• Title/Summary/Keyword: proper technique

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Novel anatomical proposal for botulinum neurotoxin injection targeting depressor anguli oris for treating drooping mouth corner

  • Kyu-Ho Yi;Ji-Hyun Lee;Hye-Won Hu;You-Jin Choi;Kangwoo Lee;Hyung-Jin Lee;Hee-Jin Kim
    • Anatomy and Cell Biology
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    • v.56 no.2
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    • pp.161-165
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    • 2023
  • The depressor anguli oris (DAO) muscle is a thin, superficial muscle located below the corner of the mouth. It is the target for botulinum neurotoxin (BoNT) injection therapy, aimed at treating drooping mouth corners. Hyperactivity of the DAO muscle can lead to a sad, tired, or angry appearance in some patients. However, it is difficult to inject BoNT into the DAO muscle because its medial border overlaps with the depressor labii inferioris and its lateral border is adjacent to the risorius, zygomaticus major, and platysma muscles. Moreover, a lack of knowledge of the anatomy of the DAO muscle and the properties of BoNT can lead to side effects, such as asymmetrical smiles. Anatomical-based injection sites were provided for the DAO muscle, and the proper injection technique was reviewed. We proposed optimal injection sites based on the external anatomical landmarks of the face. The aim of these guidelines is to standardize the procedure and maximize the effects of BoNT injections while minimizing adverse events, all by reducing the dose unit and injection points.

Novel anatomical guidelines for botulinum neurotoxin injection in the mentalis muscle: a review

  • Kyu-Ho Yi;Ji-Hyun Lee;Hye-Won Hu;Hyun-Jun Park;Hyungkyu Bae;Kangwoo Lee;Hee-Jin Kim
    • Anatomy and Cell Biology
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    • v.56 no.3
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    • pp.293-298
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    • 2023
  • The mentalis muscle is a paired muscle originating from the alveolar bone of the mandible. This muscle is the main target muscle for botulinum neurotoxin (BoNT) injection therapy, which aims to treat cobblestone chin caused by mentalis hyperactivity. However, a lack of knowledge on the anatomy of the mentalis muscle and the properties of BoNT can lead to side effects, such as mouth closure insufficiency and smile asymmetry due to ptosis of the lower lip after BoNT injection procedures. Therefore, we have reviewed the anatomical properties associated with BoNT injection into the mentalis muscle. An up-to-date understanding of the localization of the BoNT injection point according to mandibular anatomy leads to better injection localization into the mentalis muscle. Optimal injection sites have been provided for the mentalis muscle and a proper injection technique has been described. We have suggested optimal injection sites based on the external anatomical landmarks of the mandible. The aim of these guidelines is to maximize the effects of BoNT therapy by minimizing the deleterious effects, which can be very useful in clinical settings.

The Effects of Cervical Spine Mobilization versus Manipulation on Pain, Disability, and Satisfaction in Subjects with Non-specific Mechanical Neck Pain

  • Alfredo Loreto;Everett Lohman;Lida Gharibvand;Trevor Lohman;Berk Lee
    • Physical Therapy Rehabilitation Science
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    • v.13 no.3
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    • pp.261-273
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    • 2024
  • Background: Several studies have found an association between cervical spinal mobilizations (CSMob) and cervical spinal manipulations (CSM) on pain perception, disability, and satisfaction. However, choosing the proper technique continues to be a challenge for many practitioners. Objectives: To study the effects of a single session of cervical spinal mobilization versus cervical spinal manipulation on pain, disability, and satisfaction. Design: Randomized clinical trial. Methods: 36 subjects with acute and non-specific mechanical neck pain were randomly assigned to one of 3 groups (CSMob, CSM, or control). Outcome measures using the Neck Disability Index (NDI), Numeric Pain Rate Scale (NPRS), and Global Rate of Change (GROC) were quantified at baseline, 5-minutes post, and 4 days post corresponding intervention. Results: The CSM group showed significant increase in GROC (p=0.025) compared to the CSMob and control groups (p=0.472 and p=0.176 respectively) over time. There was a significant decrease in NPRS for the CSM and CSMob groups (p=0.002 and p=<0.001) and a non-significant decrease in NPRS (p=0.642) in the control group over time. Similarly, there was a significant decrease in NDI for the CSM and CSMob groups (p=<0.001 and p=<0.001) and a non-significant decrease in NDI (p=0.084) in the control group over time. Conclusion: Our study findings suggest that skilled manual therapy interventions can be a viable and effective treatment option for reducing neck pain, disability, and perceived favorable change following a single session on subjects with acute, non-specific mechanical neck pain.

Unilateral approach for bilateral clipping of posterior communicating artery aneurysms in a hybrid operating room: A technical note

  • Juan Luis Gomez-Amador;Pablo David Guerrero-Suarez;Jaime Jesus Martinez-Anda;Jorge Fernando Aragon-Arreola;Andrea Castillo-Matus;Ricardo Marian-Magana;Marcos V Sangrador-Deitos;Alan Hernandez-Hernandez;Ernesto Javier Delgado-Jurado;Ricardo Santiago Villagrana-Sanchez;Abraham Gallegos-Pedraza;Jorge Luis Diaz-Espinoza
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.468-472
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    • 2023
  • Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.

3D Printed Joining System Inspired by Traditional Japanese Wooden Joinery for ISRU

  • Yusuke Hozumi;Takehiro Wakita;Ayato Doki;Hiroto Takaguchi;Tatsuya Inden;Shinjiro Umezu;Yuji Miyazu
    • International conference on construction engineering and project management
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    • 2024.07a
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    • pp.1325-1325
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    • 2024
  • This research presents a joining system that changes an irregularly shaped material into a member that can be joined and disassembled as a single unit by attaching 3D printed joints. In extreme environments, including extraterrestrial environments, it takes much time and costs to supply materials from Earth. In addition, when living and working in such environments for long periods, a technology enabling the use of locally accessible materials or elements brought to the site for different purposes is essential to realize the construction based on the idea of In-Situ Resource Utilization (ISRU). This research proposes a joining system inspired by the traditional Japanese wooden joinery Kigumi. By integrating Kigumi's excellent features, such as high construction performance, disassemble performance, and mechanical performance, with 3D printing and 3D scanning technologies, the proposed joining system aims to enable irregular-shaped elements to be assembled and disassembled from one another without any fasteners (e.g., bolts, nails, and adhesive). Prototypes of the proposed joints, which apply the Japanese Koshikake-Ari-Tsugi technique, were printed by an additive manufacturing-type desktop 3D printer, then the investigation focused on determining the optimal clearance for the joint. Based on the results, a simple mockup was constructed. Its constructability and mechanical performance were examined. The findings revealed that the joints applying the traditional Japanese Kigumi were printable by the additive manufacturing-type desktop 3D-printer with proper clearance settings, and the proposed joining system shows high performance in construction, including disassembly. The findings provide insights into the feasibility of desktop 3D printing construction in extreme environments.

Comparison of the Results in Gastric Carcinoma Patients undergoing Billroth I and Billroth II Gastrectomiesy (원위부 위암에서 위절제술 후 위재건술식에 따른 잔위기능 및 영양 증상학적 삶의 질 비교)

  • Kim, Sung Geun;Kim, Young Kyun;Heo, Youn Jung;Song, Kyo Young;Kim, Jin Jo;Jin, Hyung Min;Kim, Wook;Park, Cho Hyun;Park, Seung Man;Lim, Keun Woo;Kim, Seung Nam;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.16-22
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    • 2007
  • Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.

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Optimization of Support Vector Machines for Financial Forecasting (재무예측을 위한 Support Vector Machine의 최적화)

  • Kim, Kyoung-Jae;Ahn, Hyun-Chul
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.241-254
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    • 2011
  • Financial time-series forecasting is one of the most important issues because it is essential for the risk management of financial institutions. Therefore, researchers have tried to forecast financial time-series using various data mining techniques such as regression, artificial neural networks, decision trees, k-nearest neighbor etc. Recently, support vector machines (SVMs) are popularly applied to this research area because they have advantages that they don't require huge training data and have low possibility of overfitting. However, a user must determine several design factors by heuristics in order to use SVM. For example, the selection of appropriate kernel function and its parameters and proper feature subset selection are major design factors of SVM. Other than these factors, the proper selection of instance subset may also improve the forecasting performance of SVM by eliminating irrelevant and distorting training instances. Nonetheless, there have been few studies that have applied instance selection to SVM, especially in the domain of stock market prediction. Instance selection tries to choose proper instance subsets from original training data. It may be considered as a method of knowledge refinement and it maintains the instance-base. This study proposes the novel instance selection algorithm for SVMs. The proposed technique in this study uses genetic algorithm (GA) to optimize instance selection process with parameter optimization simultaneously. We call the model as ISVM (SVM with Instance selection) in this study. Experiments on stock market data are implemented using ISVM. In this study, the GA searches for optimal or near-optimal values of kernel parameters and relevant instances for SVMs. This study needs two sets of parameters in chromosomes in GA setting : The codes for kernel parameters and for instance selection. For the controlling parameters of the GA search, the population size is set at 50 organisms and the value of the crossover rate is set at 0.7 while the mutation rate is 0.1. As the stopping condition, 50 generations are permitted. The application data used in this study consists of technical indicators and the direction of change in the daily Korea stock price index (KOSPI). The total number of samples is 2218 trading days. We separate the whole data into three subsets as training, test, hold-out data set. The number of data in each subset is 1056, 581, 581 respectively. This study compares ISVM to several comparative models including logistic regression (logit), backpropagation neural networks (ANN), nearest neighbor (1-NN), conventional SVM (SVM) and SVM with the optimized parameters (PSVM). In especial, PSVM uses optimized kernel parameters by the genetic algorithm. The experimental results show that ISVM outperforms 1-NN by 15.32%, ANN by 6.89%, Logit and SVM by 5.34%, and PSVM by 4.82% for the holdout data. For ISVM, only 556 data from 1056 original training data are used to produce the result. In addition, the two-sample test for proportions is used to examine whether ISVM significantly outperforms other comparative models. The results indicate that ISVM outperforms ANN and 1-NN at the 1% statistical significance level. In addition, ISVM performs better than Logit, SVM and PSVM at the 5% statistical significance level.

Total Arterial 011-Pump Coronary Revascularization with Multiple Y Arterial Composite Grafts (다중 복합 Y 동맥 이식편(Multiple Y Composite Craft)을 이용한 완저너 동맥 무인공 심폐바이패스 관상동맥우회술)

  • Kim Do-kyun;Lee Kyo Jgon;Joo Hyun Chul;Li Gyjong;Ahn Jiyoung;shim Yungee;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.551-556
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    • 2005
  • Background: Complete arterial off-pump coronary artery bypass grafting (OPCAB) by sequential anastomoses with one or two arterial grafts provides favorable outcomes. However, problems of insufficient graft length, hypopefusion, kinking of graft, and unfavorable course of graft may be encountered. To solve these problems, we have used different technique with multiple arterial Y composite graft to allow end-to-side rather than sequential anastomoses and evaluated the results of this method. Material and Method: Between February 2003 and October 2004, If patients underwent total arterial OPCAB using multiple arterial V composite grafts with left internal mammary artery (LIMA), radial artery (RA), and right internal mammary artery (RIMA). We divided RA into multiple segments by number of distal target site after measuring of individual proper length and constructed arterial composite graft. One of segments was sutured end-to-side to LIMA and other segment was sutured end-to-side to the previously constructed radial graft. Postoperative graft patency was evaluated in 6f patients by multi-slice computed tomegraphy. Result: An average of $2.5\pm0.6$ arteries and $3.7pm0.7$ distal anastomoses per patient were done. There was no perioperative myocardial infarction, clinical hypoperfusion syndromes, and operative mortality. Postoperative mean CK-MB level was $17.4pm29.7\;IU/L.$Overall graft patency was $99.1\%\;(214/216)(LIMA:\;100\%,\;RA:\;98.4\%,\;RIMA:\;100\%).$ Conclusion: This technique allows total arterial OPCAB without technical problems and provides excellent early clinical results and graft patency. We believe that this technique is more convenient in the obtuse marginal area compared to sequential technique, and helpful in patients who require complex arterial grafting.

Transition of Rice Culture Practices during Chosun Dynasty through Old References V. Cultivation and Cropping Patterns (주요 고농서를 통한 조선시대의 도작기술 전개 과정 연구 V. 재배양식)

  • Lee, Sung-Kyum;Guh, Ja-Ok;Lee, Eun-Woong;Lee, Hong-Suk
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.37 no.1
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    • pp.104-115
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    • 1992
  • The rice culture techniques included 'Jodosukyungbeob'(旱稻水耕法 : culture techniques of early-ripening paddy rice), 'Mandosukyungbeob' (晩稻水耕法) : culture techniques of late-Ripening paddy rice 'Handobeob'(旱稻&lt;山稻&gt;法 : culture techniques of upland rice), 'Myojongbeob'(苗種法 : culture techniques of paddy rice by transplanting), 'Kunangbeob'(乾秧法 : culture techniques of rice by transplanting which rears seeding in dry paddy) and 'Sudogunpanongbeob'(水稻乾播農法 : culture techniques of paddy rice seeding in dry field). Especially, 'Kunangbeob' and 'Sudogunpanongbeob' were originally developed in Korea as seen in 1600s(Kyoungje : 經濟) and early 1800s (Yoji : 要旨). In 'Jodosukyungbeob' it took 9 days for seed dipping, water-sprouting and prevent damage by birds, each for 3 days in China, but in Korea seed dipping in water took 3 days and the rest of the procedures were flexibly established. In matured soils, practices were fall plowing right after harvest, recognition of effective tillering and additional fertilization use of human manure, and stimulation of sprouting by lime application. The unique culture techniques adequate for Korean situations were practiced, which included weed control after draining accurately for 3 to 4 times, draining at mid season for improving wind and drought tolerance, rice harvesting at appropriate time for preventing grain shattering, and seeding in rows. 'Mandosukyungbeob' was improved techniques contrast to those of China, and the major contents were selection of proper varieties, good stand establishment by seeding high rates, induction of vigorous tillers, and adoption of 'Jokjongbeob'(足種法 : seeding method by foot). Also, one of the most prominent rice cultures by our ancestors was 'Kunpanongbeob' that was systemized form habitual practice of Pyongan Province. The unique technique actualized was 'Hando [旱稻(山稻)]' culture technique which was the combinations of 'Jokjongbeob', root stimulation method, and disaster-tolerant mixture cropping with adoptation of variety theory, although it was originated from China. The transplanting techniques has come before 'Jikseol'($\ulcorner$直說$\lrcorner$) and its merits were sufficiently realized. However, this method was basically prohibited from the early Chosun dynasty because extremely bad harvest was expected under drought conditions and insufficient conditions of water storage. But, it was permitted in the areas that contained water all the times and in case of large-scale farming especially. Most of rice culture was transplanted in the end of the Chosun dynasty because transplanting was continuously spreaded in the three southern provinces of Korea. Under these circumstances, transplanting technique was improved from the early to the end of the Chosun dynasty by weed control, fertilizing, water management, and quadratic transplanting. Based on these techniques, agricultural productivity was improved 5 times by that time. 'Kunpanongbeob' was created and developed properly for Korean conditions that is dry in early season and flooding in late season. This was successively developed and established into transplanting technique of nursery seedling.

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HISTOLOGICAL CHANGES IN THE ELONGATED BONE AFFECTED BY OSTEODISTRACTION OF THE MANDIBLE IN THE DOG (성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화)

  • Baek, Sun-Ho;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.404-416
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    • 2001
  • Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

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