• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.38.1-38.6
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• 2015

Background: The posterior movement of mandible was known as the main cause of the changes in the pharyngeal airway space (PAS) and the postoperative obstructive sleep apnea (OSA). The purpose of this study was to know the changes of PAS and position of hyoid bone. Methods: Lateral cephalographies of 13 patients who had undergone sagittal split ramus osteotomy (SSRO) setback surgery were taken preoperatively (T1), postoperatively within 2 months (T2), and follow-up after 6 months or more (T3). On the basis of F-H plane, diameters of nasopharynx, oropharynx, and hypopharynx were measured. The movements of the soft palate, tongue, and hyoid bone were also measured. Results: The amount of mandible setback was $7.5{\pm}3.8mm$. In the measurements of PAS, there was a statistically significant decrease of $2.8{\pm}2.5mm$ in nasopharynx (P < 0.01), and $1.7{\pm}2.4mm$ in oropharynx (P < 0.01) were observed after surgery. The hypopharynx decreased $1.0{\pm}2.1mm$ after surgery and continuously decreased $1.0{\pm}2.8mm$ at follow-up. The changes in hyoid bone position showed the posterior movement only after surgery and posteroinferior movement at follow-up. Conclusions: The PAS such as nasopharynx, oropharynx, and hypopharynx showed relatively high correlation with the amount of mandibular setback. The change of resistance in upper airway may be important for the prevention of OSA after mandibular setback surgery.

• Geotechnical Engineering
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• v.5 no.1
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• pp.47-60
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• 1989

Lateral earth Pressure distributions due to the ,randy soil backfill behind the rigid vertical walls for three different wall movement modes are obtained by the elasto-plastic finite element analys of soil deformation, and these earth pressures are compared with both Rankine's and Dubrova's active earth pressures. Thereby, the effects of the magnitude and the mode of wall displacement on the earth pressure distribution are investigated. Three different modes of wall movement considered in this study are the rotation about bottom, the rotation about top and the translation. For the case of the wall rotation about top, the earth pressure distribution is shown as a reverse S-curve-shaped distribution due to the arching effect. Consequently, the point of application of the lateral thrust is much higher than one-third of the wall height from the base. And, comparing the other modes of wall movement, the magnitude and the point of appliestion of the lateral thrust for the wall rotation about top are larger and higher, respectively. The wedge-shaped plastic zone in the backfill at active failure is developed only for the mode of wall rotation about bottom. The lateral earth pressure distributions on the walls with inclined backfill of several different slopes are shown for the mode of wall rotation about bottom.

• Archives of Reconstructive Microsurgery
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• v.23 no.2
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• pp.101-104
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• 2014

Reconstruction of soft tissue defects of the knee has always been a challenging task for plastic surgeons. Various reconstructive choices are available depending on the location, size, and depth of the defect relative to the knee joint. Defects on the knee joint have several characteristic features. The use of a free flap is preferred for reconstructions involving obliteration of large-cavity defects, but recipient pedicle isolation can be difficult because of the extent of the injury zone. Furthermore, the true defect during knee joint flexion is larger than during knee joint extension, and a durable flap is necessary for joint movement. We report for the first time on the use of pedicled perforator flaps for reconstruction of bilateral knee defects in a 76-year-old woman. The operative procedure required skeletonizing the perforators of an antero-lateral thigh flap and antero-medial thigh flap and rotating the flap in the defect. The patient returned to normal daily activity and had a full range of motion two months after the accident. The shorter operating time with decreased donor site morbidity and its durability make this flap a valuable alternative for soft tissue reconstruction of the knee.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.128-131
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• 2017

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

• The Plant Pathology Journal
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• v.32 no.6
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• pp.508-518
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• 2016

Early blight of tomato caused by Alternaria solani, is responsible for severe yield losses in tomato. The conidia survive on soil surface and old dry lower leaves of the plant and spread when suitable climatic conditions are available. Macroclimatic study reveals that highest inoculum concentration of Alternaria spores appeared in May 2012 to 2013 and lowest concentration during January 2012 to 2013. High night temperature positively correlated and significantly (P < 0.01) involved in conidial spore dispersal and low relative humidity (RH) displayed significant (P < 0.05) but negative correlation with conidial dispersal. The objective of the study was to modify microclimatic conditions of tomato crop canopy which may hamper conidial dispersal and reduce disease severity. We evaluated effect of marigold intercropping and plastic mulching singly and in consortia on A. solani conidial density, tomato leaf damage and microclimatic parameters as compar to tomato alone (T). Tomato-marigold intercropping-plastic mulching treatment (T + M + P) showed 35-39% reduction in disease intensity as compared to tomato alone. When intercropped with tomato, marigold served as barrier to conidial movement and plastic mulching prevented evapotranspiration and reduced the canopy RH that resulted in less germination of A. solani spores. Marigold intercropping and plastic mulching served successfully as physical barrier against conidial dissemination to diminish significantly the tomato foliar damage produced by A. solani.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.660-662
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• 2005

It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.524-527
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• 2007

Purpose: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. Methods: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. Results: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. Conclusion: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.35-39
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• 2023

Solitary fibrous tumor (SFT), which was initially believed to be a subtype of mesothelioma, has been reported to occur outside the pleura. In the head and neck region, it primarily manifests in the oral or nasal cavity, with rare occurrences in the facial region. A 40-year-old woman visited our hospital with a mass on her chin. Prior to surgery, involuntary movement was observed in the ipsilateral corner of the mouth upon palpation of the mass. Special care was taken during the surgical procedure to avoid damaging the facial nerve. The mass was excised, and histological examination and immunohistochemical analysis confirmed the diagnosis of an SFT. Here, we present the first reported case of an SFT diagnosed in a jaw mass in Korea. The objective of this study was to highlight the importance of the diagnostic accuracy of SFTs in lower jaw masses.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.294-297
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• 2006

Lymphedema is one of the most common complications of mastectomy. It decreases quality of life and causes functional or aesthetical problems in post-mastectomy patients. Axillary lymph needs dissection (ALND), and radiation therapy(RTx) is known as the representative factor of lymphedema. Authors discovered that breast reconstructions using latissimus dorsi(LD) myocutaneous flap decrease the incidence of lymphedema in spite of these risk factors. Therefore we compared the incidence of lymphedema between the patients who underwent breast reconstructoins by LD pedicled flap, and the patients who did not undergo breast reconstructions from January 2002 to December 2004. Lymphedema was diagnosed when difference of arm circumference was over 2cm or limitation of joint movement was greater than 20 degrees. Overall incidence of lymphedema was 14.0%, and it was 18.9% in case of ALND, and 21.1% in case of RTx, respectively. But the incidence of breast-reconstructed patients using LD pedicled flap was 3.3%. This result reveals that LD pedicled flap decreases incidence of lymphedema significantly. In the future, it is recommended to identify the causes of decrease in the incidence of lymphedema in case of breast reconstructed by LD myocutaneous pedicled flap, for example lymphoscintigraphy and so on.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.383-387
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• 2007

Purpose: A necrotizing fasciitis is a rare, but insidiously advancing fatal soft tissue infection characterized by extensive fascial necrosis. Diagnosis & treatment of this disease are difficult. Necrotizing fasciitis tend to begin with constitutional symptoms of fever and chills. Quite a many lab studies and imaging studies such as standard radiography, computerized tomography can be used, but nothing can confine the extent of affected tissue. Aggressive surgical interventions are often required because of large skin and soft tissue deformity. However, many patients with necrotizing fasciitis are not healthy enough to overcome aggressive surgical intervention. Methods: Since 2000, we treated 10 patients with necrotizing fasciitis. In 4 patients, we used magnetic resonance imaging(MRI) as a tool for diagnosis as soon as necrotizing fascitiis was doubted. We treated patients with delayed coverage with Alloderm$^{(R)}$ & split thickness skin graft or delayed wound closure in as many cases as possible. Results: In 4 patients using preoperative MRI, diagnosis could be made in earlier stage of the disease compared to other patients. Our treatment modality was debridement and coverage with Alloderm$^{(R)}$ & split thickness skin graft. We could reconstruct deformities without significant limitation of movement in 7 cases. Conclusion: We diagnosed and treated 10 necrotizing fasciitis with MRI and Alloderm$^{(R)}$ graft, and results were good.