• Archives of Plastic Surgery
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• 제41권6호
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• pp.679-685
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• 2014

Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.161-165
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• 2011

Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

• 한국구조물진단유지관리공학회 논문집
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• 제15권2호
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• pp.51-60
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• 2011

본 연구에서는 환경적인 요인으로 인한 성능저하현상으로 내구성 저하가 예상되는 건대-구의간 고가교의 현재 상태를 분석하고 내구성 저하로 인한 내구연한의 감소를 막기 위하여 고가교 구조물의 경량화를 통한 성능개선을 수행하고자 한다. 경량화 작업은 콘크리트 방음벽을 경량재 방음벽으로, 도상을 자갈도상에서 콘크리트 도상으로, 마지막으로 트라프를 경량화 함으로써 고가교 전체의 경량화를 유도한다. 이러한 고가교 경량화에 따른 정적 및 동적 거동 변화와 성능개선 효과를 분석하고, PSC I 형교 구간의 내하율 증진에 의한 구조안전성을 확인한다. 경량화 결과 구조물의 처짐이 2.6mm가 감소하고 1.07MPa의 인장응력이 감소된 것으로 평가되어 대상 구조물의 구조성능이 효과적으로 개선되었음을 알 수 있다. 고유진동수도 경량화에 따라 약 30% 증가하여 진동이 감소하고 동적거동이 향상되었다. 또한, 해석 및 계측 결과를 근거로 하여 대상교량의 내하력을 평가한 결과, 경량화에 따라 내하율이 1.82에서 1.93으로 증가하여 경량화에 따른 성능개선 효과가 우수한 것으로 판명되었다.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.248-253
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• 2018

목적: 변형-내초점 핀 고정술을 통한 골성 망치 수지의 해부학적인 직접 정복에 대한 임상적 결과를 알아보고자 한다. 방법: 2014년 3월부터 2017년 10월까지 18명의 골성 망치 수지 환자를 대상으로 K-강선을 이용하여 골편을 직접 정복하는 방법인 변형-내초점 핀 고정술을 시행하였다. 수술 후 통증, 관절 운동 범위, 방사선적인 평가를 시행하였다. 또한 골유합 시기, 기능 회복 정도, 합병증 발생률을 평가하였고, 수술 후 기능적 예후를 판정하기 위해 Crawford의 평가 기준을 이용하였다. 결과: 평균 6주(5-7주)에 방사선적 골유합을 얻었다. 전체 환자에서 평균 $2.8^{\circ}$ ($0^{\circ}-10^{\circ}$)의 신전 소실(extension loss)이 발생하였다. 모든 환자에서 관절면의 일치와 만족스러운 관절면의 재형성이 관찰되었으며, 최종 외래 추시에서 원위지간 관절의 평균 굴곡각은 $72.2^{\circ}$ ($70^{\circ}-75^{\circ}$)였다. Crawford의 평가 기준으로 아주 만족이 12명(66.7%), 만족이 6명(33.3%)이었다. 결론: 변형-내초점 핀 고정술은 골편을 직접 정복 후 고정하여 해부학적 정복을 얻는 방법으로 기존의 다른 경피적 핀 고정술들과 결합하여 적절한 적응증에 적용한다면 좋은 결과를 얻을 수 있을 것으로 기대한다.

• 한국항해항만학회:학술대회논문집
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• 한국항해항만학회 1994년도 추계학술발표회
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• pp.49-58
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• 1994

The methods of estimation of VTS effectivenss are compared and the worldwide literature related to the VTS effectiveness is reviewed. The review suggests three potential approaches ; simulation ; synthesis of expert opinion and statistical analysis of casualties. this study adopted dissimilar approaches to estimate the VTS effectiveness to the earlier studies ; the combination of synthesis of expert opinion and causal analysis of casualty. The VTS effectiveness is derived by multiplying casualty rate reduction factors by the effect level of causal factors. The development of casualty rate reduction factors was based on the questionnaire survey and the evolution of effect levels was based on the causal analysis using functional block diagram. According to these procedures the maximum benefit to be obtained through the introduction of a VTS system was approximately 46 percent overall. The collision reduction rate was estimated to be approximately 50 percent for a VTS system with advanced radar surveillance. And 47 percent of groundings 36 percent of rammings and 21 percent of founderings could be reduced by the introduction of VTS. These figures are more or less the same to the earlier studies. The VTS effectiveness by the different causal factor groups was examined. VTS may reduce about 68 percent of causal factors classified as environmental conditions 40 percent of human factors and 35 percent of technical factors in collision accidents. As a whole 60 percent of environmental factors 41 percent of human factors and 20 percent of technical factors may be prevented by a VTS. The key variable of the effectiveness percentage is the value of weight coefficient $\delta$. Therefore differing values for this input was discussed and the impact that these variations have on the VS effectiveness noted. As the results of sensitivity analysis of VTS effectiveness by $\pm$10 percent the effectiveness is varied approximately three to seven percent by casualty type. And the value is changed roughly four to eight percent by a $\pm$10 percent variation by different sub-areas.

• 한국지진공학회논문집
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• 제16권3호
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• pp.13-22
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• 2012

지반-구조물의 상호작용은 구조물의 동적 해석 및 기초 설계에 있어 지대한 영향을 미침에도 불구하고 그 중요성이 간과되어 왔다. 이는 모델링 과정의 복잡성으로 인해 실무자를 위한 적절한 절차가 미비 하다는 점에서 상당부분 그 이유를 찾을 수 있을 것이다. 본 연구에서는 먼저 구조물의 동적 해석이 필수적으로 요구되는 강진지역인 미국 캘리포니아에 위치한 Cal(IT)2 건물을 대상으로 지반 경계조건을 달리했을 시 해석상의 차이가 어느 정도 나는지를 검토해 보았다. 기초 모델링 기법의 하나인 Beam on Nonlinear Winkler Foundation Model을 Linear Matrix Inequalities Model Reduction 기법을 활용하여 보다 간략하게 사용할 수 있도록 하였다. 이렇게 하여 만들어진 대상 건물의 유한요소 모델과 실재 얻어진 가속도 데이터를 비교하여 제시된 방식을 통해 매우 우수한 해석 결과를 얻을 수 있음을 보였다.

• 청정기술
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• 제9권2호
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• pp.87-100
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• 2003

본 연구는 청정생산기술의 개념을 염색가공분야에 도입시키기 위한 방법론을 제시한 것이다. 먼저 각 분야별 전문가로 이루어진 진단지도팀을 구성하여 대상업체에서 진행중인 제조공정 진행상태를 파악하고 사용하는 원부자재의 성능 및 환경적 분석과 폐수의 환경적 분석을 실시하였다. 원부자재(조제 및 염료)의 환경성은 TOC, CODMn, CODCr, $BOD_5$의 항목으로 평가하였고, 발생되는 폐수는 TOC, CODMn, CODCr, $BOD_5$, TDS, pH의 항목으로 평가하였다. 또 물질수지 분석과 LCA 평가 후 다음 단계로 공정, 에너지, 원부자재, 생산관리, 일반관리에서의 문제점을 도출한 후 그 중에서 개선 대상을 선정하고 마지막 단계에서 각 부분에 대해 지도하여 개선토록 한 후 최종 개선 효과를 분석하였다.

• Preventive Nutrition and Food Science
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• 제12권3호
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• pp.167-172
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• 2007

This study was conducted to determine the effect of hygienic processing (HP) on the reduction of microorganisms during manufacturing of saengshik with two vegetables (carrots and cabbage) and two grains (barely and glutinous rice) compared to general processing (GP). For GP, distilled water was used for washing raw materials and equipment. For HP, aqueous ozone (3 ppm) in combination with 1% citric acid and 70% alcohol were used for washing raw materials and the equipment, respectively. In carrots, after cutting, total aerobic bacteria (TAB), yeast and mold (YM) and coliforms were significantly increased to 5.19, 8.04 and 2.08 ($log_{10}$ CFU/g), respectively (p<0.05). Washing effectively reduced the increased microorganisms from cross contamination during cutting, but cross contamination increased with subsequent GP drying and milling procedures to 8.56, 8.27 and 3.71 ($log_{10}$ CFU/g) for TAB, YM and coliforms, respectively (p<0.05). On the other hand, HP washing of carrots with 3 ppm ozone in combination with 1% citric acid showed higher antimicrobial effect than GP washing, significantly decreasing the number of microorganisms (p<0.05). Further cross contamination did not occur through drying and milling due to cleaning the equipments with 70% alcohol prior to processing. After milling, the number of TAB, YM and coliforms were significantly decreased to 3.89, 4.47 and not detectable level ($log_{10}$ CFU/g), respectively (p<0.05). Similar results were observed in cabbage and grains. During storage for two months at different temperatures (22 or $4^{\circ}C$), there were no changes in numbers of spoilage microorganisms in the packaged saengsik after either processing. This suggests the importance of HP for the reduction of microorganisms during saengsik production, and demonstrates the effectiveness of disinfection at each processing stage in minimizing contamination levels to enhance microbial safety of saengshik products.

• Journal of Oral Medicine and Pain
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• 제31권2호
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• pp.177-183
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• 2006

관절강세정술은 통상의 보존적 치료법에 실패한 측두하악관절장애 환자에서 합병증의 위험성이 높은 침습적인 외과적 수술법에 대신하여 첫 번째로 고려될 수 있는 치료법이다. 본 증례의 환자들은 측두하악관절의 비정복성 관절원판변위로 진단되어 지속적인 교합안정장치치료, 행동요법치료, 물리치료, 약물치료 등의 보존적 치료에도 불구하고 심한 관절동통과 하악운동범위의 제한을 호소하였다. 따라서 보존적 치료법에 잘 반응하지 않는다고 판단하여 반복적인 관절강세정술을 시행하였고, 시술직후 유의한 동통감소, 하악운동범위의 개선과 함께 양호한 치료경과를 나타냈다. 관절강세정술은 최소의 침습성을 지니는 가장 보존적인 외과적 술식으로서 통법의 보존적 치료에 반응하지 않는 비정복성 관절원판변위 환자를 상기 증례와 같이 적절히 선택한다면 측두하악관절장애의 동통과 기능제한에 효과적인 보조적 치료법이라고 생각된다.

• 대한족부족관절학회지
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• 제24권1호
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• pp.25-30
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• 2020

Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.