• 제목/요약/키워드: IAN

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Inferior alveolar nerve cutting; legal liability versus desired patient outcomes

  • Kim, Soung Min;Lee, Jong Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권5호
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    • pp.318-323
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    • 2017
  • Objectives: Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be. Materials and Methods: We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient's perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University. Results: Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation. Conclusion: This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon's position with respect to legal liability.

이안천의 식생분포 (Distribution of riparian vegetation in Ian Stream)

  • 김호준;이혜근;최광순
    • 한국수자원학회:학술대회논문집
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    • 한국수자원학회 2005년도 학술발표회 논문집
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    • pp.1274-1279
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    • 2005
  • The complex vegetation and plant species distributions within riparian corridors influence plant species diversity patterns at both local and regional scales and further reflect both natural and anthropogenic disturbances. Because of these characteristics, riparian zones are often the ecosystem level component that are most sensitive to changes of the surrounding environment; they provide early indications of environmental change and can be viewed as the important source in the watershed. The objectives of this study were two concepts: first, document the composition and dominance of plant communities of riparian areas in the stream, second, compare species composition and temporal diversity between stations in riparian areas of the Ian Stream. The flora was composed to total 158 kinds of the vascular plants as 49 family, 54 genera, 145 species, 12 varieties, 1 forma When the naturalized plant were applied to the recent classification system 280 kinds, the naturalization rate was $10.8\% higher than that of mean value($10.3\%$) of the Korean mountain district. Furthermore, urbanization index (UI) was $6.1\%$. The dominant vegetation communities were distributed in the habitats of three compartments from upstream to downstream. The vegetations were included Phragmites japonica, Salix gracilistyla, S. hulteni and Robinia pseudo-acacia in the riparian area, and Persicaria sieboldii, Stellaria alsine var. undulata, Draba nemorosa var. hebecarpa, Capsella bursa-pastoris, Lepidium apetalum, Bidens frondosa, Trigonotis peduncularis and Hemistepta lyrata in the sandbank or the riparian area, and Equisetum arvense, Humulus japonicus, Persicaria perfoliata, Trifolium repens, Artemisia princeps var. orientalis, Lactuca indica var. laciniata, Avena fatua, Agropyron yesoense, Oenothera odorata, Viola mandshurica, Rumex crispus in banksides, respectively.

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A computed tomography-based analysis of the structure of the mandible according to age and sex

  • Jung, Soyeon;Yun, Hyunjong;Chung, Chul Hoon;Kim, Kuylhee;Chang, Yongjoon
    • 대한두개안면성형외과학회지
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    • 제23권3호
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    • pp.103-110
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    • 2022
  • Background: The primary objectives of mandibular surgery are to achieve optimal occlusion, low sensory disturbance, and adequate fixation with early movement. In-depth knowledge of the mandibular structure is required to achieve these goals. This study used computed tomography (CT) to evaluate the mandibular cortical thickness and cancellous space according to age and sex. Methods: We enrolled 230 consecutive patients, aged 20 to 50 years, who underwent CT scanning. The cortex and cancellous space centered around the inferior alveolar nerve (IAN) canal were measured at two specific locations: the lingula and second molar region. Statistical analysis of differences according to increasing age and sex was performed. Results: The t-test revealed that the cancellous space and cortical thickness differed significantly with respect to the threshold of 35 years of age. Both cortical thickness and cancellous space in the molar region were negatively correlated with age. Meanwhile, both cortical thickness and cancellous space in the lingula region showed a positive correlation with age. With respect to sex, significant differences in the cancellous space at the molar region and the cortical thickness at the lingula were observed. However, no further statistically significant differences were observed in other variables with respect to sex. The sum of each measurement on the mandibular body reflected the safe distance from the surface of the outer cortex to the IAN canal. The safe distances also showed statistically significant differences between those above and below 35 years of age. Conclusion: Knowledge of the anatomical structure of the mandible and of changes in bone structure is crucial to ensure optimal surgical outcomes and avoid damage to the IAN. CT examination is useful to identify changes in the bone structure, and these should be taken into account in the planning of surgery for older patients.

이언 매큐언의 『인듀어링 러브』에 나타난 이기적 유전자와 사랑 (The Selfish Gene and Love in Ian McEwan's Enduring Love)

  • 우정민
    • 영어영문학
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    • 제55권4호
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    • pp.661-692
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    • 2009
  • From the Darwinian perspective, all the human behaviors and thoughts are operated by "the selfish gene," the term coined by Richard Dawkins, which has long been evolving to survive by utilizing the limited quality and quantity of resources. And an organism which fails to regenerate by creating its "replicator" is doomed to extinction, for gene combinations which help an organism to survive and reproduce tend to also improve the gene's own chances of being passed on through generations. Dawkins also coins the term "meme" for a unit of human cultural evolution analogous to the gene, suggesting that such selfish replication may also be the principle for human culture. Ian McEwan is not only a controversial but more importantly influential writer in the 21st century academic world. His 1997 book Enduring Love is not exceptional in that it draws both literary and scientific attention. Intentionally set up with the dynamic conflict between the two cultures, namely art and science, the book explores the way in which the state of the modern minds is misinterpreted and estranged by each other. In this novel, the three main protagonists, Joe, Clarissa, and Jed, each representing the very important three elements of human civilization-cognition/science, emotion/art, and faith/religion-meet an unexpected peril of life. The author of the novel employs the narrative of evolutionary science-in particular the narratives of gene and meme-to provoke the question of the two cultures famously addressed by Snow in the mid 20th century and the further discussions followed by the later Darwinian scholars such as Richard Dawkins. In this paper I aim to illustrate the way in which the author develops the idea of gene science and literature and how he proceeds to provide a sophisticated bridge between the two cultures and induce a kind of consilience by the recurrent name of love in the story of Enduring Love.

Cone-beam Computed Tomography Measurement of the Position of the Inferior Alveolar Nerve Canal in Mandibular Prognathism

  • Yun, Sung-Hun;Park, Ji-Young;Ko, Young-Kyung;Park, Je-Uk;Pyo, Sung-Woon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권1호
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    • pp.26-30
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    • 2009
  • Background and Objectives: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). Materials and Methods: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, $a^{\dag}$ and $a^{\ddag}$), from the IAN canal to the alveolar crest (b and $b^{\dag}$) and the anterior margin ($b^{\ddag}$) and finally the buccal cortical thickness (c, $c^{\dag}$ and $c^{\ddag}$) were measured at three reference planes (VP, OP and HP). Results: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of $a^{\dag}$, $b^{\dag}$ and $c^{\dag}$ was 6.11, 8.83 and 2.63 mm. For the HP, the distance of $a^{\ddag}$, $b^{\ddag}$ and $c^{\ddag}$ was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of $a^{\dag}$, $b^{\dag}$ and $c^{\dag}$ was 4.77, 8.75 and 2.68 mm. On the HP, the distance of $a^{\dag}$, $b^{\dag}$ and $c^{\ddag}$ was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). Conclusion: The CBCT data provided accurate information about the location and course of the IAN.

과학자의 '손탄다' 현상이 과학교육에 주는 함의 -이언 해킹의 현상의 창조를 중심으로- (Implications of the 'Sontanda' Phenomenon of Scientists for Science Education: Focusing on Ian Hacking's Creation of Phenomena)

  • 최진현;전상학
    • 한국과학교육학회지
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    • 제42권2호
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    • pp.253-264
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    • 2022
  • 본 연구에서는 이언 해킹(Ian Hacking)의 '현상의 창조'의 관점으로 과학자의 실행을 살펴보았다. 해킹의 관점에 따르면 과학적 현상은 규칙적인 것으로 과학자의 개입이나 실험 도구 없이는 자연 상태에 존재할 수 없다. 본 연구는 네 명의 생명과학자가 직접 경험한 '손탄다' 현상에 대한 생각과 에피소드를 분석함으로써 과학 교육적 의미를 도출하였다. 손탄다 현상은 과학자들 사이에서 통용되는 은어로써 동일한 실험 방법과 재료를 가지고 실험을 수행함에도 결과가 일정하게 나타나지 않는 현상을 일컫는다. 연구 결과 다음과 같은 네 가지 교육적 시사점을 도출하였다. 첫째, 실험에서 단순히 실험과정에 익숙해지는 것을 넘어 매순간 적절한 판단과 반응을 통해 당면한 문제를 해결하는 체화된 지식, 즉 비언어적인 지식의 중요성을 확인하였다. 이는 학생들에게 실제적인 탐구 경험을 제공하기 위해서 명제적 지식과 더불어 비언어적인 지식을 균형 있게 다루어야함을 시사한다. 둘째, 실험의 이미지를 재고하고자 하였다. 과학자의 인터뷰에 의하면 현상은 드물게 나타나며 현상을 안정화하기까지는 오랜시간이 소요된다. 반면 학교 실험의 이미지는 늘 성공적이고 안정적이므로 이에 대한 관점의 변화가 요구된다. 셋째, 과학적 실천의 구체적인 의미를 확인할 수 있었다. 본 연구는 과학자가 상황적 맥락에 맞게 지식을 적절하게 활용하는 것을 확인하였으며 이를 바탕으로 과학적 실천을 학교 교육에 적용시킬 방안에 대해 논의하였다. 마지막으로 손탄다 현상은 불확실성을 촉발함으로써 학생들을 과학적 참여로 이끄는 기회를 제공할 것으로 예상한다. 본 연구를 통해 학교실험 교육이 요리책식 실험을 탈피하여 학생들에게 과학적 실천을 경험시키려는 노력에 기여할 것으로 기대한다.

Sensory change after implant surgery: related factors for recovery

  • Jung, Joon-Ho;Ko, Ji-Hoon;Ku, Jeong-Kui;Kim, Jae-Young;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권5호
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    • pp.297-302
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    • 2022
  • Objectives: This retrospective study aimed to analyze data on nerve damage in patients who complained of sensory changes after dental implant surgery, the clinical results according to proximity of the implant fixture to the inferior alveolar nerve (IAN) canal, and the factors affecting recovery of sensation. Materials and Methods: The electronic medical records of 64 patients who had experienced sensory change after implant surgery were reviewed. Patients were classified by sex, age, implant installation sites, recovery rate and the distance between the implant fixture and IAN canal on computed tomography (CT). The distance was classified into Group I (D>2 mm), Group II (2 mm≥D>0 mm), and Group III (D≤0 mm). Results: The 64 patients were included and the mean age was 57.3±7.3 years. Among the 36 patients who visited our clinic more than two times, 21 patients (58.3%) reported improvement in sensation, 13 patients (36.1%) had no change in sensation, and 2 patients (5.6%) reported worsening sensation. In Group II, symptom improvement was achieved in all patients regardless of the removal of the implant fixture. In Group III, 8 patients (40.0%) had reported symptom improvement with removal of the implant fixture, and 2 patients (33.3%) of recovered patients showed improvement without removal. Removal of the implant fixture in Group III did not result in any significant difference in recovery (P=0.337), although there was a higher possibility of improvement in sensation in removal cases. Conclusion: Clinicians first should consider removing the fixture when it directly invades the IAN canal. However, in cases of sensory change after dental implant surgery where the drill or implant fixture did not invade the IAN canal, other indirect factors such as flap elevation and damage due to anesthesia should be considered as causes of sensory change. Removal of the implant should be considered with caution in these situations.