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Cranial Base Reconstruction and Secondary Frontal Advancement for Meningoencephalocele Following LeFort III Osteotomy in a Patient with Crouzon Syndrome: Case Report

  • Sungmi Jeon;Yumin Kim;Ji Hoon Phi;Jee Hyuk Chung
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.54-58
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    • 2023
  • Patients with Crouzon syndrome have increased risks of cerebrospinal fluid rhinorrhea and meningoencephalocele after LeFort III osteotomy. We report a rare case of meningoencephalocele following LeFort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed tomography and magnetic resonance imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencephalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during LeFort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

Development of Automated Welding System for Construction: Focused on Robotic Arm Operation for Varying Weave Patterns

  • Doyun Lee;Guang-Yu Nie;Aman Ahmed;Kevin Han
    • International Journal of High-Rise Buildings
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    • v.11 no.2
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    • pp.115-124
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    • 2022
  • Welding is a significant part of the construction industry. Since most high-rise building construction structures rely on a robust metal frame welded together, welding defect can damage welded structures and is critical to safety and quality. Despite its importance and heavy usage in construction, the labor shortage of welders has been a continuous challenge to the construction industry. To deal with the labor shortage, the ultimate goal of this study is to design and develop an automated robotic welding system composed of a welding machine, unmanned ground vehicle (UGV), robotic arm, and visual sensors. This paper proposes and focuses on automated weaving using the robotic arm. For automated welding operation, a microcontroller is used to control the switch and is added to a welding torch by physically modifying the hardware. Varying weave patterns are mathematically programmed. The automated weaving is tested using a brush pen and a ballpoint pen to clearly see the patterns and detect any changes in vertical forces by the arm during weaving. The results show that the weave patterns have sufficiently high consistency and precision to be used in the actual welding. Lastly, actual welding was performed, and the results are presented.

Fashion Films From the Modern Ugliness perspective -Case of SHOWstudio's Works- (현대적 추의 관점에서 살펴본 패션 필름 -SHOWstudio의 작품을 중심으로-)

  • Junyoung Hong;Jisun Lee;Jaehoon Chun
    • Journal of the Korean Society of Clothing and Textiles
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    • v.47 no.1
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    • pp.152-170
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    • 2023
  • Although ugliness had long been considered a negative form of beauty, it has become an independent aesthetic category. However, most previous art studies have focused on Rosenkranz's theory, making its application to contemporary fashion analysis challenging. Therefore, it is necessary to redefine ugliness. This study highlighted four modern ugliness categories from a modern perspective following the examination of the historical considerations of the ugliness concept, namely ugliness as a violation of taboo, ugliness as an unpleasant emotion, ugliness as a vulgar taste, and ugliness as an ethical flaw. From this perspective, SHOWstudios for fashion films were analyzed in the present study. The results of our analysis showed that ugliness in the film was related to socially sensitive subjects and stimulating images. Whereas costumes in the film were used as a tool to convey the subject and to enhance the visual effect of the image. In addition, clothing was identified as a core subject element of the video, particularly when considering ugliness as an ethical defect. This study provides further insights into contemporary fashion analysis, expanding the ugliness perspective, which had been limited to the specific perspectives of scholars.

Short-Term Results of Osteochondral Autologous Transfer and Femoral Neck Osteochondroplasty for the Treatment of Osteochondral Lesions of the Femoral Head and Concomitant Femoroacetabular Impingement Syndrome: A Case Series

  • Fernando Diaz-Dilernia;Franco Astore;Martin Buttaro;Gerardo Zanotti
    • Hip & pelvis
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    • v.34 no.3
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    • pp.177-184
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    • 2022
  • This study aimed to analyse the initial results of five patients with symptomatic osteochondral lesions (OCL) and femoroacetabular impingement (FAI) who were treated successfully with osteochondral autologous transfer (OAT) and femoral neck osteochondroplasty (OCP) through surgical dislocation of the hip. Five patients with FAI and OCL of the femoral head who underwent surgery between 2015-2018 were studied retrospectively. All patients had a grade IV OCL, and the median defect size was 2 cm2 (interquartile range [IQR], 2-2). At the final follow-up, the modified Harris hip score showed a median value of 94 (IQR, 91-95) (P=0.04). Pain evaluation using the visual analogue scale showed a median value of 1 (IQR, 1-2) (P=0.04). Adequate graft union and healthy formation of the chondral surface were observed by magnetic resonance imaging. Although the procedure is demanding, the combination of OAT and femoral neck OCP appears to be an effective alternative in young patients.

Role of Redistribution and 24 Hour Reinjection Images to assess Myocardial Viability in Patients with Acute Myocardial Infarction (급성심근경색환자의 심근생존능 평가에 있어서 T1-201 재분포영상과 24시간 재주사영상의 역할)

  • Yoon, Seok-Nam;Pai, Moon-Sun;Park, Chan-H.;Yoo Myung-Ho;Choi, Byung-Il William
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.325-331
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    • 1998
  • Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in T1-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection T1-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or 1 (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assessment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of myocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.

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Toxic Optic Neuropathy Caused by Chlorfenapyr Poisoning (클로르페나피르 음독 후 발생한 독성 시신경병증 1예)

  • Park, Su Jin;Jung, Jae Uk;Kang, Yong Koo;Chun, Bo Young;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1097-1102
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    • 2018
  • Purpose: To report a case of toxic optic neuropathy caused by chlorfenapyr ingestion accompanied by central nervous system involvement. Case summary: A 44-year-old female visited our clinic complaining of reduced visual acuity in both eyes for 7 days. She had ingested a mouthful of chlorfenapyr for a suicide attempt 2 weeks prior to the visit. Gastric lavage was performed immediately after ingestion at the other hospital. Her best-corrected visual acuity was finger count 30 cm in the right eye and hand motion in the left eye. Both pupils were dilated by 5.0 mm and the response to light was sluggish in both eyes. A relative afferent pupillary defect was detected in her left eye. Funduscopy revealed optic disc swelling in both eyes. Magnetic resonance imaging of the brain showed a symmetric hyper-intense signal in the white matter tract including the internal capsule, corpus callosum, middle cerebellar peduncle, and brainstem. The patient was diagnosed with toxic optic neuropathy induced by chlorfenapyr ingestion, and underwent high-dose intravenous corticosteroid pulse therapy. Three days later, the best-corrected visual acuity was no light perception in both eyes. Three months later, optic atrophy was observed in both eyes. Optical coherence tomography revealed a reduction in the thicknesses of the retinal nerve fiber layer and ganglion cell and inner plexiform layer in the macular area. Conclusions: Ingestion of even a small amount of chlorfenapyr can cause severe optic nerve damage through the latent period, despite prompt lavage and high-dose steroid treatment.

Development of E-PAD based condition evaluation system for facility safety inspection (시설물 안전점검을 위한 E-PAD 기반 상태평가 시스템 개발)

  • Jung, Hae-Yong;Lee, Heung-Su;Yi, Jong-Hwa;Kim, Young-Seok;Park, Chul
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.23 no.4
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    • pp.1-7
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    • 2019
  • As a unify operational processes of the safety inspection for major national facilities, it is expected that the efficiency and professionalism of the project will be enhanced. Also it is being emphasized that the importance of visual inspection that initially find physical and functional defects in facilities. In this study, we developed an E-PAD-based condition evaluation system to check the safety of the facility to overcome the problems and limitations of the existing inspection method. This system consists of introduction, work list, visual inspection, defect table and so on. It is possible to download the inspection drawings at the site and input the damage information to the drawings and check the evaluation grade. In order to verify the E-PAD based condition evaluation system, the inspection data of 10 sample bridges were inputted into the system and the evaluation results were compared. As a result, it was confirmed that the safety grade calculated from the system and the existing safety grade are the same. The feasibility analysis of the AHP method also showed that the function increased by 10%, cost by 36%, and value by 30% compared to the existing method. Therefore, it is expected to contribute to systematic data and information analysis system for improvement of facility management.

Micro-CT Evaluation of Stainless Steel Crowns on Extracted Primary Molars (Micro-CT를 이용한 발거된 유구치의 기성금속관 평가)

  • Jung, Boram;Shin, Jonghyun;Jeong, Taesung;Kim, Jiyeon;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.53-61
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    • 2015
  • This study was conducted for the purpose of evaluating the stainless steel crowns on extracted primary molars and thus identifying frequent errors and defects. Visual assessment and micro-computed tomography (micro-CT) image analysis were performed on 97 primary molars for evaluation of the state of marginal adaptation, cement loss, secondary caries, ledge formation, attritive perforation and marginal polishing defect. The results were as follows: In the examination of object teeth by evaluation criteria, cement loss was found most frequently (98%), followed by secondary caries (42.3%), marginal polishing defect (41.2%), ledge formation (29.9%) and attritive perforation (17.5%), in this order. The cement loss at the margins showed a significant relationship with marginal gap and secondary caries: the larger the marginal gap is, the more frequent is the cement loss (p < 0.05). The average marginal gap was $0.31{\pm}0.26mm$ and showed the highest value in the maxillary 2nd primary molars. The location of the crown margin above the cementoenamel junction was found most frequently and it was found that the higher the crown margin is located, the less the marginal gap becomes (p < 0.05). In conclusion, it is thought very desirable to pay closer attention to crown margins and shapes for stainless steel crown restoration in order to minimize the marginal gaps and consequent cement loss.

Correlation between a Rupture of the Hypovascular Zone and Early Single Heel Raising after Achilles Tendon Repair (아킬레스건 봉합술 후 조기 단일 하지 거상과 아킬레스건 허혈성 구간 침범과의 상관관계)

  • Song, Si-Jung;Lee, Moses;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.21-25
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    • 2018
  • Purpose: To analyze the correlation between a rupture of the hypovascular zone and early single heel raising after Achilles tendon repair. Materials and Methods: From January 2012 to August 2015, 68 patients, who underwent surgical treatment for a Achilles tendon rupture using Krackow method, were analyzed retrospectively. The patients were divided into two groups according to possibility of single heel raises within 3 months postoperatively. During the periodic outpatient observations, the visual analogue scale, Achilles tendon total rupture score (ATRS), and timing capable single heel raises were evaluated. In addition, the preoperative defect size and distance between the calcaneal osteotendinous junction and the rupture site were measured by ultrasound in all cases. Results: Twenty-three patients could perform a single heel raise within 3 months after surgery (early single heel raise group), and fortyfive patients could perform a single heel raise after 3 month postoperatively. The age, gender, body mass index, smoking, and operation delay were similar in the two groups. In addition, the defect size and distance between the calcaneal osteotendinous junction and rupture site as measured by preoperative ultrasound were similar (p=0.379 and p=0.631, respectively). On the other hand, when the rupture site was divided into the hypovascular zone (4~7 cm from calcaneal osteotendinous junction) and non-hypovascular zone, the hypovascular zone rupture rate was significantly lower in the early single heel raise group (60.9%, 14/23; 91.1%, 41/45; p=0.003). In logistic regression analysis, the odds of the hypovascular zone rupture group being capable of early single heel raise were 0.189 (p=0.017). The ATRS score at 3 months and 1 year after surgery were significantly higher in the early single heel raise group (p<0.001). Conclusion: Achilles tendon rupture at the hypovascular zone is a poor prognostic factor for early single heel raise and might affect the prognosis significantly after an Achilles tendon rupture operation.

A Case of Unilateral Focal Pigmented Paravenous Retinochoroidal Atrophy (단안에 국소적으로 발현된 색소정맥옆망막맥락막 위축 1예)

  • Park, Hyo Song;Yang, Jong Yun;Park, Hyun Ju
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1190-1194
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    • 2018
  • Purpose: We report a case of unilateral, focal, pigmented paravenous retinochoroidal atrophy (PPRCA). Case summary: A 46-year-old female visited our clinic in complaint of a vague problem with her right eye identified during a general medical examination. The visual acuity (without correction) of both eyes was 1.0. Slit-lamp examination of both eyes revealed no specific signs. Fundus examination of the right eye revealed focal, bony-spicule-shaped retinochoroidal atrophy with pigmentation along the course of the superior retinal vein. A fundus autofluorescence examination revealed principally hypofluorescence with some hyperfluorescence at the margin of the atrophic retinochoroidal lesion. Optical coherence tomography revealed mixed clumping and atrophy of the retinal pigment epithelium (RPE) layer and thinning of the choriocapillaris layer. Fluorescence angiography revealed a window defect and blockage at the site of the lesion (the fluorescent material did not enter the lesion). The site of the window defect was in correlation with the atrophic RPE region. The site of the blockage at lesion also matched with the site of the regional pigment clumping. No definite leakage was observed. Conclusions: To the best of our knowledge, this is the first case of unilateral focal PPRCA reported from Korea.