• Archives of Plastic Surgery
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• 제43권2호
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• pp.172-180
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• 2016

Background Conventional frontalis transfer may cause a range of complications. In order to overcome complications, we made modifications to the surgical technique, and compared the outcomes of patients who underwent conventional frontalis transfer with those of patients who underwent modified frontalis transfer. Methods We conducted a retrospective study of 48 patients (78 eyes) who underwent conventional frontalis transfer between 1991 and 2003 (group A) and 67 patients (107 eyes) who underwent modified frontalis transfer between 2004 and 2014 (group B). The frontalis transfer procedures were modified conform to the following principles. The tip of the frontalis muscle flap included soft tissue that was as thick as possible and the soft tissue on the tarsal plate was removed to the greatest extent possible. A double fold was created in cases of unilateral ptosis. In order to evaluate the objective effects of modification, preoperative and postoperative values of the marginal distance reflex 1 (MRD1), the corneal exposure area, and the decrease in eyebrow height were compared between the two groups. Results In group A, patients showed an improvement of 1.19 mm in the MRD1, a 6.31% improvement in the corneal exposure area, and a 7.82 mm decrease in eyebrow height. In group B, patients showed an improvement of 2.17 mm in the MRD1, an 8.39% improvement in the corneal exposure area, and an 11.54 mm decrease in eyebrow height. The improvements in group B were significantly greater than those in group A. Conclusions Modified frontalis transfer showed better results than the conventional procedure and provided satisfactory outcomes.

• Journal of Oral Medicine and Pain
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• 제22권2호
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• pp.309-325
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• 1997

In order to set the lasing variables and evaluate, clinically, the therapeutic effects of a pulsed Nd:YAG laser on oral lesion, the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (wavelength 1064nm, Pulse duration 120$\mu$sec, fiber diameter 200$\mu$m/320$\mu$m) to 22 cases of oral soft tissue lesions and 6 cases of oral hard tissue lesions. The obtained results were as follows : 1. The effective excision with contact mode and the effective hemostasis of accompanied bleeding with noncontact mode were occurred by lasing on oral soft tissue lesions with fiber diameter of 320$\mu$m under the variables of 2.0~4.0W and 20~50Hz which were controlled into high power/low pulses for excision, low power/high pulses for hemostasis, low power in granulation tissue and high power in fibrous tissue according to therapeutic goals and tissue conditions. 2. About 50% of decreasing effect on hypersensitivity was occurred by lasing with non-contact and contact mode on cervical abrasion which caused dentinal hypersensitivity with fiber diameter of 320$\mu$m under the variables of 0.7 - 1.0W and 10Hz which were applied 2~3 times with 1 week interval. 3. The effective sterilization of infected root canal and lesion of periapical abscess was occurred by lasing with contact and spiral modes on wall of root canal and periapical abscess with fiber diameter of 200$\mu$m of which the tip was placed about 1mm shorter than root canal length under the variables of 1.OW and 10Hz.

• 한국지반공학회지:지반
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• 제1권1호
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• pp.73-84
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• 1985

본 연구에거는 유한요소법에 의해서 제상하중을 받고 있는 연약지반의 응력분포와 변위를 규명하 였다. 응력에는 체적응력, 간극수압, 연직응력, 수평응력, 전단응력이 포함된다. 유한요소기법으로서 Christian-Boehmer방법을 택하였으며 진배수 및 비배수조건에서 일반탄성model과 참정 Cam-clay model을 지배방정으로 선정하였다. 그 결과는 다음과 같다. 1. 체적응력은 간극수압과 거의 일치한다. 이는 비배수조건에서 전응력이 간극수탄과 같다는 것 을 의미한다. 2. 연직응력은 배수 및 비배수표건이라 구성식의 model에 관계없이 같은 갈을 나타런다. 3. 수평응력은 배수조건과는 무관하지만 구함식의 model에 따라서 다른 값으로 나타난다. 4. 전단응력은 배수조건 및 구성식의 model model에 따라 다른 값이 된다. 수정 Cam-clay에 의한 해석치가 가장 크게 된다. 5. 변위 Vector의 방향은 하중이 증가하는 동안 성토법면근방에서 외향으로 향한다. 6. 변위의 크기는 수정 Cam-clay에 의한 해석이 탄성 model의 2배가 된다.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.127-129
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• 2011

Purpose: Nasotracheal or oral intubation procedure is widely used for facial bone fractures. However, during the operation intubated tube can interfere or obstruct the view of the operator. We authors used a modified submental intubation method in panfacial bone fracture patients for intact airway and the operation view. Methods: After intravenous induction of anaesthesia, traditional orotracheal tubation was done. A horizontal incision was made 2 cm from the midline, 2 cm medial to and parallel with the mandible in the submental region. 1 In order to approach to the floor of the oral cavity, a haemostat was pushed through the soft tissues. A chest tube front cover was applied to the intubation tube and the tube was inserted through the submental tunnel. Orotracheal tube was disconnected and pulled back through the soft tissue and secured with a suture. Results: The procedure took about 30 minutes and there were no problems during the intubation. Intraoral manipulation and occlusal checks were free without any interference. Extubation was also easily done without any complications such as lung aspiration, infection, hematoma, or fistula. Conclusion: Submental endotracheal intubation is fast, safe, easy to use and free from the concern about the tube being pull back again. Conventional submental intubations are being held without any coverage of the tip. We authors applied the modified method to the trauma patients and obtained satisfactory results. From the above advantages, modified submental intubation can be widely available not only in fractured patients, but also in aesthetic or orthognathic surgeries.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.208-213
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• 2008

Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5 cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site. Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

• Archives of Reconstructive Microsurgery
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• 제18권1호
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• pp.35-39
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• 2009

Purpose: Various techniques have been attempted for design of the flaps. However, there are some disadvantages. They have thin, pliable, and two dimensional methods. The aim of this study is to report usefulness of polyurethane foam dressing materials for three dimensional design of the digital island flap. Methods: From June of 2007 to september of 2008, 10 patients received digital island flap surgery for soft tissue defect of the finger. After minimal debridement of the wound, size and shape of the defect were measured using polyurethane foam. We used Medifoam-$5^{(R)}$ And then, designed this inset the wound. The flap was designed on the donor site with a arterial pedicle as the central axis according to size and shape. A full thickness skin graft from the groin is applied on the flap donor defect and secured with a tieover bolster dressing. Results: Reviewing sizes of the flaps, the length and width of flaps ranged from 1.5 to 3.3 cm and 1.0 to 2.5 cm. The PACS(Picture Archiving Communication System) program allows identification of the donor depth of finger. The distance for the soft tissue ranged from 4.3 mm to 6.7 mm. Mean depth of donor site was 5.3${\pm}$0.6 mm. Also, the thickness of Medifoam-$5^{(R)}$ ranged nearly 5 mm. On flap insetting, full-thickness skin graft was necessary. We did not experience any problems in the recipient site size either, regardless of the extended flaps. Conclusion: Polyurethane foam has many advantages over the more conventional templates. Refinements in flap design and surgical technique resulted in favorable functional and cosmetic results. Especially, for beginner, Polyurethane foam dressing material is a simple and safe tool and therefore is an excellent choice for design of the island flap.

• 대한치과교정학회지
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• 제45권6호
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• pp.308-321
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• 2015

Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

• 한국지반공학회논문집
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• 제27권1호
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• pp.77-86
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• 2011

건설 프로젝트의 대형화와 시공장소의 다양화에 따라 지반 조사 내용이 다양해지고 있다. 더욱이 날로 엄격해지는 시공조건으로 인해 보다 높은 수준의 지반정보가 요구되고 있다. 그러나 우리나라에서는 최근까지도 비교적 결과의 신뢰도가 낮은 표준관입실험 등의 원위치 실험법에 의존하고 있는 현실이다. 본 논문에서는 복합적인 지반의 거동 특성 평가를 위하여 연약지반은 물론 암반에서도 에너지 변화를 측정할 수 있는 새로운 콘관입 실험기를 개발하고자 하였다. 본 연구에서는 롯드의 체결 방식에 따른 에너지 감쇠를 평가하기 위해 롯드를 인위적으로 불완전하게 체결하거나, 전체 길이는 일정하게 유지시키면서 체결된 롯드의 수를 변화시키며 실험을 수행하였다. 또한, 체결 조건이 다른 롯드에서 탄성파의 전달율과 반사율을 적용하여 에너지 손실을 평가 하였다. 그리고 정동적 콘관입 실험 장비를 제작하여 두부와 선단부에 변형률계와 가속도계를 부착함으로써 에너지 손실을 실내 실험을 통하여 평가하고자 하였다. 실험 결과 롯드의 체결 상태가 완벽하지 않으면 에너지 전달률이 급격히 감소하는 것을 실험과 시뮬레이션을 통하여 알 수 있었다. 또한 실내 실험결과 새로 개발된 정동적 콘 관입 실험기의 두부와 선단부의 전달에너지가 다름을 알 수 있었다. 본 연구에서는 두부는 물론 선단부에서의 에너지 평가가 필요함을 알 수 있었다.

• 한국지반공학회논문집
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• 제26권8호
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• pp.15-25
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• 2010

점토층 사이에 존재하는 모래 협재층은 연약지반 거동에 중요한 영향을 미친다. 협재층은 주로 표준 콘(단면적: $10cm^2$)에서 측정된 지반의 저항력과 간극수압 값을 이용하여 평가하고 있지만, 높은 해상도를 위하여 소형 콘이 널리 활용되고 있다. 본 논문의 목적은 연약지반에 얇게 분포된 협재층을 선단저항력, 주면마찰력 그리고 전기비저항을 이용하여 평가할 수 있는 전기비저항 콘(Cone Resistivity Penetrometer, CRP)을 개발하고 적용하는 것이다. CRP는 각각 실내실험(단면적: $0.78cm^2$, 직경: 1.0cm)과 현장실험(단면적: $1.76cm^2$, 직경: 1.5cm)에 활용되도록 제작하였으며, 길이는 표준 콘(단면적: $10cm^2$, 직경: 3.57cm)의 단면적과 마찰부의 면적비를 고려하여 제작하였다. 실내실험은 모래와 점토가 반복적으로 조성된 다층의 층상탐지 셀을 사용하여 각 지층의 경계면을 탐사하였으며, 현장실험은 광양지역에서 심도 6m부터 15m까지 관입실험을 수행하였다. CRP는 실내실험에서 측정된 선단저항력과 전기비저항으로 조성된 시료의 각 지층 경계면을 뚜렷하게 평가하였으며, 현장실험에서는 3개의 협재층을 탐지하였다. 본 연구에서 개발된 CRP는 실내 및 현장결과 적용성이 뛰어나 추후 유용하게 사용될 것으로 판단된다.

• Journal of Chest Surgery
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• 제14권1호
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• pp.67-70
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• 1981

Aneurysms of the extracranial carotid artery are rare. This is a case report of the rapidly expanding false carotid aneurysm at left common carotid artery, which was repaired surgically with internal shunt This 20 year old male patient had a large pulsatile mass on left lateral aspect of neck at the time of admission. About 1 month before admission, he had received a trauma on left neck by glass piece and noted massive blood loss. And its skin of lesion was sutured simply at local clinic and well healed. 10 days before the admission, he had the sudden onset of the adult thumb sized and pulsatile mass and the mass had been enlarged more and more to the adult first-sized one. The cervical film showed a egg-sized and soft tissue mass. There was systolic bruit on the mass. The diagnosis was confirmed with the angiogram of left carotid artery and this showed the man`s thumb tip-sized extravasation at the point 2 Cm below the bifurcation of Internal and external carotid arteries. The emergency operation was performed by the internal shunt with carotid artery. The aneurysm was enclosed with the adventitia and carotid sheath, and the intima and media were Intact and had the opening of 0.5 cm in diameter. The opening was sutured by the one-hand mattress suture method and firmed with the Aron Alpha-A "Sankyo." The postoperative course was uneventful and the patient was discharged with good general condition.