• 한국컴퓨터그래픽스학회논문지
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• 제20권1호
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• pp.1-11
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• 2014

뇌성마비에서 나타나는 하지 변형은 정상 보행 및 자세 유지에 어려움을 준다. 이를 교정하기 위해 임상의는 변형 정도를 측정하여 교정 절골술 계획을 수립하고 계획된 정도만큼 절골술을 시행한다. 그러나 절골술 시행 후 원래 계획보다 더 적거나 더 많이 교정되는 상황이나 의도치 않았던 변형이 발견되는 상황이 종종 발생한다. 이러한 문제 상황들이 발생하는 이유는 절골술 계획수립 시, 기존의 방법이 하지골의 정확한 형태학적 정보를 반영하기 어렵고 하지골을 절골하여 회전 시키는 정도에 따라 최종 결과가 어떻게 나오는지 사전에 예측하는 것이 쉽지 않으며 효과적인 교정 결과를 얻을 수 있는 절골술 방법, 회전각도 등 다양한 입력 조건의 최적 조합을 찾기가 어렵기 때문이다. 본 논문은 이를 해결하기 위해 컴퓨터 그래픽스 분야의 정기구학, 역기구학 및 최적화 기법을 하지 교정 절골술에 적용하여 임상의가 최적의 절골술 계획을 수립할 수 있도록 하는 방법을 제안한다. 하지 골의 3차원 메쉬 모델을 입력으로 받아 이를 분석하여 하지 특징점을 추출하고 임상지표를 자동으로 계산하여 변형 정도를 파악하는 방법, 하지 골을 대상으로 하는 5가지 교정 절골술의 시뮬레이션을 통해 그 결과를 사전에 예측할 수 있는 방법 그리고 비선형 최적화 문제로 변환하여 최적 교정 절골술 계획을 자동으로 수립하는 방법을 제안한다. 이를 통해 하지 골 교정 절골술과 관련된 거의 모든 경우의 수를 사전에 확인해 볼 수 있어서 종래의 방법보다 훨씬 쉽고 효율적으로 절골술을 계획하고 실행할 수 있을 것이다.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.486-491
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• 2013

In performing upper blepharoplasty in the elderly, looking younger and keeping the eyelids harmonious with the rest of the face have to be achieved at the same time. The most important goal in upper blepharoplasty for aging is correcting the drooping upper eyelid skin, and in this process, the surgeon may or may not create a double eyelid fold. The pros and cons have to be fully discussed with the patient, but the author personally prefers creating a double fold unless the patient refuses, because it is efficient in correcting and preventing further drooping of the skin. In most patients, the brow is elevated to compensate for the drooping eyelid, and when the drooping is corrected, brow ptosis may ensue. The surgeon has to prepare for these consequences before performing the procedure, and estimate the exact amount of skin to be excised. In the elderly, the skin and the orbicularis oculi muscle is thin, with a decreased amount of subcutaneous fat and retro-orbicularis oculi fat, and in most cases, excision of the skin alone is enough to correct the deformity. Removing large portions of soft tissue may also prolong the recovery period. Unlike younger patients, the lower skin flap should not be stretched too much in the elderly, as it may create an aggressive looking appearance. A few wrinkles in the lower flap should remain untouched to create a natural look. In this article, the author's own methods of performing an aging blepharoplasty are described specifically, with a step-by-step guide and surgical tips.

• 대한물리치료과학회지
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• 제5권1호
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• pp.573-581
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• 1998

Gait is a highly complex activity in which many variables can be observed and measured. Walking is a repetitious sequence of limb to move the body and to maintain stability. Normal gait is rhythmic and characterized by alternating propulsive and retropulsive motions of the lower extremities. Pathological gait patterns have four functional categories (deformity, muscle weakness, impaired control, pain). The purpose of this study was to assess the quantitive gait variables(the width of the base, length of a step, stride length, cadence, velocity) in patients with low back pain. Patients walked more slowly, took shorter steps and did not show the symmetrical gait patterns.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.63-67
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• 2012

Purpose: Lipogranuloma is the reaction of adipose tissue to various oils, paraffin, and other hydrocarbons injected into subcutaneous tissue for cosmetic or other reasons. The authors experienced a case of sclerosing lipogranuloma on the nasal dorsum. Methods: A 42-year-old female, without a history of the injection of any foreign materials, was admitted on our hospital for a painless, irregular, and firm mass located on her nasal dorsum with step-off deformity. It was considered that the mass had developed after augmentation rhinoplasty. The size of mass had been increased after closed reduction of nasal bone fracture. On April 2011, under general anesthesia, the mass was removed by open rhinoplasty technique. In addition, a pathologic examination was performed. After the mass extirpation, dermofat graft was performed for the correction of depression deformity. Results: The histopathological findings demonstrated a Swiss cheese pattern with variably-sized vacuoles, which corresponded to lipid removed with tissue processing, and variable foreign body giant cell reaction, fat necrosis, and hyalinized fibrous tissue. The pathologic diagnosis is lipogranuloma replacing nasalis muscle. It has been considered that sclerosing lipogranuloma is caused by nerve injury during augmentation rhinoplasty and the ointment used after the closed reduction of nasal bone fracture, which infiltrated through the injured mucosa. Conclusion: During the treatment of rhinoplasty or nasal bone fracture, the nerve injury or the ointment use can lead to lipogranuloma. Therefore, careful dissection for avoidance of the nerve injury and limited use of ointment seems to be helpful in decreasing incidence of lipogranuloma.

• PNF and Movement
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• 제9권4호
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• pp.41-48
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• 2011

Purpose : The purpose of this study was to assess the tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity of tibialis anterior, soleus, gluteus maximus, transverse abdominis according to pronated foot and supinated foot. Methods : Group of pronation and supination were taped using augmented low-day method to make pronated and supinated foot the three case were assessed by agnostic radiology for investigating foot structure. Results : 1) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in one step. 2) When supinated foot & pronated foot, soleus & transverse abdominis muscle activity was decreased in one step. 3) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in squat. 4) When supinated foot & pronated foot, soleus muscle activity was decreased in squat. 5) When pronated foot, transverse abdominis muscle activity was decreased in squat. 6) When supinated foot, transverse abdominis muscle activity was augmented in squat. 7) When pronated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was augmented in sit to stand. 8) When supinated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was decreased in sit to stand. 9) When supinated foot & pronated foot, soleus muscle activity was decreased in sit to stand. Conclusion : 1) Pronated foot & supinated foot effects on soleus, gluteus maximus, transverse abdominis muscle activity in one step. 2) Pronated foot & supinated foot effects on tibialis anterior, gluteus maximus, transverse abdominis muscle activity in squat. 3) Pronated foot & supinated foot effects on soleus, transverse abdominis muscle activity in sit to stand. Therefore we suggest the deformity of the foot effects on tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity.

• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.66-70
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• 2012

Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.

• 대한치과보철학회지
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• 제54권1호
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• pp.35-40
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• 2016

상악골 결손은 악안면 부위의 해부학적 기형과 기능 장애를 초래한다. 기능적 측면에서, 상악골 결손은 발음, 저작, 연하 장애를 일으킬 수 있다. 상악절제술을 받은 환자에게 폐색장치는 이러한 기능적 회복에 큰 역할을 한다. 폐색장치가 구강 내에서 적절히 기능하기 위해서는 충분한 유지가 필요하며, 이러한 유지의 증가를 위해서는 폐색장치의 무게 감소가 필요하다. Hollow bulb 폐색장치에는 개방형, 폐쇄형 두 가지 형태가 존재한다. 폐쇄형 형태는 많은 장점을 가지나, 제작이 어렵고 누수가 발생할 경우 처치의 어려움 등의 단점이 존재하여 많은 술자들은 개방형 형태로 제작한다. 본 증례에서 두 열가소성 레진 시트로 만든 hollow body를 이용하여 one-step 중합 기술로 폐쇄형 hollow bulb 폐색장치를 제작하였고, 이는 기존의 폐쇄형 hollow 폐색장치 제작법의 단점들을 보완할 것이다.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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• pp.10-17
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• 2020

Objective: Hallux valgus (HV) is a common musculoskeletal deformity that is accompanied with pain and continues to decrease one's quality of life and ability to perform daily life activities by affecting gait and static stability. Therefore, this study aimed to investigate the effect of the angle of HV (HVA) and to compare the one-legged stance and gait parameters in young adults with less HV and severe HV. Design: Cross-sectional study. Methods: Forty young adults were divided into two groups, where HVA ≥15° (n=20) was defined as HV, and HVA <15° (n=20) was defined as normal. For balance ability, the center of pressure (COP) path, velocity, length of axis of the COP path, deviation of the x-axis and y-axis, and percentage of foot pressure were measured, and gait, the foot rotation angle, step length, percentage of each phase of the gait cycle, time change from the heel to forefoot, and maximum pressure of the forefoot and midfoot were measured. Results: Significant differences were found in sway length and time change from heel to forefoot during walking between the normal and HV groups (p<0.05). Most parameters were not associated with the HVA, but parameters such as length of axis and time to change from heel to forefoot were significantly associated with the HVA (p<0.05). Conclusions: These results suggest that most one-legged stance and gait parameters were not significantly affected by the HVA in young adults; therefore, future studies are needed in order to address other dynamic parameters and other methods of gait analysis for detecting clinically meaningful conditions.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.490-492
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• 2007

Purpose: Nipple reconstruction is an important step in breast reconstruction after mastectomy. There are considerable number of reconstructive methods developed over the past years. Each of these has not only its own special advantages, but also limitations. Therefore, no single method has become the overwhelming favorite. Sometimes it seems to be compromised when the nipple must be located directly over a linear scar. Methods: A 48-year-old female patient received a central lumpectomy with circumareolar resection of the nipple areolar complex 4 months ago. The newly designed nipple must be positioned directly astride a scar. We drew two equal-sized rectangular flaps sharing a common limb on a transverse scar and the result was two opposing plow form. Each flap size was about 1.3 cm wide and 2.5 cm long. First we elevated the flap from the distal part at a deep dermal plane, then deepened the level of dissection to raise the dermal-fat flaps. The donor site could be closed directly without any dog-ear deformity. Then we folded down the elevated flaps and loosely sutured skin with nonabsorbable materials. Each flap inner side was approximated side by side. Finally we made new natural nipple with 6 mm projection. We applied tattooing in the areola area with micropigmentation device after three months. Results: After ten months of follow-up periods, the nipple projection was stable and symmetric. The nipple projection was 3.1 mm, compared with 2.8 mm for the opposite nipple. Conclusion: Our experiences shows that this double opposing plow flap is a particularly useful and simple technique when there is a traverse scar crossing the center of the proposed nipple area.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.299-306
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• 2021

Purpose: This study aimed to propose a fully automatic landmark identification model based on a deep learning algorithm using real clinical data and to verify its accuracy considering inter-examiner variability. Materials and Methods: In total, 950 lateral cephalometric images from Yonsei Dental Hospital were used. Two calibrated examiners manually identified the 13 most important landmarks to set as references. The proposed deep learning model has a 2-step structure-a region of interest machine and a detection machine-each consisting of 8 convolution layers, 5 pooling layers, and 2 fully connected layers. The distance errors of detection between 2 examiners were used as a clinically acceptable range for performance evaluation. Results: The 13 landmarks were automatically detected using the proposed model. Inter-examiner agreement for all landmarks indicated excellent reliability based on the 95% confidence interval. The average clinically acceptable range for all 13 landmarks was 1.24 mm. The mean radial error between the reference values assigned by 1 expert and the proposed model was 1.84 mm, exhibiting a successful detection rate of 36.1%. The A-point, the incisal tip of the maxillary and mandibular incisors, and ANS showed lower mean radial error than the calibrated expert variability. Conclusion: This experiment demonstrated that the proposed deep learning model can perform fully automatic identification of cephalometric landmarks and achieve better results than examiners for some landmarks. It is meaningful to consider between-examiner variability for clinical applicability when evaluating the performance of deep learning methods in cephalometric landmark identification.