• Title/Summary/Keyword: Reconstruction plate

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Comparison of Sequelae According to the Types of Implants in Blow-Out Fracture (안와 파열 골절 치료 시 삽입물 종류에 따른 후유증 비교)

  • Kim, Tae-Gon;Im, Jong-Hyo;Lee, Jun-Ho;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.23-28
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    • 2009
  • Purpose: Blow out fracture can present tenderness, swelling, enophthalmos, extraoccular muscle limitation, paresthesia, diplopia according to severity of injury, so reconstruction of blow out fracture is important. Orbital soft tissue should be in orbit and defected orbital wall should be corrected by autologus tissue or alloplastic implants. Every implants have their merits and faults, every implants are used various. This study was designed to compare the sequelae of blow-out fracture repair using the alloplastic implants: micro-titanium mesh(Micro Dynamic titanium $mesh^{(R)}$, Leibinger, Germany), porous polyethylene ($Medpor^{(R)}$, Porex, USA), absorbable mesh plate(Biosorb $FX^{(R)}$ . Bionx Implants Ltd, Finland). Methods: Between January 2006 and April 2008, 52 patients were included in a retrospective study analysing the outcome of corrected inferior orbital wall fracture with various kind of implants. Implants were inserted through subciliary incision. Twenty patients were operated with micro-titanium mesh, fourteen patients with porous polyethylene and eighteen patients with absorbable mesh plate. In comparative category, enophthalmos, diplopia, range of motion of extraoccular muscle, inferior orbital nerve injury were more on frequently statistically in patients. Results: Fourteen of 18 patients underwent surgical repair to improve diplopia, 11 of 17 patients to improve parasthesia, 11 of 15 patients to improve enophthalmos, 8 of 9 patients to improve extraoccular muscle limitation. Duration of follow-up time ranged from 6 months to 12 months(mean, 7.4 months). There was no statistic difference of sequelae between micro titanium mesh and porous polyethylene and absorbable mesh plate in blowout fracture, inferior wall. Conclusion: There is no difference of sequelae between micro-titanium mesh, porous polyethylene and absorbable mesh plate in blow-out fracture, inferior wall. The other factors such as defect size, location, surgeon's technique, may influence the outcome of blow-out fracture repair.

Operative Treatment of Unstable Fracture of the Proximal Humerus (상완골 근위부 불안정성 골절의 수술적 치료)

  • Kim Young-Kyu;Jang Young-Hun;Kim Keon-Beom
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.198-204
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    • 1998
  • Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

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NDP-sugar production and glycosylation of ${\varepsilon}$-rhodomycinone in Streptomyces venezuelae (Streptomyces Peucetius에서의 ${\varepsilon}$-rhodomycinone 추출 및 이종균주에서의 rhodomycin D 생산 연구)

  • Park, Sung-Hee;Cha, Min-Ho;Kim, Eun-Jung;Yoon, Yeo-Joon;Sohng, Jae-Kyung;Lee, Hee-Chan;Liou, Kwang-Kyoung;Kim, Byung-Gee
    • KSBB Journal
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    • v.23 no.1
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    • pp.44-47
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    • 2008
  • Anthracycline antibiotics doxorubicin (DXR) is clinically important cancer therapeutic agent produced by Streptomyces peucetius. DXR result by further metabolism of rhodomycin D (RHOD) and require a deoxy-sugar component for their biological activity. In this study, production of TDP-L-daunosamine and its attachment to ${\varepsilon}$-rhodomycinone (RHO) to generate RHOD has been achieved by bioconversion in Streptomyces venezuelae that bears eleven genes. S. peucetius seven genes (dnmUTJVZQS) were transformed by plasmid and S. venezuelae two genes desIII, IV and two more S. peucetius drrA, B genes were integrated into chromosomal DNA. To generate the feeding substrate RHO, 6L S. peucetius grown on agar plate was harvested, extracted with organic solvent and then purified using preparative HPLC. Recombinant S. venezuelae grown on agar plate containing RHO was harvested and its n-butanol soluble components were extracted. The glycosylated product of aromatic polyketide RHO using heterologous host S. venezuelae presents the minimal information for TDP-L-daunosamine biosynthesis and its attachment onto aglycone. Moreover, the structure of auxiliary protein, DnrQ, was predicted by fold recognition and homology modeling in this study. This is a general approach to further expand of new glycosides of antitumor anthracycline antibiotics.

Pigmented villonodular synovitis of the temporomandibular joint - computed tomography and magnetic resonance findings: a case report

  • Kim, Il-Kyu;Cho, Hyun-Young;Cho, Hyun-Woo;Seo, Ji-Hoon;Lee, Dong-Hwan;Peng, Wang
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.3
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    • pp.140-146
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    • 2014
  • Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion.

Orbital Floor Reconstruction Using Endoscope and Selected Urethral Balloon Catheter (내시경과 선택적 도뇨관 풍선을 이용한 안와하벽복원술)

  • Choi, Hwan-Jun;Lee, Joo-Chul;Lee, Hyung-Gyo;Kim, Jun-Hyuk
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.35-42
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    • 2011
  • Purpose: Blow-out fractures can be reduced using various methods. The orbital reconstruction technique using a balloon under endoscopic control has advantages over other methods. However, this method has some problems too, such as postoperative follow-up, management of the balloon catheter, and reduction of the posterior orbital floor. Thus, we developed a simple, effective method for orbital floor reduction that involves molding and shaping the antral balloon catheter. Methods: A 0, 30, or $70^{\circ}$, 4-mm endoscope was placed though a two-point, 5-mm maxillary antrostomy. The balloon catheter is placed directly at the orbital apex to reconstruct the anterior shelf (spherical shape), while it is turned in a U-shape towards the anterior maxilla for the posterior shelf (elliptical shape). Orbital floor defects, compound or comminuted fractures are reconstructed with alloplastic materials through an open lid incision under the endoscopic control. Results: This technique was applied to ten patients with orbital floor fractures: five anterior shelf and five posterior shelf fracture, respectively. Four of the patients had zygomatico-orbital fractures, while the rest had isolated orbital floor fractures. Two patients were given porous polyethylene implants Synpor$^{(R)}$) and three underwent reconstruction with a resorbable mesh plate. No complication associated with this technique was identified. Conclusion: The freestyle placement and selection of a urinary balloon catheter under endoscopic control and the preoperative estimation of the volume enhanced the stabilization of the orbital contour. This method improves the adaptation of the orbital floor without the risk of injuring the surrounding orbital contents, dissecting blindly, or using sharp traction. One drawback of this method is the patient's discomfort from the catheter during treatment.

Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

  • Kim, Jin Hyung;Kim, Jeong Min;Park, Jang Wan;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.742-747
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    • 2013
  • Background The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. Methods This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. Results All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. Conclusions Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.

Geometric Region Reconstruction of Steel-tube Computed Radiography Using Nonlinear Structural Analysis (비선형 구도해석에 의한 강관 CR영상의 기하학적 영역복원)

  • Hwang, Jae-Ho
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.46 no.6
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    • pp.146-152
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    • 2009
  • The steel-tube is exposed to a radiation from X-ray source. The transmitted radiation is detected by a detector, usually film or more recently an imaging plate(IP) of Computed Radiography(CR). The detected radiation overlaps the region of both sides of the object. The radiographic images reflect the projections of the rays, passing twice through both external and internal tube material. Nonlinear distortion due to the radioactive transmission and geometric disposition also appears on images. In this paper, an analytical approach is presented to achieve image reconstruction from the steel-tube CR images. Parameters related to radiation and measuring structure, such as intensities, absorption in material and geometric specifications linked with the collimating components, are calculated and identified in order to construct the renoval images for twofold regions of circle-type steel tubes. A correction procedure for region recovery most similar to the true tube is designed. The application of this approach on CR images is shown and reconstructed results are discussed.

Functional Primary Surgery in Unilateral Complete Cleft Lip (편측구순열 1차수술)

  • NISHIO Juntaro;ADACHI Tadafumi;KASHIMA Yukiko
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.2
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    • pp.41-50
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    • 2000
  • The alar base on the cleft side in unilateral complete cleft lip, alveolus and palate is markedly displaced laterally, caudally and dorsally, By incising the pyriform margin from the cleft margin of the alveolar process, including mucosa of the anterior part of the inferior turbinate, to the upper end of the postnasal vestibular fold, the alar base is released from the maxilla, A physiological correction of nasal deformity can be accomplished by careful reconstruction of nasolabial muscle integrity, functional repair of the orbicular muscle, raising and rotating the displaced alar cartilage, and finally by lining the lateral nasal vestibule, The inferior maxillary head of the nasal muscle complex is identified as the deeper muscle just below the web of the nostril, The muscle is repositioned inframedially, so that it is sutured to the periosteum that overlies the facial aspect of the premaxilla in the region of the developing lateral incisor tooth, And then, the deep superior part of the orbicular muscle is sutured to the periosteum and the fibrous tissue at the base of the septum, just in front of the anterior nasal spine, The nasal floor is surgically created by insertions of the nasal muscle complex in deep plane and of the orbicular muscle in superficial one, The upper part of the lateral nasal vestibular defect is sutured by shifting the alar flap cephalically, The middle and lower parts of this defect are closed by use of cleft margin flaps of the philtral and lateral segments, respectively, Authors stress the importance of nasal floor reconstruction at primary surgery and report the technique and postoperative results.

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Geophysical exploration for the Site Charcteristics of Iljumun Gate in Hwanseongsa Temple (지구물리탐사를 이용한 경산시 환성사 일주문 지반조사)

  • Kim, Ki-Hyun;Suh, Man-Cheol
    • 한국지구물리탐사학회:학술대회논문집
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    • 2008.10a
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    • pp.131-136
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    • 2008
  • We performed a non-destructive geophysical survey such as an elastic wave survey, electric specific resistance survey, plate loading test, etc. in order to grasp the structure and status of the ground around the pillar gate and to provide the directions and design data for preservation and maintenance during reconstruction. The result of electric specific resistance survey shows 50-1300 ohm-m range of general electric specific resistance distribution. Besides, the positions around 1m south of stone pillars, between stone pillar No.3 and 4, and 1m north of stone pillar No.2 and 3 show abnormality of relatively lower electric specific resistance than their surroundings. The abnormality of low electric specific resistance appearing between stone pillar No.3 and 4 shows consistency with the abnormal section appearing from the result of elastic wave reflection survey. The result of a plate loading test shows that allowable bearing force is over $10.70tf/m^2$, and the settlement amount at this time was calculated as 19.635mm. The design load during reconstruction of pillar gates was calculated as $16.37t/m^2$ by applying assumption values, which is far more than the allowable bearing force, so it is judged that a measure to strengthen the foundation ground is necessary.

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FLORID OSSEOUS DYSPLASIA;REPORT OF A CASE (Florid Osseous Dysplasia 의 치험 1예)

  • Lee, Choong-Kook;Lee, Jae-Hwy;Kim, Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.1
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    • pp.193-201
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    • 1990
  • This is a case report of a florid osseous dysplasia occurred in the left posterior region of the mandible in a 60-year-old female. Florid osseous sysplasia is a distinct clincial pathologic entity representing an exuberant variant of osseous dysplasia, defined by Robinson to be a abnormal reaction of bone to irritation or stimulation. The treatment was performed with partial mandibulectomy and immediate reconstruction with metal plate and iliac bone graft. The patient did well postoperatively and has shown no sign of recurrence or complication during the 6 month postoperative period.

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