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Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

  • Lee, Bu-Kyu;Hong, Jun Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.14.1-14.11
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    • 2020
  • Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

An Experimental Study on the Degradations of Material Properties of Vinylester/FRP Reinforcing Bars under Accelerated Alkaline Condition (급속 알칼리 환경하에서의 비닐에스터/FRP 보강근의 재료성능 저하 특성에 관한 실험적 연구)

  • Oh, Hongseob;Kim, Younghwan;Jang, Naksup
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.23 no.2
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    • pp.51-59
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    • 2019
  • There is increasingly more research focusing on the application of FRP reinforcing bars as an alternative material for steel reinforcing bars, but most such research look at short term behavior of FRP reinforced structures. In this study, the microscopic analysis and tensile behavior of Basalt and Glass FRP bars under freezing-thawing and alkaline conditions were experimentally evaluated. After 100 cycles of the freezing and thawing, the tensile strength and elastic modulus of FRP bars decreased by about 5%. In the case of microstructure of FRP bars during the initial 20 days, no significant damages of FRP bar sections were found under $20^{\circ}C$ alkaline solution; however, the specimens immersed in $60^{\circ}C$ alkaline solution were found to experience resin dissolution, fiber damage and the separation of the resin-fiber interface. In the alkaline environment, the strength decrease of about 10% occurred in the environment at $20^{\circ}C$ for 100 days, but the tensile strength of FRPs exposed for 500 days decreased by 50%. At temperature of $40^{\circ}C$ and $60^{\circ}C$, an abrupt decrease in the strength was observed at 50 and 100 days. Especially, the tensile strength decrease of Basalt fiber Reinforced Polymer bars showed more severe degradation due to the damage caused by dissolution of resin matrix and fiber swelling in alkaline solution. Therefore, in order to improve the long-term performance of the surface braided FRPr reinforcing bars, surface treatment is required to ensure alkali resistance.

Changes in the Riverbed Landforms Due to the Artificial Regulation of Water Level in the Yeongsan River (인위적인 보 수위조절로 인한 영산강 하도 지형 변화)

  • Lim, Young Shin;Kim, Jin Kwan
    • Journal of The Geomorphological Association of Korea
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    • v.27 no.1
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    • pp.1-19
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    • 2020
  • A river bed which is submerged in water at high flow and becomes part of the river at low flow, serves as a bridge between the river and the land. The channel bar creates a unique ecosystem with vegetation adapted to the particular environment and the water pool forms a wetland that plays a very important role in the environment. To evaluate anthropogenic impacts on the river bed in the Middle Yeongsangang River, the fluvial landforms in the stream channel were analyzed using multi-temporal remotely-sensed images. In the aerial photograph of 2005 taken before the construction of the large weirs, oxbow lakes, mid-channel bars, point bars, and natural wetlands between the artificial levees were identified. Multiple bars divided the flow of stream water to cause the braided pattern in a particular section. After the construction of the Seungchon weir, aerial photographs of 2013 and 2015 revealed that most of the fluvial landforms disappeared due to the dredging of its riverbed and water level control(maintenance at 7.5El.m). Sentinel-2 images were analyzed to identify differences between before and after the opening of weir gate. Change detection was performed with the near infrared and shortwave infrared spectral bands to effectively distinguish water surfaces from land. As a result, water surface area of the main stream of the Yeongsangang River decreased by 40% from 1.144km2 to 0.692km2. A large mid-channel bar that has been deposited upstream of the weir was exposed during low water levels, which shows the obvious influence of weir on the river bed. Newly formed unvegetated point bars that were deposited on the inside of a meander bend were identified from the remotely sensed images. As the maintenance period of the weir gate opening was extended, various habitats were created by creating pools and riffles around the channel bars. Considering the ecological and hydrological functions of the river bed, it is expected that the increase in bar areas through weir gate opening will reduce the artificial interference effect of the weir.

Geomorphology and Spatio-Temporal Land Cover Changes in Sincheon Wetland, Mangyeong River (만경강 신천습지의 지형과 시공간적 토지 피복 변화)

  • Jangsoo Kim;Jeong-Sik Oh
    • The Korean Journal of Quaternary Research
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    • v.34 no.1
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    • pp.41-51
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    • 2024
  • The Sincheon wetland shows a remarkable diversity of fluvial landforms, such as river islands, anastomosing channels, braided channels, and sand-gravel bars, which contribute to its rich ecological habitat. The wetland area is characterized by a ecological diversity of herbaceous and woody plants. Significant changes in land cover within the wetlands were observed from 2008 to 2020. Notably, there was a rapid decrease in agricultural area from 18% to 0.04%, while the vegetation area expanded from 45% to 54%. Concurrently, the water area also experienced a notable increase from 34% to 41%. The surface sediment composition in the studied area displays sandy loam characteristics and exhibits acidic soil properties. Sediment acidity tends to increase downstream and in the central part of channels. Variations in acidity are also observed at nearby collection sites due to the tributaries and local discharge. The presence of dense vegetation in river islands and bars has led to a significant transformation of sediments into soil, with this change being more pronounced downstream, particularly near the weirs. The installation of a weir in Sincheon wetland is believed to have a significant impact on altering flow velocities between upstream and downstream sections, as well as influencing erosion and sediment deposition patterns. However, given the formation of landforms in response to weirs, effective administration and management are essential to address potential risks of catastrophic environmental disruptions, such as the removal of weirs and/or the maintenance of river channels.

Formation Environment of Quaternary deposits and Palynology of Jangheung-ri Archaeological Site (Jiphyeon County, Jinju City), Korea (진주 집현 장흥리 유적 제4기 퇴적층 형성 및 식생환경 연구)

  • 김주용;박영철;양동윤;봉필윤;서영남;이윤수;김진관
    • The Korean Journal of Quaternary Research
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    • v.16 no.2
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    • pp.9-21
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    • 2002
  • In Korea, many open-air upper palaeolithic sites are located at the river valley, particularly exposed in gently rotting terrain along the river course. They are situated at an altitude less trail 30 m above present river bottom, and covered with the blankets of slope deposits of several meters in thickness. The purpose of this research is to eluridate depositional and vegetational environment of the alluvial upper palaeolithic Jangheung-ri sites on the basis of analytical properties of grain size population, chronology, palynology, soil chemistry and clay mineralogy and magnetic susceptibility of the Jangheung-ri Quaternary formations. The lithostratograpy of Jangheung-ri sit is subdivided into 3 layers based on the depositional sequence and radiocarbon ages. From bottom to top, they are composed of slope deposits with lower paleosol layers, young fluvial sand and gravel with backswamp organic muds, and upper paleosol layers. The upper paleosol was formed under rather dry climatic condition between each flooding period. Dessication cracks were prevalent in the soil solum which was filled with secondarily minuted fragments due to pedogenetic process. The soil structure shows typical braided-typed cracks in the root part of cracking texture, and more diversified pattern of crackings downward. The young fluvial sand gravel were formed by rather perennial streams after LGM. The main part of organic muds was particularly formed after 15Ka. Local backswamp were flourished with organic muds and graded suspension materials in the flooding muds were intermittently accumulated in the organic muds until ca. 11Ka. This episode was associated with migration of Nam River toward present course. Organic muds were formed in backswamp or local pond. Abies/Picea-Betula with Ranunculaceae, Compositae, Cyperaceae were prevalent. This period is characterized with B$\Phi$lling, Older Dryas, Allerod, and Younger Dryas (MIS-1). Stone artefacts were found in the lower paleosol layers formed as old as 18Ka-22Ka. Based on the artefacts and landscape settings of the Jangheung-ri site, it is presumed that settlement grounds of old people were buried by frequent floodings of old Nam River, the river-beds of which were heavily fluctuated laterally and river-bed erosions were activated from south to north in Jangheung-ri site until the terminal of LGM9ca 17Ka).

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Sliding Knots and the Effect of Additional Half-Hitch Knots on Optimal Knot-Holding Capacity (체이동 매듭과 추가적인 반 매듭 증가에 따른 매듭의 장력 변화와 최적 유지력)

  • Hur, Chang-Yong;Kim, Seung-Ho;Kim, Byung-Kwan;Yoo, Jae-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.37-44
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    • 2004
  • Purpose: To evaluate the optimal number of additional half hitches for achieving an optimal knot-holding capacity (KHC) of Lockable sliding knots. Methods: Four configurations of arthroscopic knots (Duncan loop, Field knot, Giant knot, and SMC knot) were tested for their knot-holding capacity. For each knot configuration, 6 sequential knots were made including the initial sliding knot and additional 5 knots by incrementing one half hitches at a time. Each added half-hitch were in reversing half-hitches with alternate posts (RHAPs) fashion. For each sequential knot configuration, 12 knots were made by No. 2 braided sutures. On the servo-hydraulic material testing system (Instron 8511, MTS, Minneapolis, MN), cyclic loading, load to clinical failure (3-mm displacement), load to ultimate failure, and mode of failure were measured. Results: Most of the initial loop without additional half-hitch showed dynamic failure with cyclic loading. The mean displacement after the end of cyclic loading decreased with each additional half-hitches. SMC and Giant knot reached plateau to 0.1 mm or less displacement after one additional half-hitch, shereas Field and Duncan loop needed 3 additional half-hitches. The SMC and Duncan knots needed 1 additional half-hitch to reach greater than 80N at clinical failure, whefeas the other 2 knots needed2 additional half-hitches. For the load exceeding 100N for clinical failure, the SMC knot required 3 additional half-hitches and the other three knots needed 4 additional half-hitches. As the number of additional half-hitches incremented, the mode of failure switched from pure loop failure (slippage) to material failure (breakage). Duncan loop showed poor loop security in that even with 5 additional half-hitches, some failed by slippage (17%). On the other hand, after 3 additional half-hitches, the 3 other knots showed greater than 75% of failure by material breakage mode (SMC and Field 92%, Giant 75%). Conclusion: Even with its own locking mechanism, lockable sliding knot alone does not withstand the initial dynamic cyclic load. For all tested variables, SMC knot requires a minimum of 2 additional half-hitches. Duncan knot may need more than 3 additional half-hitches for optimal security. All knots showed a mear plateau in knot security with 3 or more additional half-hitches.

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Fluvial Deposits Distributed along the Seomjin River (섬진강 유역의 하성 퇴적층에 관한 연구)

  • You, Hoen-Su;Cho, Seok-Hee;Koh, Yeong-Koo
    • Journal of the Korean earth science society
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    • v.21 no.2
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    • pp.174-187
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    • 2000
  • The Quaternary coarse-grained sandy sediments are distributed along the channels of Seomjin River. The fluvial sediments were sedimentologically studied in horizontal and vertical distributions. To analyze depositional environments and facies changes in the sediments, sediment sampling from river mouth to upper stream and desctriptive approaches to the sediment profiles outcropped near Kurye were carried out. The sediments along the stream lines of the river are assigned to very coarse to coarse sand in grain size. The sediment grains are widely scattered in sorting and moderately sorted in average. For skewness and kurtosis, the sediments ranges from very fine to very coarse skewed and from very lepto-kurtic to extremelyl epto-kurtic states, respectively. The sediments are divided into slightly gravelly sand, gravelly sand and sandy gravel in sediment type. The pain shape in the sandy sediments are dominant in equant and tabular forms showing wide varieties. The sandy sediments are mostly poorly sorted and are highly variable in surface texture with SEM. Some smaller grains in the sediments ordinarily show polished surfaces. Of those grains, quartz ones are commonly angular to surounded. On the basis of facies changes and sedimentary structures, outcropped fluvial sediment profiles in Kurye are classified into xGyS, mGyS, gGyS, xSM, xS, mS, mGyM, IgM in facies. These eight facies are reformed as facies assemblage I and ll. The facies assemblage I and II are interpreted as the products of the channel deposits in braided stream and flood plain ones besides channels, respectively. The change facies assemblage I with facies assemblage ll imply that depositional environments hadbeen migrated from braied sream to flood plain ones.

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Sedimentary Facies and Evolution of the Cretaceous Deep-Sea Channel System in Magallanes Basin, Southern Chile (마젤란 분지의 백악기 심해저 하도 퇴적계의 퇴적상 및 진화)

  • Choe, Moon-Young;Sohn, Young-Kwan;Jo, Hyung-Rae;Kim, Yea-Dong
    • Ocean and Polar Research
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    • v.26 no.3
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    • pp.385-400
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    • 2004
  • The Lago Sofia Conglomerate encased in the 2km thick hemipelagic mudstones and thinbedded turbidites of the Cretaceous Cerro Toro Formation, southern Chile, is a deposit of a gigantic submarine channel developed along a foredeep trough. It is hundreds of meters thick kilometers wide, and extends for more than 120km from north to south, representing one of the largest ancient submarine channels in the world. The channel deposits consist of four major facies, including stratified conglomerates (Facies A), massive or graded conglomerates (Facies B), normally graded conglomerates with intraformational megaclasts (Facies C), and thick-bedded massive sandstones (Facies D). Conglomerates of Facies A and B show laterally inclined stratification, foreset stratification, and hollow-fill structures, reminiscent of terrestrial fluvial deposits and are suggestive of highly competent gravelly turbidity currents. Facies C conglomerates are interpreted as deposits of composite or multiphase debris flows associated with preceding hyperconcentrated flows. Facies D sandstones indicate rapidly dissipating, sand-rich turbidity currents. The Lago Sofia Conglomerate occurs as isolated channel-fill bodies in the northern part of the study area, generally less than 100m thick, composed mainly of Facies C conglomerates and intercalated between much thicker fine-grained deposits. Paleocurrent data indicate sediment transport to the east and southeast. They are interpreted to represent tributaries of a larger submarine channel system, which joined to form a trunk channel to the south. The conglomerate in the southern part is more than 300 m thick, composed of subequal proportions of Facies A, B, and C conglomerates, and overlain by hundreds of m-thick turbidite sandstones (Facies D) with scarce intervening fine-grained deposits. It is interpreted as vertically stacked and interconnected channel bodies formed by a trunk channel confined along the axis of the foredeep trough. The channel bodies in the southern part are classified into 5 architectural elements on the basis of large-scale bed geometry and sedimentary facies: (1) stacked sheets, indicative of bedload deposition by turbidity currents and typical of broad gravel bars in terrestrial gravelly braided rivers, (2) laterally-inclined strata, suggestive of lateral accretion with respect to paleocurrent direction and related to spiral flows in curved channel segments around bars, (3) foreset strata, interpreted as the deposits of targe gravel dunes that have migrated downstream under quasi-steady turbidity currents, (4) hollow fills, which are filling thalwegs, minor channels, and local scours, and (5) mass-flow deposits of Facies C. The stacked sheets, laterally inclined strata, and hollow fills are laterally transitional to one another, reflecting juxtaposed geomorphic units of deep-sea channel systems. It is noticeable that the channel bodies in the southern part are of feet stacked toward the east, indicating eastward migration of the channel thalwegs. The laterally inclined strata also dip dominantly to the east. These features suggest that the trunk channel of the Lago Sofia submarine channel system gradually migrated eastward. The eastward channel migration is Interpreted to be due to tectonic forcing imposed by the subduction of an oceanic plate beneath the Andean Cordillera just to the west of the Lago Sofia submarine channel.

Architecture and Depositional Style of Gravelly, Deep-Sea Channels: Lago Sofia Conglomerate, Southeyn Chile (칠레 남부 라고 소피아 (Lago Sofla) 심해저 하도 역암의 층구조와 퇴적 스타일)

  • Choe Moon Young;Jo Hyung Rae;Sohn Young Kwan;Kim Yeadong
    • The Korean Journal of Petroleum Geology
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    • v.10 no.1_2 s.11
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    • pp.23-33
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    • 2004
  • The Lago Sofia conglomerate in southern Chile is a lenticular unit encased within mudstone-dominated, deep-sea successions (Cerro Toro Formation, upper Cretaceous), extending from north to south for more than $120{\cal}km$. The Lago Sofia conglomerate is a unique example of long, gravelly deep-sea channels, which are rare in the modern environments. In the northern part (areas of Lago Pehoe and Laguna Goic), the conglomerate unit consists of 3-5 conglomerate bodies intervened by mudstone sequences. Paleocurrent data from these bodies indicate sediment transport to the east, south, and southeart. The conglomerate bodies in the northern Part are interpreted as the tributary channels that drained down the Paleoslope and converged to form N-S-trending trunk channels. In the southern part (Lago Sofia section), the conglomerate unit comprises a thick (> 300 m) conglomerate body, which probably formed in axial trunk channels of the N-5-trending foredeep trough. The well-exposed Lago Sofia section allowed for detailed investigation of sedimentary facies and large-scale architecture of the deepsea channel conglomerate. The conglomerate in Lago Sofia section comprises stratified conglomerate, massive-to-graded conglomerate, and diamictite, which represent bedload deposition under turbidity currents, deposition by high-density turbidity currents, and muddy debris flows, respectively. Paleocurrent data suggest that the debris flows originated from the failure of nearby channel banks or slopes flanking the channel system, whereas the turbidity currents flowed parallel to the orientation of the overall channel system. Architectural elements produced by turbidity currents represent vertical stacking of gravel sheets, lateral accretion of gravel bars, migration of gravel dunes, and filling of channel thalwegs and scoured hollows, similar to those in terrestrial gravel-bed braided rivers. Observations of large-scale stratal pattern reveal that the channel bodies are offset stacked toward the east, suggestive of an eastward migration of the axial trunk channel. The eastward channel migration is probably due to tectonic tilting related to the uplift of the Andean protocordillera just west of the Lago Sofia deep-sea channel system.

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Analysis of Clothing in a Painting Album of a 60th Wedding Anniversary Feast in the Collection of the National Museum of Korea (국립중앙박물관 소장 《회혼례도첩》 속 등장인물의 복식 고찰)

  • LEE Eunjoo
    • Korean Journal of Heritage: History & Science
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    • v.56 no.3
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    • pp.76-98
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    • 2023
  • The results of analyzing the outfits of male and female characters depicted in the "Hoehonryedocheop" (回婚禮圖帖, Deoksu 6375) held by the National Museum of Korea and estimating its production date of the "Hoehonryedocheop"are as follows. Firstly, an elderly groom is depicted wearing a patterned heukdanryeong (黑團領) with rank badges, a garment commonly donned by government officials in works such as "Jeonanryedo (奠鴈禮圖)" and "Gyobaeryedo (交拜禮圖)". And the old groom in "Heonsuryedo (獻壽禮圖)" "Jeobbindo (接賓圖)" and "Jungroeyeondo (重牢宴圖)" is shown wearing a jarip (purple hat) without a paeyoung (ornamental jewelry strap), accompanied by jade colored robe with a red strap belt. Gireokabeom (雁夫) is observed wearing a jarip (紫笠) adorned with a paeyoung (貝纓) and a patternless heukdanryeong with rank badges. Adult male descendants are depicted wearing dopo (道袍), while guests wear dopo, cheolrik (帖裏), and jikryeong (直領), accompanied by red and blue straps denoting their social status. Jingssi (徵氏), sidong (侍童), and young grandchildren are observed wearing jungchimak(中赤莫). The young servants are wearing jungchimak, and the boys carrying the food have braided their hair and worn sochangu (小氅衣), while adults servants wore jeonrip (氈笠) and sochangui. Performers are seen clad in a sochangui, jeonbok, and a blue sash around their waists. Secondly, the elderly bride is portrayed wearing a keunmeori (ceremonial headdress) and a green wonsam (圓衫) in "Gyobaeryedo," while in "Heonsuyeondo," she is depicted in a blue skirt and a jade colored jeogori (赤古里). Women descendants are shown adorning headdress decorations, such as binyeo(簪), banja(斑子) and pearl daenggi (眞珠唐紒) on their eoyeomeori (於于味, ceremonial headdress). They are further dressed in skirts of navy, red, and jade hues, paired with various-colored jeogori. Additionally, a woman wearing a navy skirt and a green jangot (長衣) is also depicted. The dongnyeo (童女, unmarried women) wear beolsaengmeri (娘子雙髻), headdress) with long binyeo and long dodaik-daenggi (都多益唐只). They wear chilbo-jokduri (七寶簇頭里) and a red skirt with a green hoejang-jeogori (回裝赤古里). Bija (婢子) wears garima (加里亇) on her eoyeomeori and is seen dressed in skirts and jeogori resembling those worn by noble women, albeit with lighter colors, shorter skirt length, and a subdued volume. Ginyeo's attire bears similarities to that of noble women, although with a dress with less vibrant tones and devoid of decorations on the eoyeomeori. Thirdly, based on the main character's jarip, along with the cheolrik and jikryeong worn by the guests, as well as the performances by musicians of the military camp, it is suggested that the main character of the 60th wedding anniversary is connected to the Ministry of Military Affairs or the military camp. Judging by the military band's short-sleeved vest, the silhouettes of the women dress, and the headdresses, it is likely that the "Hoehonryedocheop" was produced between the 1760s and 1780s.