal implants were fixed with fibrous connective tissue not with bony tissue because of weak primary stability. The control group observed poor bone response and there was no significant change at any observation time. However the test group showed advanced bone formation and showed direct bone to implant contact under LM on 8th week. The test group observed much rER in the cell of osteoblast but the control group showed little rER under TEM. Conclusions: The test group showed better bone formation than the control group at the condition of weak primary stability. With these results IBAD surface treatment method on Anodized surface, may be good effect at the condition of weak primary stability.

• Journal of Korean Neurosurgical Society
• /
• v.63 no.6
• /
• pp.821-826
• /
• 2020

Objective : Hyperostosis in meningiomas can be present in 4.5% to 44% of cases. Radical resection should include aggressive removal of invaded bone. It is not clear however to what extent bone removal should be carried to achieve pathologically free margins, especially that in many cases, there is a T2 hyperintense signal that extends beyond the hyperostotic bone. In this study we try to investigate the perimeter of tumour cells outside the visible nidus of hyperostotic bone and to what extent they are present outside this nidus. This would serve as an initial step for setting guidelines on dealing with hyperostosis in meningioma surgery. Methods : This is a prospective case series that included 14 patients with convexity meningiomas and hyperostosis during the period from March 2017 to August 2018 in two university hospitals. Patients demographics, clinical, imaging characteristics, intraoperative and postoperative data were collected and analysed. In all cases, all visible abnormal bone was excised bearing in mind to also include the hyperintense diploe in magnetic resonance imaging (MRI) T2 weighted images after careful preoperative assessment. To examine bony tumour invasion, five marked bone biopsies were taken from the craniotomy flap for histopathological examinations. These include one from the centre of hyperostotic nidus and the other four from the corners at a 2-cm distance from the margin of the nidus. Results : Our study included five males (35.7%) and nine females (64.3%) with a mean age of 43.75 years (33-55). Tumor site was parietal in seven cases (50%), fronto-parietal in three cases (21.4%), parieto-occipital in two cases (14.2%), frontal region in one case and bicoronal (midline) in one case. Tumour pathology revealed a World Health Organization (WHO) grade I in seven cases (50%), atypical meningioma (WHO II) in five cases (35.7%) and anaplastic meningioma (WHO III) in two cases (14.2%). In all grade I and II meningiomas, bone biopsies harvested from the nidus revealed infiltration with tumour cells while all other bone biopsies from the four corners (2 cm from nidus) were free. In cases of anaplastic meningiomas, all five biopsies were positive for tumour cells. Conclusion : Removal of the gross epicentre of hyperostotic bone with the surrounding 2 cm is adequate to ensure radical excision and free bone margins in grade I and II meningiomas. Hyperintense signal change in MRI T2 weighted images, even beyond visible hypersototic areas, doesn't necessarily represent tumour invasion.