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Relationship between Perception of Facial Asymmetry and Posteroanterior Cephalometric Measurements (안면비대칭에 대한 주관적 인지도와 정모두부방사선사진 분석치의 연관성)

  • Ahn, Jeong-Soon;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.489-498
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    • 2001
  • This study was aimed at how posteroanterior cephalometric measurements affect the perception of the patient about his/her facial asymmetry. One hundred orthodontic patients, over the age of 12, who required a posteroanterior cep-halogram in the Department of Orthodontics of Chonnam National University Hospital were used as the subjects. They were asked if they thought their faces were asymmetrical. Their responses were classified into 5 groups based on the level of asymmetry as follows : Definitely No, Probably No, Don't Know, Probably Yes, and Definitely Yes. Nine linear and low angular measurements from each posteroanterior cephalometric radiographs were analysed on the standard of the line between crista galli and anterior nasal spine to show the extent of asymmetry. Through this comparative study, the following results were obtained. 1. As the deviation of menton and the midline discrepancy of the upper and lower jaws were greater, the perception of patients about their facial asymmetry was higher. 2. All the measurements from the group 'Don't Know' showed no statistical difference from those of the groups 'Definitely No' or 'Probably No.' 3. All the measurements from the group 'Probably Yes' showed no statistical difference from those of the group 'Definitely yes.' .

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The width of keratinized gingiva and the frenum in mandible (하악에서 부착치은의 폭경과 소대에 관한 연구)

  • Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.28 no.4
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    • pp.785-797
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    • 1998
  • This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.

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The soil moisture fluctuation between surface and subsurface drained plots in the different soil characteristics (토양별 지표, 지하배수간 토양수분 변화에 대하여)

  • 이순혁
    • Water for future
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    • v.7 no.2
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    • pp.75-82
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    • 1974
  • 본시험은 관개 및 배수 설계를 위한 기초자료 제공을 목적으로 토양수분 및 지하수위의 변화상태를 구명하고자 하는 것으로 카나다 퀴백(Quebec) 지방 저지대의 대표적인 2종의 태양인 점토와 사질로움 토양에 대해서 일차적으로 지표, 지하배수간의 토양수분과 지하수위의 변화를 연구분석한 것으로 그 결과를 요약하면 다음과 같다. 1. 2종의 토양(점토, 사질로움)에 있어서 공히 토양수분은 지표로부터 지하로 내려갈수록 증가되는 상태를 나타냈으면 이는 하층토로 내려감에 따라 팽창된 치밀한 토양 조직을 가지고 있음을 시사하며 2. 동기에 있어서는 지표로부터 12inch 깊이의 토양수분이 더 깊은 18inch나 24inch 깊이의 토양수분보다 증가된 상태를 유지하였다. 이는 토양내의 빙결막이나 지표면의 눈 또는 어름에 영향으로 생각되며 이 경향은 점토질 토양에서 보다 토양내 빙결막으로의 수분 이종을 조장해주는 투수 계수가 큰 사질로움 토양에서 더 높았다. 3. 양식험구 공히 지표에서 얕은 지하 0∼3inch 이내의 토양수분은 항우를 전후해서 급격한 변화를 가져왔다. 여기에서 수분의 급상승은 호우시나 표층토가 하층토의 토양수분에 영향을 주는 항우이전에 포장용수량(Field capacity)에 달했기 때문에 급항하는 지표면의 물 분자가 열에너지에 의해 증발산되고 천층에 산재한 초, 수근에 의해 소비되는 때문인 것으로 사료된다. 4. 지하수위하의 토양수분은 포화에 달하여 거의 일정할 것으로 기대되었지만 실제로 많은 변화를 가져왔다. 이들 변화에는 부분적으로 토양사극이 지하수위하이라도 채워지지 않았거나(Capillary pressure가 작을 시) 혹은 관측기간 중에 토양의 융기와 수축에 기인된다고 생각된다. 5. 지하배수구가 지표배수구에 비해 지하수위항하가 빨랐음은 물론 사질로움 토양에서는 보다 높은 투수계수로 인해서 지하수위의 항하가 점토질 토양에서 보다 훨씬 빨랐음을 보여주고 있다.표시할 수 있다.된다.acid $0.41{\sim}0.65%$, 오미자는 malic acid $1.51{\sim}3.90%$, citric acid $2.40{\sim}3.92%$로 주요 유기산이 있다. 타닌은 물보다 에탄올 추출물이 다소 함량이 높았으며 특히 오갈피는 $3.35{\sim}3.85%$로 매우 높은 함량이었다.a 6 cases, etc. 2. The retroperitoneal space including kidneys were the most commonly involved site (43.5%), of which Wilms' tumor was the commonest. 3. About 2/3 of tumors developed under the age of 6 and the commonest lesion was Wilms' tumor and the next being neuroblastoma, teratoma, ovarian cyst and so forth. 4. In all tumors except ovarian tumor and choledochal cyst, male was more frequently affected. 5. In plain abdomen 75% of neuroblastoma crossed the mid line while in Wilms' tumor only 2 cases (14%) showed midline cross. Calcific density was 입력불가 in all 6 cases of teratoma (100%) as dense and discrete ossification, in 3 case of neuroblatoma (38%) characteristically in diffuse stippled appearance and in one case

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Effect of a Intentional Scapular Abduction on the Sit-and-Reach Test (의도적인 견갑골 외전이 Sit-and-Reach Test에 미치는 영향)

  • Kim, Suhn-Yeop;Chi, Chang-Yean;Kim, Kwang-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.6 no.1
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    • pp.15-26
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    • 2000
  • Purpose : This study was done to examine the actual effect of the scapular position in these flexibility tests. The purpose of this study was to examine the differences between the measurement of SRT(Sit-and-Reach Test) without intentional abduction of the scapular (pre-test) and with intentional abduction of the scapular (post-test). The hypothesis is: 1. There is no differences in the SRT result of the pre-test and the post-test. 2. There is no differences in the HJA(Hip Joint Angle) result of the pre-test and the post-test. 3. There is no differences in the Spine Motion Test(SMT) result of the pre-test and the post-test. Method : The total 60 people (30 men, 30 women) were participated in this study. In the pre-test, the subjects were asked to sit on the examination table and try the SRT motion; and then the HJA, SRT and the SMT numerical values were taken. In the post-test. the subjects were instructed to intentionally bring the scapula outward from the midline; and the HJA, SRT and the SMT numerical values were taken. Result : In the pre-test. the SRT result averaged 34.17cm. and in the post-test. the SRT result averaged 36.68cm. The difference was about 2.81cm which showed a significant mean statistically (p<0.01). The measurement increased by 8.22%. The HJA was $85.9^{\circ}$ in pre-test, and it was $85.5^{\circ}$ in post-test. giving the $0.4^{\circ}$ differences. Therefore, it didn't have a statistical mean (p>0.05). The SMT value was 69.56cm in the pre-test. and it was 69.28cm in the post-test, about 0.28cm decreased. Therefore, it didn't have a statistical mean (p>0.05). SRT values and HJA values were correlated (p<0.01). SMT values and SRT values (p<0.01), and SMT values and HJA values(p<0.05) were each in counter correlation. Conclusion : The result of the SRT without intentional scapular abduction (34.17cm) and with intentional scapular abduction (36.68cm) showed a significant increase about 8.22% (p<0.01). In SRT, the effect of the intentional scapular abduction on SMT showed no significant means, the pretest value being 69.56cm and the post-test value being 69.28cm (p>0.05).

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Experimental Studies of the Pericardial Releasing Technique in Rabbits (가토에서 심낭이완술에 관한 실험적 연구)

  • 박만실
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.451-457
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    • 1987
  • Reoperations following cardiac surgery have an increased risk of the danger of damaging the heart, great vessels or extracardiac grafts because of adhesions to the sternum. We experimentally evaluated 3 different methods for pericardial closure. A standardized procedure for induction of pericardial adhesions was carried out in 30 rabbits. For closure of pericardium, animals were divided into 3 groups, 10 animals respectively: Croup 1 [simple pericardial closure]The pericardium was primarily resuture; Group 2 [Core-Tex surgical membrane as a pericardial substitute]- A Gore-Tex surgical membrane was interposed between the sternum and the heart; and Group 3 [pericardial tension releasing technique]-Three longitudinal overlapping incisions were made on the right side of the pericardium while the midline incison was sutured. Animals were put to death 4 weeks postoperatively and the pericardial space was examined for pericardial adhesions and epicardial reactions. The extent of adhesions and reactions were graded as: I-none; II-minimal; III-moderate; and IV-severe. Histologic studies of the pericardium, the pericardial substitute and the epicardium were also performed. The results were as follows: 1. In group 1 [simple pericardial closure], the degree of pericardial adhesions were grade I in 1 animal, grade II in 2, grade III in 4 and grade IV in 3. Epicardial reactions were grade I in 1 animal, grade II in 3, grade III in 5 and grade IV in 1. Histologic examination revealed thick fibrous tissue that obliterated the pericardial space in 7 animals. 2. In group 2 [Gore-Tex surgical membrane as a pericardial substitute], the degree of pericardial adhesions were grade I in 3 animals, grade II in 3, grade III in 2 and grade IV in 2. The degree of epicardial reactions were grade II in 1 animal, grade III in 5 and grade IV in 4. Histologic studies revealed a thin layer of dense fibrous tissue which covered the Gore-Tex surgical membrane and thick loose fibrous tissue on the epicardium just beneath the substitute. 3. In group 3 [pericardial tension releasing technique], the degree of pericardial adhesions were grade I in 3 animals, grade II in 4, grade III in 2 and grade IV in 1. The degree of epicardial reactions were grade 1 in 4 animals, grade II in 4 and grade III in 2. Severe epicardial reactions were not observed in this group. Histologic examination showed normal epicardium in 4 animals and the epicardium of the other 6 animals only revealed very thin fibrous layer compared to group I and group II. Pericardial adhesions more than grade III were 70% in group 1, 40% in group 2 and 30% in group 3. Pericardial adhesions were reduced in group 2 and group 3 compared to group 1, but statistically not significant. Epicardial reactions more than grade III were 60% in group 1, 90% in group 2 and 20% in group 3. Epicardial reactions were significantly reduced in group 3 compared to group 2. Author`s modified pericardial releasing technique provides marked augment of pericardial surface area and facilitates tension-free pericardial closure. Furthermore, pericardial adhesion and epicardial reaction will be reduced with the pericardial tension releasing technique.

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The Variation of Position of the Conus Medullaris in Korean Adults - A Magnetic Resonance Imaging Study - (한국 성인에서 척수원추 위치의 다양성 - 자기 공명 영상 연구 -)

  • Joo, Sung-Pil;Kim, Soo-Han;Lee, Jung-Kil;Kim, Tae-Sun;Jung, Shin;Kim, Jae-hyoo;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.451-455
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    • 2001
  • Objectives : There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. Methods : we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. Results : The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions : The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.

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Pallidotomy Guided by MRI and Microrecording for Parkinson's Disease (파킨슨환자의 자기공명영상과 미세전극기록을 이용한 담창구 파괴술)

  • Lee, Kyung Jin;Son, Hyung Sun;Park, Sung Chan;Cho, Kyung Keun;Park, Hae Kwan;Choi, Chang Rak
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.41-46
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    • 2001
  • Objective : The exact position of the lesion during the pallidotomy is critical to obtain the clinical improvement of parkinson's disease without damage to surrounding structure. Ventriculogrphy, CT(computed tomograpy) or MRI(magnetic resonance imaging) have been used to determine the initial coordinates of stereotactic target for pallidotomy. The goal of this study was to determine whether microelectrode recording significantly improves the neurophysiologic localization of the target obtained from MRI. Methods : Twenty patients were studied. They underwent a unilateral pallidotomy. Leksell frame was applied and T1 axial images parallel to the AC-PC(anterior commissure-posterior commissure) plane using a 1.5 Tesla MRI with 3mm slice thickness were obtained. Anteroposterior coordinate of target was chosen at 2mm in front of the midcommissural point and lateral coordinate between 19 and 22mm from the midline. The vertical coordinate was calculated on coronal slice using a fast spin echo inversion recovery sequence(FSEIR) related to the position of the choroidal fissure and ranged over 4-5mm below the AC-PC plane. Confirmation of the anatomical target was done on axial slices using the same FSEIR sequence . Microrecording was done at the pallidum contralateral to the symptomatic side using an electrode with a tip diameter of $1{{\mu}m}$ diameter tip and 1.1-1.4 mOhm impedance at 1000Hz. Electrophysiologic localization of the target was also confirmed intraoperatively by macrostimulation. Results : Microrecording techniques were reliable to define the transition from the base of the pallidum which was characterized by the disappearance of spike activity and by the change of the audible background activity. Signals from high amplitude neurons firing at 200-400Hz were recorded in the pallidal base. X, Y and Z coordinates of target obtained from the MRI were within 1mm from the X, Y, Z coordinates obtained with microrecording in 16 patients (80%), 15 patients(75%), 10 patients(50%) respectively. The difference of Y coordinate between on MRI and on microrecording was 4mm in only one patient. Conclusion : The MRI was accurate to localize the target within 1mm of the error from microrecording target in 70% of the patients. 4mm discrepancy was observed only once. We conclude that MRI alone can be used to determine the target for pallidotomy in most patients. However, microrecording technique can still be extremely valuable in patents with aberrant anatomy or unusual MRI coordinates. We also consider physiologic confirmation of the target using macrostimulation to be mandatory in all cases.

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Clinical Analysis of Posterior Thoracic and Endoscopic Surgical Approach for Essential Hyperhidrosis (본태성 다한증의 후흉추 접근법 및 내시경수술의 임상고찰)

  • Cheon, Hyo Cheol;Kim, Jae Hyoo;Lee, Jung Kil;Kim, Tae Sun;Jung, Shin;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.992-997
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    • 2001
  • Objectives : Essential hyperhidrosis is a common condition characterized by excessive body sweating. Excessive sweating beyond what is necessary to maintain normal body temperature need not be considered pathological unless it interferes with one's occupation and/or life-style. The existing non-operative therapeutic options seldom give sufficient relief or show a transient effect. In this regard, the thoracic sympathectomy may provide a definitive cure. In the past, surgical procedures were highly invasive and caused significant morbidity, but the minimally invasive thoracoscopic procedure provided detailed visualization of sympathetic ganglia and is associated with minimally postoperative morbidity. Nowadays, thoracoscopic transthoracic sympathectomy is accepted as the treatment of choice for essential hyperhidrosis. In palmar hyperhidrosis, however, the level of sympathetic chain to be blocked has been somewhat obscure. It is assumed that the incidence of compensatory hyperhidrosis may closely related to the extent of thoracic sympathectomy. Material & Methods : To compare the results of posterior midline approach with endoscopic sympathectomy, and the results of T2 with T2, 3 sympathectomy or sympathicotomy, we retrospectively studied 62 patients treated for palmar hyperhidrosis between September 1993 and May 2000. We reviewed medical records and recently interviewed the patients by telephone calls. Results : The treatment effect of T2 sympathectomy is no different from T2, 3 sympathectomy. But, the incidence of compensatory hyperhidrosis is less in the T2 sympathectomy group than the T2, 3 sympathectomy group. Conclusion : Thoracoscopic sympathectomy is considered a simple, safe, and effective method for treating palmar hyperhidrosis, with a shorter operation time, fewer hospital days, and a better cosmetic result, as compared with the open approaches. However, sympathicotomy seems to provide the advantages of a limited extent of denervation and the resultant decrease of compensatory hyperhidrosis compared to sympathectomy.

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Characteristics of Trigeminal Evoked Potential and It's Pathway in the Rat (백서에서 삼차신경 유발전위의 특성과 경로 분석)

  • Kim, Se-Hyuk;Zhao, Chun-Zhi;Kwon, Oh-Kyoo;Lee, Bae-Hwan;Park, Yong-Gou;Chung, Sang-Sup
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.985-994
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    • 2000
  • Objective : There are some advantages of trigeminal evoked potential(TEP) recording compared to other somatosensory evoked potential(SSEP) recordings. The trigeminal sensory pathway has a pure sensory nerve branch, a broader receptive field in cerebral cortex, and a shorter pathway. Despite these advantages, there is little agreement as to what constitutes a normal response and what wave forms truly characterize the intraoperative TEP. This study presents the normative data of TEP recorded on the epidural surface of the rat with a platinum ball electrode. Materials & Methods : Under general anesthesia with urethane, the adult Sprague-Dawley male rats(300-350g) were given electrical stimulation with two stainless steel electrodes which were inserted into the subcutaneous layer of the area around whiskers. A reference electrode was positioned in the temporalis muscle ipsilateral to the recording site. Results : TEPs were recorded in the Par I area of somatosensory cortex and recorded most apparently on the point of 2mm posterior from the bregma and 6mm lateral from the midline. The typical wave form consisted of 5 peaks (N1-P1-N2-P2-N3 according to emerging order, upward negativity). Each latency to corresponding peaks was not influenced by the different intensities of stimulation, especially from 1 to 5mA. Average latencies of 5 peaks were in the following order ; 7.7, 11.1, 15, 22.3, 29.4ms. There was also no significant difference between latencies before and after administration of muscle relaxant(pancuronium). For the electrophysiological localization of recorded waves, the action potential of a single unit was recorded with glass microelectrode(filled with 2M NaCl, $3-5M{\Omega}$) in the thalamus of rat. A sharp wave was recorded in the VPM nucleus, in which the latency was shorter than that of N1. This suggests that all 5 peaks were generated by neural activities in the suprathalamic pathway. Conclusion : In terms of recording near-field potentials, our data also suggests that TEP in the rat may be superior to other SSEPs. In overall, these results may afford normative data for the studies of supratentorial lesions such as hydrocephalus or cerebral ischemia which can have an influence on near-field potentials.

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Compare the Intracranial Pressure Trend after the Decompressive Craniectomy between Massive Intracerebral Hemorrhagic and Major Ischemic Stroke Patients

  • Huh, Joon;Yang, Seo-Yeon;Huh, Han-Yong;Ahn, Jae-Kun;Cho, Kwang-Wook;Kim, Young-Woo;Kim, Sung-Lim;Kim, Jong-Tae;Yoo, Do-Sung;Park, Hae-Kwan;Ji, Cheol
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.42-50
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    • 2018
  • Objective : Massive intracerebral hemorrhage (ICH) and major infarction (MI) are devastating cerebral vascular diseases. Decompression craniectomy (DC) is a common treatment approach for these diseases and acceptable clinical results have been reported. Author experienced the postoperative intracranaial pressure (ICP) trend is somewhat different between the ICH and MI patients. In this study, we compare the ICP trend following DC and evaluate the clinical significance. Methods : One hundred forty-three patients who underwent DC following massive ICH (81 cases) or MI (62 cases) were analyzed retrospectively. The mean age was $56.3{\pm}14.3$ (median=57, male : female=89 : 54). DC was applied using consistent criteria in both diseases patients; Glasgow coma scale (GCS) score less than 8 and a midline shift more than 6 mm on brain computed tomography. In all patients, ventricular puncture was done before the DC and ICP trends were monitored during and after the surgery. Outcome comparisons included the ictus to operation time (OP-time), postoperative ICP trend, favorable outcomes and mortality. Results : Initial GCS (p=0.364) and initial ventricular ICP (p=0.783) were similar among the ICH and MI patients. The postoperative ICP of ICH patients were drop rapidly and maintained within physiological range if greater than 80% of the hematoma was removed. While in MI patients, the postoperative ICP were not drop rapidly and maintained above the physiologic range (MI=18.8 vs. ICH=13.6 mmHg, p=0.000). The OP-times were faster in ICH patients (ICH=7.3 vs. MI=40.9 hours, p=0.000) and the mortality rate was higher in MI patients (MI=37.1% vs. ICH=17.3%, p=0.007). Conclusion : The results of this study suggest that if greater than 80% of the hematoma was removed in ICH patients, the postoperative ICP rarely over the physiologic range. But in MI patients, the postoperative ICP was above the physiologic range for several days after the DC. Authors propose that DC is no need for the massive ICH patient if a significant portion of their hematoma is removed. But DC might be essential to improve the MI patients' outcome and timely treatment decision.