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Investigation of the effects of miniscrew-assisted rapid palatal expansion on airflow in the upper airway of an adult patient with obstructive sleep apnea syndrome using computational fluid-structure interaction analysis

  • Hur, Jae-Sik;Kim, Hyoung-Ho;Choi, Jin-Young;Suh, Sang-Ho;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.353-364
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    • 2017
  • Objective: The objective of this study was to investigate the effects of miniscrew-assisted rapid palatal expansion (MARPE) on changes in airflow in the upper airway (UA) of an adult patient with obstructive sleep apnea syndrome (OSAS) using computational fluid-structure interaction analysis. Methods: Three-dimensional UA models fabricated from cone beam computed tomography images obtained before (T0) and after (T1) MARPE in an adult patient with OSAS were used for computational fluid dynamics with fluid-structure interaction analysis. Seven and nine cross-sectional planes (interplane distance of 10 mm) in the nasal cavity (NC) and pharynx, respectively, were set along UA. Changes in the cross-sectional area and changes in airflow velocity and pressure, node displacement, and total resistance at maximum inspiration (MI), rest, and maximum expiration (ME) were investigated at each plane after MARPE. Results: The cross-sectional areas at most planes in NC and the upper half of the pharynx were significantly increased at T1. Moreover, airflow velocity decreased in the anterior NC at MI and ME and in the nasopharynx and oropharynx at MI. The decrease in velocity was greater in NC than in the pharynx. The airflow pressure in the anterior NC and entire pharynx exhibited a decrease at T1. The amount of node displacement in NC and the pharynx was insignificant at both T0 and T1. Absolute values for the total resistance at MI, rest, and ME were lower at T1 than at T0. Conclusions: MARPE improves airflow and decreases resistance in UA; therefore, it may be an effective treatment modality for adult patients with moderate OSAS.

Sensory Inputs to Upper Cervical Spinal Neurons Projecting to Midbrain in Cats

  • Kim, Jong-Ho;Jeong, Han-Seong;Park, Jong-Seong;Kim, Jong-Keun;Park, Sah-Hoon
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.1
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    • pp.9-19
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    • 1998
  • The present study was primarily carried out to characterize the properties of the spinomesencephalic tract (SMT) neurons that project from the upper cervical spinal segments to the midbrain. It was also investigated whether these neurons received convergent afferent inputs from other sources in addition to cervical inputs. Extracellular single unit recordings were made from neurons antidromically activated by stimulation of midbrain. Recording sites were located in lamina $I{\sim}VIII\;of\;C1{\sim}C3$ segments of spinal cord. Receptive field (RF) and response properties to mechanical stimulation were studied in 71 SMT neurons. Response profiles were classified into six groups: complex (Comp, n=9), wide dynamic range (WDR, n=16), low threshold (LT, n=5), high threshold (HT, n=6), deep/tap (Deep, n=10), and non- responsive (NR, n=25). Distributions of stimulation and recording sites were not significantly different between SMT groups classified upon their locations and/or response profiles. Mean conduction velocity of SMT neurons was $16.7{\pm}1.28\;m/sec$. Conduction velocities of SMTs recorded in superficial dorsal horn (SDH, n=15) were significantly slower than those of SMTs recorded in deep dorsal horn (DDH, n=18), lateral reticulated area (LRA, n=21), and intermediate zone and ventral horn (IZ/VH, n=15). Somatic RFs for SMTs in LRA and IZ/VH were significantly larger than those in SDH and DDH. Five SMT units (4 Comps and 1 HT) had inhibitory somatic RFs. About half (25/46) of SMT units have their RFs over trigeminal dermatome. Excitabilities of 5/12 cells and 9/13 cells were modulated by stimulation of ipsilateral phrenic nerve and vagus nerve, respectively. These results suggest that upper cervical SMT neurons are heterogenous in their function by showing a wide range of variety in location within the spinal gray matter, in response profile, and in convergent afferent input.

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Jeogori Pattern Development for Female in Late 20s According to Shape of Upper Back (20대 후반 여성의 상반신 뒷면 형상에 따른 저고리 원형 개발)

  • Eom, Ran-I;Lee, Yejin
    • Korean Journal of Human Ecology
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    • v.23 no.6
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    • pp.1191-1204
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    • 2014
  • Even though a Han-bok, or traditional Korean costume, should be inherited since it is invaluable part of our culture, research on Han-bok is scarce. Since the development of a Jeogori pattern, the upper garment of Korean traditional clothes, is done mostly based on the chest size, the design does not completely consider on wearer's body shape. Moreover, unless made by an expert, trial and error is almost always necessary to improve the fit of the clothes. In this research, a Jeogori pattern was suggested that improves the fit based on the shape of the upper back(straight or bent) of a female in her late 20s who often wears a Han-bok and is comfortable when moving. Using a 3D virtual clothing system, the optimum pattern was selected based on the body shape. The final selection was made, and each subjects tried the garment on to evaluate the comfort when moving, along with its appearance, based on a seven point Likert scale. As a result, for a straight body shape, the optimum ease for the front bust width was 2.5cm, and that for the back bust width was 2.0cm. The optimum center back dart was 1.0cm. The optimum Geodae width was 7.6cm, and the optimum back Geodae point was 2.0cm. For the bent body shape, the optimum ease for the front and back bust was 2.0cm. The optimum Geodae width was 8.4cm, and the optimum back Geodae point was 1.5cm. Furthermore, if the Hwajang slope was set at half of the vertical distance between the laterals of the neck and shoulder, a fitted silhouette appeared, which is preferred nowadays. In the appearance evaluation, the final pattern designed in this research received higher scores than the original design(straight; p<.001, bent; p<.05). The results of the evaluation of the comfort when moving also showed higher scores for the final pattern that was designed.

The Characteristics of Heavy Rainfall over the Korean Peninsular - Case Studies of Heavy Rainfall Events during the On- and Off- Changma Season- (장마기와 장마 후의 한반도 집중호우 특성 사례분석)

  • Chung, Hyo-Sang;Chung, Yun-Ang;Kim, Chang-Mo;Ryu, Chan-Su
    • Journal of Environmental Science International
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    • v.21 no.12
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    • pp.1511-1521
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    • 2012
  • An attempt is made to analyse characteristic features of heavy rainfalls which occur at the metropolitan area of the Korean peninsular the on- and off- Changma season. For this, two representative heavy rainfall episodes are selected; one is the on-Changma season wherein a torrential rain episode happened at Goyang city on 12 July 2006, and the other is the off-Changma season, a heavy rainfall event in Seoul on 21 September 2006. Both recorded considerable amounts of precipitation, over 250mm in a half-day, which greatly exceeded the amount expected by numerical prediction models at those times, and caused great damage to property and life in the affected area. Similarities in the characteristics of both episodes were shown by; the location of upper-level jet streak and divergence fields of the upper wind over heavy rainfall areas, significantly high equivalent potential temperatures in the low atmospheric layer due to the entrainment of hot and humid air by the low-level jet, and the existence of very dry air and cold air pool in the middle layer of the atmosphere at the peak time of the rainfall events. Among them, differences in dynamic features of the low-level jet and the position of rainfall area along the low-level jet are remarkable.

Diffraction Properties from Periodic Slot Array in the Upper Wall of Parallel Plate Waveguide (평행평판 도파관의 윗면에 위치한 주기적인 슬롯 배열에 의한 전자파의 회절특성)

  • Park Jin-Taek;Hong Jae-Pyo;Ko Ji-Whan;Cho Young-Ki
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.16 no.3 s.94
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    • pp.311-318
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    • 2005
  • Periodically perforated slot structure in the upper wall of the parallel plate waveguide is analyzed with main interest focusing on the diffraction Properties. The Periodic slot array is of infinite extent in one direction and of finite extent in the other direction. Various numerical results for reflection from the slotted section and transmission beyond the slotted section, and the radiation through the slotted section into the upper half space are presented with the height of feeding parallel plate waveguide, single slot size, and the periodicity between slots as parameters. This study is thought to be helpful to the design of the ventilation hole in the TFT-LCD and PDP.

A New Interpretation of Ptosis-like Eyes through the Results of Small-Incision Double-Eyelid Operation (부분절개 쌍꺼풀성형술의 결과로 유추한 가성 안검하수의 새로운 해석)

  • Park, Sung Gyu;Lee, Seung Kook;Baek, Rong Min
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.449-453
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    • 2006
  • Purpose: Perceiving the experience that $MRD_1$ is increased after small-incision double-eyelid operation, it has been statistically verified the improvement of $MRD_1$ retrospectively. Therefore, we suggest new interpretation for Korean-specific small eye and more definite classification for ptosis. Methods: In operation, we made 3 small incisions according to the line designed on upper eyelid and removed some soft tissues including connective tissues. Then, figure-of-8 continuous buried ligation was performed through the incision windows. This study is a retrospective study, measures $MRD_1$ changes and excursion distance change of eyelid margine and eyebrow using pre-and post-operative photos of 14 patients. Results: Postoperative photos were taken on the 4th day and all of 14 patients had an improvement in $MRD_1$ statistically. The excursion distance of upper eyelid was improved in half of patients, though not in the range of statistical verification. It was statistically confirmed that the movement of eyebrow was reduced after operation. Conclusion: It is thought that $MRD_1$ improvement without any operation on levator complex means that soft tissue including connective tissue eliminated in operation restricts the movement of upper eyelid. It is defined such factors as burden factors and such phenomenon as burdened eyelid. It is thougt that Korean's small eye is mainly burdened eyelid and cosmetic improvement may be obtaind even by removing such burden factors.

The Influence of Physical Functions on Clothing Behavior of Elderly People (고령자의 신체 기능이 의복 착용 행동에 미치는 영향)

  • Lee, Eun-Suk;Jeong, Su-Jin;Chu, Mi-Seon
    • Fashion & Textile Research Journal
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    • v.14 no.1
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    • pp.136-143
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    • 2012
  • The purpose of this study was to investigate the influence of physical functions of elderly people on their clothing behavior and to provide basic information about manufacturing comfortable apparels for the elderly. A total of 219 people, with ages between 60s and 70s, participated in the survey and in the experiment to correlate their tendency of wearing clothes with the state of their physical functions. About 78.5% of the elderly showed eyesight deterioration in the subjective evaluation. Elders in their 60s raised their arms higher up in overhead reach, and showed shorter distance between middle fingertips in behind back stretch and in back scratch than elders in their 70s. Also, the former stretched farther to the floor in standing trunk flexion, and maintained more steady in one leg stand and in tandem stance than the latter. The narrower the movement range of the upper limb joints was, the more the elderly preferred upper garments with full front opening to those with half or no opening. The more inflexible the upper limbs and waist and the more unbalanced the body was, the more likely the elderly put on pants while sitting on the floor. The time taken to button up the shirt and to put on and take off pants showed a positive correlation with the overhead reach, the behind back stretch, the back scratch and the standing trunk flexion, whereas the former showed a negative correlation with the one leg stand and the tandem stance.

A Study on the Castability of Non-precious Porcelain Metal According to Investing Method (매몰방법에 따른 도재용 비금속의 주조성에 관한 연구)

  • Lee, In-Kyu;Kim, Yong-Won
    • Journal of Technologic Dentistry
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    • v.19 no.1
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    • pp.5-12
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    • 1997
  • To examine the difference of castability of non -precious porcelain metal according to 2 type of investing method, experiments were carried out using the method of both existing investing method and the investment with spaces to the upper & lower parts of the ring. The following conclusion were obtained from the result. 1. Seperataly using the existing investment and with spaces to the upper & lower parts of the ring, 44 samples resulted in success with the former method and 52 with the latter out of 84 samples. 2. Under the existing investing method, 44 samples out of 56 total resulted in success when the temperature of the ring was $870^{\circ}C$, and all samples failed when the temperature was $800^{\circ}C$. 3. Under the investment that gives space to the ring, when casted with the temperature of the ring fixed at $870^{\circ}C$, 40 samples out of 56 and 17 samples with the temperature fixed at $800^{\circ}C$ resulted in success. 4. Under the existing investing method with the temperaure of the ring fixed at $870^{\circ}C$ and heat soaking time given an hour, 26 out of 28 samples resulted in success and 18 resulted the same with half an hour heat soaking time. 5. Using the investment that gives space to the ring, at ring temperature $870^{\circ}C$ with heat soaking time 1 hour, all of total 28 rusulted insuccess however only 12 smaples succeeded with 30 minutes heat soaking time. 6. Under the existing investing method, samples with heat soaking time 1 hour equally given at ring temperature $870^{\circ}C$, 26 samples out of 28 succeed however at $800^{\circ}C$ all samples failed. 7. In the case of ring's upper and lower parts opened ring temperature is $870^{\circ}C$ and $800^{\circ}C$ and the heat soaking time was fixed at 1 hour, all 28 samples resulted in success and at $800^{\circ}C$ 17 succeed.

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TREATMENT OF BASAL CELL NEVUS SYNDROME WITH ENUCLEATION FOLLOWING MARSUPIALIZATION : A CASE REPORT (다발성 악골의 치성 각화낭을 동반한조대술 후 적출술을 이용한 기저세포모반증후군의 치험례)

  • Park, Chul-Min;Kim, Hak-Kyun;Kim, Su-Gwan;Lee, Kye-Joon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.485-489
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    • 2008
  • Basal cell nevus syndrome is a hereditary disease of an autosomal dominant trait with variable conditions such as basal cell carcinomas of the skin, deformity of rib, fusion of vertebrae, mental retardation, hypertelorism, and multiple odontogenic keratocysts. A 32 years old man with pus discharge from fistula on the vestibule of left upper 1st molar visited to Chosun University Dental Hospital. Radiographic evaluation revealed multiple maxillary and mandibular cysts that had multilocular radiolucency on left mandibular body area, thining of inferior border of left border of ramus and well defined unilocular radiolucency above right upper 1st and 2nd molar and from left upper 1st premolar to 2nd molar. In chest PA view, he had a forked rib in the left 4th rib and in skull PA view the calcification of falx cerebri was observed. There was not any skin lesion. After the preliminary evaluation, the patient was diagnosed with basal cell nevus syndrome and he underwent marsupialization for decreasing the size of cystic lesion and came to hospital for dressing 3days a week. As time goes by, the size of lesion decreased. So, one and half year after marsupialization, he underwent cyst enucleation and iliac bone graft for the mandibular lesion and buccal fat pad grafts for the maxillary lesions. After the surgery, the patient experienced normal healing without any complications and he is on long-term follow-up.

Thoracic Epidural Anesthesia for Upper Abdominal Surgery and Postoperative Pain Control (상복부 수술을 위한 흉추 경막외 마취와 술후 통증관리)

  • Choi, Kyu-Taek;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.66-71
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    • 1989
  • It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.

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