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A Radiographic study of Fibro-osseous lesions of the jaw bones (악골 섬유성 골병소의 방사선학적 연구)

  • Kwon Kyung-Yun;Choi Karp-Shik
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.27-36
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    • 1998
  • The purpose of this study was to obtain information on the clinical and radiographic features of the fibro-osseous lesions in the jaws. For this study, the author examined and analysed the clinical records and radiographs of 71 cases of 68 patients in fibrous dysplasia, 35 cases of ossifying fibroma and 30 cases of 16 patients of periapical cemental dysplasia diagnosed by clinical and radiographic or histopathological examinations. The obtained results were as followings: L Fibrous dysplasia occurred most frequently in the 2nd decade (30.0%), ossifying fibroma in the 3rd-4th decades, periapical cemental dysplasia in the 4th decade, and all of three lesions showed slight predilection in females. In most cases, chief complaints were painless facial swelling in fibrous dysplasia and ossifying fibroma, and periapical cemental dysplasia was found accidentally in radiographs. 2. Fibrous dysplasia was occurred more frequently in maxilla, ossifying fibroma in mandible and both lesions in premolar-molar area. Periapical cemental dysplasia was occurred most frequently in the mandibular anterior area. The size of fibrous dysplasia was larger than that of ossifying fibroma, and the shape of ossifying fibroma was more round and elliptical than fibrous dysplasia whose was fusiform. 3. Fibrous dysplasia was shown homogeneous radiopaque shadow of 57.6% and ossifying fibroma & periapical cemental dysplasia were shown mixed appearance of radiolucency and radiopacity shadows at 74.2%, 60.0%, respectively. 4. Fibrous dysplasia was entirely shown poorly defined at 87.7%, but ossifying fibroma & periapical cemental dysplasia were shown well outlined at 60.0%, 70.0%, respectively. 5. Cortical thinning and expansion were observed in fibrous dysplasia and ossifying fibroma, and severe in ossifying fibroma than fibrous dysplasia, and those signs were not seen in periapical cemental dysplasia. Loss of lamina dura was dominant in fibrous dysplasia and root resorption was dominant in ossifying fibroma. Displacement of mandibular canal and the degree of the increase of vertical dimension were alike in both lesions. Displacement of maxillary sinus or nasal cavity, thinning & expansion of the maxillary sinus were dominant in fibrous dysplasia. 6. Polyostotic fibrous dysplasia was occurred at 5.9%, Multiple periapical cemental dysplasia at 43.7%. Occurrence rate in the edentulous area of fibrous dysplasia and ossifying fibroma were 7.0%, 8.6%, respectively.

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Incidence of Paresthesia Related to the Insertion Length of Catheter during the Epidural Catheterization (경막외강 카테터 삽입 시 삽입 길이와 감각이상의 빈도)

  • Lim, Jun Goo;Kim, Young Jae;Cho, Jae Heung;Lee, Sang Eun;Kim, Young Hwan;Lim, Se Hoon;Lee, Jeong Han;Lee, Kun Moo;Cheong, Soon Ho;Choi, Young Kyun;Shin, Chee Mahn
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.50-53
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    • 2007
  • Background: Continuous epidural catheterization is a popular and effective procedure for postoperative analgesia. However, continuous epidural catheterization has associated complications such as venous puncture, dural puncture, subarachnoid cannulation, suboptimal catheter placement, and paresthesia because the tip of the epidural catheter touches thenerves of the dura in the epidural space. In this study, we compared the incidence of paresthesia in two different lengths of epidural catheter insertion. Methods: One hundred women undergoing gynecologic or orthopedic surgery were enrolled in this prospective, double-blinded, randomized study. All patients were randomly divided into two groups based on the insertion length of the epidural catheter 2 cm (group A) or 4 cm (group B). A Tuohy needle was inserted in the lumbarspinal region with a bevel directed cephalad by use of the median approach, and then the epidural space was confirmed by the loss of resistance technique with air. While the practitioner inserted an epidural catheter into the epidural space, a blind observer checked for paresthesia or withdrawal movement. Results: In 97 included patients, 30.6% of the patients in group A (n = 49) had paresthesia, versus 31.3% in group B (n = 48). Withdrawal movements were represented in 2% and 6% of the patients in group A and group B, respectively. There was no difference in the incidence of paresthesia and withdrawal movement between the two groups. Conclusions: There is no clear relationship for the incidence of catheter-related paresthesia according to the catheter length inserted into the epidural space for epidural analgesia.

The furulamelllal study in order to obtain the hydrological design basis for hydrological structures in Korea (Run ofl estimate and Flood part) (한국에 있어서 제수문구조물의 설계의 기준을 주기 위한 수문학적 연구(류거, 홍수 편))

  • 박성우
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.8 no.1
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    • pp.1011-1034
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    • 1966
  • This thesis is the final report which has long been studied by the author to obtain the design basis for various hydrological constructions with the specific system suitable to the natural environmental conditions in Korea. This report is divided into two parts: one is to estimate runoff volume from watersheds and the other to estimate the peak discharge for a single storm. According to the result of observed runoff record from watersheds, it is known that Kajiyama formula is useful instrument in estimating runoff volume from watersheds in this country. But it has been found that this formula shows us 20-30% less than the actual flow. Therefore, when wihed to bring a better result, the watershed characteristics coefficient in this formula, that is, f-value, should be corrected to 0.5-0.8. As for the method to estimate peak discharge from drainage basin, the author proposes to classify it in two ways; one is small size watershed and the other large size watershed. The maximum -flood discharge rate $Q_p$ and time to peak Pt obtained from the observed record on the small size watershed are compared by various methods and formulas which are based upon the modern hydrological knowledge. But it was fou.d that it. was not a satisfied result. Therefore, the author proposes. tocomputate $Q_p$, to present 4.0-5.0% for the total runoff volume ${\Sigma}Q$.${\Sigma}Q$ is computed under the assumption of 30mm 103s in watershed per day and to change the theoritical total flow volume to one hour dura tion total flow rate when design daily storm is given. Time to peak Pt is derived from three parameters which are u,w,k. These are computed by relationship between total runoff volume (ha-m unit)and $Q_p$. (C.M.S. unit). Finally, the author checked out these results obtained from 51 hydrographs and got a satisfied result. Therefore the author suggested the model of design dimensionless unit-hydrograph. And the author believes that this model will be much available at none runoff record river site. In the large size watersheds in Korea when the maximum discharge occurs, the effective rainfall is two consequtive stormy days. So the loss in watershed was assutned as 6Omm/2days,and the author proposed 3-hour-daration hydrograph flow distribution percentage. This distribution percentage will be sure to form the hydrograph coordinate.

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Repair of Large Spinal Soft Tissue Defect Resulting from Spinal Tuberculosis Using Bilateral Latissimus Dorsi Musculocutaneous Advancement Flap: A Case Report (척추결핵으로 인한 광범위한 결손에 대해 양측 넓은등근전진피판술을 이용한 치험례)

  • Kim, Yeon-Soo;Kim, Jae-Keun
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.695-698
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    • 2011
  • Purpose: Since spinal tuberculosis is increasing in prevalence, it appears that a repair of spinal soft tissue defect as a complication of spinal tuberculosis can be a meaningful work. We report this convenient and practical reconstructive surgery which use bilateral latissimus dorsi musculocutaneous advancement flap. Methods: Before the operation, $13{\times}9.5$ cm sized skin and soft tissue defect was located on the dorsal part of a patient from T11 to L3. And dura was exposed on L2. Under the general endotrachel anesthesia, the patient was placed in prone position. After massive saline irrigation, dissection of the bilateral latissimus dorsi musculocutaneous flaps was begun just upper to the paraspinous muscles (at T11 level) by seperating the paraspinous muscles from overlying latissimus dorsi muscles. The plane between the paraspinous muscles fascia and the posterior edge of the latissimus dorsi muscle was ill-defined in the area of deformity, but it could be identified to find attachment of thoracolumbar fascia. The seperation between latissimus dorsi and external oblique muscle was identified, and submuscular plane of dissection was developed between the two muscles. The detachment from thoracolumbar fascia was done. These dissections was facilitated to advance the flap. The posterior perforating vasculature of the latissimus dorsi muscle was divided when encountered approximately 6 cm lateral to midline. Seperating the origin of the latissimus dorsi muscle from rib was done. The dissection was continued on the deep surface of the latissimus dorsi muscle until bilateral latissimus dorsi musculocutaneous flaps were enough to advance for closure. Once this dissection was completely bilateraly, the bipedicled erector spinae muscle was advanced to the midline and was repaired 3-0 nylon to cover the exposed vertebrae. And two musculocutaneous units were advanced to the midline for closure. Three 400 cc hemovacs were inserted beneath bilateral latissimus dorsi musculocutaneous flaps and above exposed vertebra. The flap was sutured with 3-0 & 4-0 nylon & 4-0 vicryl. Results: The patient was kept in prone and lateral position. Suture site was stitched out on POD14 without wound dehiscence. According to observative findings, suture site was stable on POD55 without wound problem. Conclusion: Bilateral latissimus dorsi musculocutaneous advancement flap was one of the useful methods in repairing of large spinal soft tissue defect resulting from spinal tuberculosis.

Treatment of Aplasia Cutis Congenita on Scalp using Hyalomatix$^{(R)}$: A Case Report (하이알로매트릭스를 이용한, 두개골결손을 동반한 선천성피부무형성증의 치료: 1례 보고)

  • Rhee, Suk-Hyun;Hong, Jong-Won;Roh, Tai-Suk;Kim, Young-Seok;Rah, Dong-Kyun
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.469-472
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    • 2010
  • Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.

Microsurgical Anatomy in Transoral Odontoidectomy (경구강 치상돌기제거술의 수술해부학)

  • Park, Kwan;Lee, Sang Koo;Cho, Tae Goo;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.309-316
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    • 2000
  • Objective :The transoral approach allows direct view of the ventral craniovertebral junction and provides useful management of the various lesions of this area. We present a step by step guide to the performance of the transoral excision of the odontoid process in the cadaveric model. Methods : Ten cadaver heads were used in fixed or unfixed state. We describe the relevant surgical anatomy in the cadaveric dissection and surgical technique of transoral transpharyngeal odontoidectomy. Results : The surgical procedure of transoral odontoidectomy was categorized by six steps;soft palate, posterior pharyngeal wall, muscular structures, osseous structures, odontoid process and ligaments, cruciate ligament and dura. Conclusion : With anatomical knowledge of these regions neurosurgeons can deal with wide variety of lesions in the ventral craniovertebral junction.

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The Sociocultural Codes for Interpreting Racism in Puerto Rico (푸에르토리코의 인종주의를 읽는 세 가지 사회문화적 코드)

  • Lee, Euna
    • Cross-Cultural Studies
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    • v.44
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    • pp.7-28
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    • 2016
  • This study examines the sociocultural background of negritude by delving into Caseríos, Reggaeton, and $Trigue{\tilde{n}}os$, which are interrelated with the racism deeply embedded in Puerto Rican society. These terms have also been discussed in relation to the ideological discourse of racial democracy, which has caused Puerto Rican people to be blind to silenced inequality and hegemonic racial policies. Caseríos, housing projects for the poor urban class, are targeted by the state - sponsored project 'Mano Dura'. Due to the policing, control and surveillance of this anticrime project, Caseríos became perceived even more as residential communities of violence, poverty, and insecurity generally connected to the stigmatization of blackness. Reggaeton emerged as a mega hit genre of transnational Puerto Rican music in the 2000s, which in turn, drew attention to both the afrodiaspora in New York and the urban musical power in the Island. This musical genre serves to highlight the meaningfulness of black heritage in the national cultural identity of Puerto Rico. $Trigue{\tilde{n}}idad$ has recently become a common racial cultural term that embraces a broader racial paradigm of mestizaje. This term can function as an alternative concept of blackness, but it has not yet been transformed into enough cultural politics to resist ongoing racial democracy. The three terms intrinsically address both the uprooted racism and potential methods of challenging it. This paper argues the necessity of stronger and more responsive cultural politics to defy the pervasiveness and invisibility of racial discrimination in Puerto Rico.

Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

  • Seong Bin Youn;Gyojun Hwang;Hyun-Gon Kim;Jae Seong Kang;Hyung Cheol Kim;Sung Han Oh;Mi-Kyung Kim;Bong Sub Chung;Jong Kook Rhim;Seung Hun Sheen
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.536-542
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    • 2023
  • Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. Results : Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4-333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006-0.762; adjusted OR, 0.068; 95% CI, 0.006-0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion : Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

The Performance Evaluation of In-situ Carbonation Mortar Using Gaseous CO2 (기체 CO2를 사용한 In-situ 탄산화 모르타르 성능평가)

  • Changgun Park;Deukhyun Ryu;Seongwoo Choi;Kwangwoo Wi;Seungmin Lim
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.11 no.3
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    • pp.226-233
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    • 2023
  • In this study, two phases were conducted to investigate the direct injection of gaseous CO2 into cement mortar. The aim was to advance carbon capture, utilization, and storage (CCUS) technology by harnessing industrial waste CO2 from the domestic ready-mixed concrete industry. In the first phase, the factors influencing the physical properties of cement mortar when using gaseous CO2 were identified. This included a review of materials to achieve physical properties comparable to a reference formulation. As a result of this phase, it was confirmed that traditional approaches, such as adjusting the water-to-cement ratio, had limitations in achieving the desired physical properties. Consequently, the second phase focused on the optimization of CO2-injected mortar. This involved studying the CO2 application and mixing method for cement mortar. Changes in properties were observed when gaseous CO2 was injected into the mortar. The optimal injection quantity and time to enhance the compressive strength of mortar were determinded. As a result, this study indicated that an extra mixing time exceeding 120 seconds was necessary, compared to conventional mortar. The optimal CO2 injection rate was identified as 0.1 to 0.2 % by weight of cement, taking both flowability and compressive strength performance into account. Increasing the CO2 injection time did not further enhance strength. For this approach to be employed as a CCUS technology, additional studies are required, including a microstructural analysis evaluating the amount of immobilized CO2.

Imaging of Sequestered Lumbar Discs (요추 분리추간판의 영상 소견)

  • Gangwon Jeong;Heecheol Park;Sun Joo Lee;Dae-Hyun Park;Sung Hwa Paeng;Eugene Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.3-23
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    • 2024
  • Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.