• 대한두개안면성형외과학회지
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• 제19권4호
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• pp.291-295
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• 2018

Dental origins are a common cause of facial cutaneous sinus tracts. However, it can be easily overlooked or misdiagnosed if not suspected by a surgeon who is not familiar with dental origins. Cutaneous odontogenic sinuses are typically nodulocystic lesions with discharge and are most frequently located on the chin or jaw. This article presents two cases of unusual cutaneous odontogenic sinus presentations, as deep dimpling at the middle of the cheek. The patients were undergone surgical excision of sinus tract and dimpling immediate before and after treatment of causal teeth and the lesions resolved without recurrence. Surgeons should consider dental origins of facial dimpling lesions with discharge and provide appropriate treatment.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.427-432
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• 2010

Purpose: The purpose of this study is to estimate muscle defect by ultrasonography in the patients with secondary deformities of the lip. We investigated the association between the muscle defect in the repaired cleft lip and the philtral appearance not only at resting state but also maximal puckering. Methods: From December 2006 to November 2007, 52 children were evaluated after primary or secondary cheiloplasty. Digital photographs were taken both from the front and both three quarter views in repose and at maximal pucker. Video clips were also taken in repose and at maximal pucker. A panel of four, scored the philtral ridge and dimple seen on these photographs and videos by using two visual analog scales. Eminence of the philtral ridge was scored by a 5 point grading scale, from "conspicuous groove" to "normal philtral ridge" and the philtral dimple was scored by 3 point grading scale, from "no dimple" to "prominent dimple". Ultrasound images of the upper lip were made using a linear array transducer at the resting position of the lip and evaluated by a single radiologist. Results: The philtral ridge eminence scored $2.79{\pm}0.54$ and $1.40{\pm}0.53$ at resting and maximal pucker, correlating with "flat" and "conspicous groove". The philtral dimpling scored $1.44{\pm}0.53$ and $2.27{\pm}0.66$ at resting and maximal pucker, correlating with "no dimple" and "slight dimple". Ultrasound imaging showed the average muscle dehiscence to be $3.78{\pm}2.14$ mm at resting position. Correlation between the muscle defect in ultrasound imaging and philtral ridge eminence at rest was statistically significant (p<0.050), but was not significant (p=0.756) at maximal pucker using Spearman's rank correlation. Correlation between the muscle defect in ultrasound imaging and philtral dimpling was not statistically significant both at rest (p=0.920) and at maximal pucker (p=0.815) using Spearman's rank correlation. Conclusion: Quantitative assessment of the muscle defect using ultrasonography correlates with the static philtral appearance, but does not correlate with the dynamic appearance. Also, the size of the muscle defect does not show any correlation with the philtral dimpling. Our findings reveal that ultrasound imaging partially reflect static appearance of philtrum but cannot reflect dynamic appearance and suggest the need for further research to evaluate dynamic appearance.

• 한국항공우주학회지
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• 제31권8호
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• pp.36-43
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• 2003

본 연구에서는 탑재체 장착을 위한 인공위성의 탑재부에 대한 모듈 단위 구조 최적설계를 수행하였다. 구조 최적화에 있어, 고유진동수 및 응력과 같은 일반적인 제한조건이외에 우주 발사환경에서 특별히 고려하는 링클링, 딤플링, 크림핑 응력과 같은 하니컴 부재의 불안정성 조건 및 론저론의 크리플링 파단을 추가로 고려하였다. 이러한 다양한 제한 조건을 포함하기 위해, 본 연구에서는 최적화프로그램과 구조해석프로그램을 연결하여 해석을 수행하였다. 해석 결과 탑재모듈의 최적화에 큰 영향을 미친 제한 조건은 고유진동수, 크리플링 그리고, 링클링 임을 알 수 있었다. 또한 설계변수들의 변화를 통해서 탑재모듈의 구조적인 특성에 가장 많은 영향을 주는 부재를 확인 할 수 있었다. 결론적으로, 탑재모듈의 특수한 제한조건을 고려한 최적화를 통해서 주어진 조건에 더 효율성 있고 안정성 있는 탑재모듈의 구조 최적화설계를 도출할 수 있었다.

• 소성∙가공
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• 제25권1호
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• pp.12-20
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• 2016

Press machines and dies are commonly used for 3D curved sheet forming. Using conventional die forming can cause economic problems since various modifications of the die shape are required depending on the product shape. Various types of flexible forming such as multi-point dieless forming (MDF), flexible incremental roll forming have been developed to improve the needed process flexibility. Although MDF can reduce the production cost using reconfigurable dies, it still has significant material loss. Drawbacks such as wrinkling, dimpling, and forming errors can also occur despite continuous investigations to mitigate these defects. A novel sheet forming process for 3D curved surfaces, a flexibly-reconfigurable roll forming (FRRF), has been recently proposed to overcome the economic and technical limitations of current practice. FRRF has no limitation on blank size in the longitudinal direction, and also minimizes or eliminates forming defects such as wrinkling and dimpling. Feasibility studies of FRRF have been conducted using FE simulations for multi-curved shapes and various sheet thicknesses. Therefore, the fabrication of a FRRF apparatus is required for any follow-up studies. In the current study, experiments with reconfigurable rollers were conducted using a simple design pre-FRRF apparatus prior to fabricating the full size FRRF apparatus. There are three candidates for the reconfigurable roller: a bar-type shaft, a flexible shaft, a ground flexible shaft. Among these candidates, the suitable reconfigurable roller for FRRF is determined through various forming tests.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.257-262
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• 2011

Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.399-406
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• 2006

Purpose: The authors accessed the anthropometric measurements of fourty non-cleft normal a three-month-old infant and using this obtained data as a basic guideline, authors applied the modified Noordhoff technique for the treatment of bilateral cleft lip. Methods: Over a period of 10 years, a total of 21 bilateral cleft lips were operated. 13 cases of complete and 8 cases of incomplete bilateral cleft lip and palate. In the complete type of bilateral cleft palate, elastic head cap and passive intraoral appliance were applied at 1 to 2 week of age for 2 months duration. The definitive cheiloplasty was performed at 3 months of age using the modified Noordhoff technique. Results: After a follow-up period ranging one to nine years, most patients presented with cosmetically and functionally satisfying results, with an exception of two cases where an undesired peaking effect of the vermilion and dimpling of the vermilion mucosa was encountered. Conclusion: Accessing the anthropometric measurements of fourty non-cleft normal three-month-old infant and using this obtained dara as a guideline, the modified Noordhoff technique can be applied to either complete or incomplete bilaterally cleft lip providing more naturally pleasing and cosmetically satisfying scars that lie in harmony with the philtral ridges, lip tubercle positioned just below the vermilion and a distinct white line and Cupid's bow.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권1호
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• pp.99-103
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• 2001

심한 심와부 동통과 구토를 주소로 내원한 5세여아에서 상부 위장관 내시경으로 위유문동에서 중심요와를 보이는 비정상적인 주름을 관찰하였다. 복통이 계속되어 이소성췌장으로 생각하고 위부분절제술을 시행하여 치료한 위 선근종 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• 대한청각학회지
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4723-4726
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• 2014

Background: Breast cancer is the second most common cancer in the world and by far the most frequent cancer among women. Objective: The present study was undertaken to assess the awareness of breast cancer warning signs and screening methods among the women of Pokhara valley, Nepal. Materials and Methods: A cross-sectional questionnaire survey was carried out in a community setting with the female population. The questionnaire was administered in face-to-face interviews by trained research assistants. Results: Nepalese women demonstrated poor awareness of warning signs like a breast lump, lump under the armpit, bleeding or discharge from the nipple, pulling of the nipple, changes in the position of the nipple, nipple rash, redness of the breast skin, changes in the size of the breast or nipple, changes in the shape of the breast or nipple, pain in the breast or armpit, and dimpling of the breast skin. While 100% of nurses were aware about breast self-examination(BSE), mammography and warning signs of breast cancer. Levels of knowledge were significantly poorer in women with other occupations. Graduates were more aware about BSE, mammogram and warning signs of breast cancer compared to those with other educational levels. Conclusions: The findings indicated that the level of awareness of breast cancer, including knowledge of warning signs and BSE, is sub-optimal among Nepalese women.