• Title/Summary/Keyword: 성형수술

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Surgical treatment of Mallet finger deformity with Hook plate (고리 금속판을 이용한 망치 손가락의 수술적 치료법)

  • Choi, Seok Min;Jung, Sung Gyun;Shin, Ho Seong;Park, Eun Soo;Kim, Yong Bae
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.318-321
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    • 2009
  • Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.

Surgical Treatment of Pulmonary Tuberculosis (폐결핵의 절제술에 대한 임상적 고찰)

  • Kim, Ae-Jung;Gu, Ja-Hong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.397-402
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    • 1996
  • A clinical study of 36 cases of pulmonary tuberculosis that had had a surgical resection during the period of 13 years from January 1979 to December 1992 was performed in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital The ratio between male and female was 3.5 1 and the age of peak incidence was in the 2nd and 3rd decades. The common prodromal symptoms were chest pain (38.9 %) and hemoptysis or blood tinged sputum (36.1 %). Preoperative diagnostic examination of sputum positivity for AFB stain despite antituberculosis chemotherapy was noticed in 22.8 oyo . Surgical indications were destroyed lobe or segment with or without cavity (58.3 oyo), mass unable to differentiate from lung cancer (16.7 %), total destroyed lung (13.9 %), bronchostenosis with atelectasis and distal bronchiectasis (11.1 %). Types of resection were pneumonectomy in 16.7%, lobec omy and segmentectomy 2.7%, lobectomy 50 %, segmentectomy 27.8%, and wedge resection 2.7%. Postoperatively, pulmonary function Improved compared to the preoperative examination, although these changes were not statistically significant. One patient died of ulcerative colitis due to drug hypersensitivity, and the postoperative complications were remnant dead space in 11.1 %, spreading of tuberculosis in 5.5%, and empyema with BPF in 5.5%.

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A Case of Orthognathic Surgery in Congenital Alveolar-Palatal cleft patient (구순 및 구개열을 가진 상악 후퇴증 환자의 교정-외과적 치험 1례)

  • Park, Jae-Hyun;Lee, Myung-Jin;Lee, Chang-Kon;Kim, Jong-Sub;Chin, Byung-Rho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.189-196
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    • 1992
  • Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

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센서 네트워크용 초소형 OS

  • Song, Jun-Geun;Ma, Pyeong-Su;Park, Seung-Min
    • Information and Communications Magazine
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    • v.24 no.7
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    • pp.26-35
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    • 2007
  • 최근 몇 년간 유비쿼터스 서비스를 구현하기 위한 핵심 기술 중 하나인 무선 센서 네트워크에 대한 관심이 높아지고 있다. 무선 센서 네트워크 기술은 물류, 유통, 환경 감시, 홈오토메이션, 군사 분야 등 다양한 분야에 적용 될 수 있기 때문에 앞으로 관련 분야의 시장 또한 커질 것으로 예상되고 있다 [1]. 무선 센서 네트워크는 기존 유선 센서 네트워크나 무선 네트워크 환경과는 많은 차이를 가진다. 우선 극도로 제한된 시스템 자원만을 가질 수 있으며, 열악한 환경 속에서 무선매체를 통해 유기적으로 동작하여야 하는 특징을 가지고 있다. 적게는 수십 개에서 많게는 수백, 수천 개의 자율적인 하드웨어 노드들로 구성되는 무선 센서 네트워크에서 제한된 자원을 효과적으로 활용하기 위해서는 센서 노드에 적합한 운영체제가 필수적으로 요구된다. 지난 몇 년간 센서 노드하드웨어의 발달과 더불어 많은 센서 네트워크용 초소형 운영체제가 개발되어왔다. 현재 많이 알려져 있는 센서 네트워크용 OS로는, 가장 활발한 참여를 보이고 있는 TinyOS[3]부터 SOS[4], MANTIS[5], Contiki[6], T-kernel[7] 등이 있으며, 국내 기술로 개발된 Nano-Qplus[8] 등이 존재한다. 본고에서는 우선 센서 네트워크에 대한 배경 지식과 플랫폼 등에 대한 내용을 간단히 다루고, 본론에서 센서 네트워크용 운영체제가 가져야 할 조건과 현재 개발되어 있는 센서 네트워크 OS들의 특징에 대해 간략히 살펴보도록 하겠다. 또한 센서 네트워크 OS와 밀접한 연관성을 가지는 분야에 대해 간단히 살펴보고, 마지막으로 앞으로의 방향에 대해 알아본다.고려해 볼 때 atlas의 장축의 시계방향 회전은 액티베이터의 사용 효과로 생각되며, 이는 차후 II급 부정교합자에서 액티베이터 치료 효과를 판단하는 또 하나의 지표가 될 수 있다고 생각한다.인해 한반도를 포함한 동아시아 대륙이 태평양판 쪽으로 밀려감으로써 섭입하던 태평양판의 각도가 급해져 동아시아 연변에 강력한 흡입력이 발생하였으며, 이 때문에 태평양판의 운동 방향이 북북서에서 서북서방향으로 회전되었을 가능성이 있다. 따라서 약 51 Ma부터 한반도 동남부에는 지판 경계의 강력한 흡입력으로 동서 내지 서북서-동남동의 인장력이 작동되어 B그룹 암맥군이 관입한 것으로 해석된다.Ledge는 세 군 모두에서 나타나지 않았다. 4. 파일 binding 횟수는 MC군이 가장 적고 PT군이 가장 많았다 (p < 0.05). 이상의 결과를 볼 때, Mtwo 전동 파일을 crown-down technique으로 사용하는 것이 single length technique과 유사한 성형 효율을 보이면서도 더 안전할 것으로 추정된다.고 1명(3%)에서 원격전이를 보였다. 치료 중 급성 합병증으로 11명(37%)에서 RTOG grade 1-2의 장염을 보였으며 1명은 대장의 천공이 발생하여 수술로 치유되었다. 12명(40%)에서 RTOG grade 1-2의 급성 방광염을 보였다. 3명(10%)에서 RTOG grade 1-2의 백혈구 감소증이 보였으며 1명에서 심한 백혈구 감소증(RTOG grade 4)이 나타났으나 회복되어 치료를 완료하였다. 만성 합병증으로 5명(15%)에서 RTOG grade 1-2의 만성 장염을 보였으며 별다른 치료 없이 지내고 있으며

A CLINICOSTATISTICAL STUDY ON MIDFACIAL BONE FRACTURE (중안면골 골절에 대한 임상통계학적 연구)

  • Ryu, Sun-Youl;Cho, Kyu-Seung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.367-376
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    • 1997
  • The 234 patients who received treatment of midfacial fractures at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1, 1992 to Dec. 31, 1996 were analyzed clinicostastically. Results obtained were as follows ; Male predominated over females by a ratio of 5.3 to 1. The frequently developing age groups were first 3rd (25%), 4th (21%) and the 2nd (18%) decade on succession. The peakest month was the August (16%), and May (11%), September (9%), October (9%). When it comes to the reasons for in-patients, traffic accident was predominant to 38%. In the 234 cases of midfacial fractures, zygomaticomaxillary complex fracture was the most by 37%. The most common with injury show that facial laceration marked by 49%, neurologic injury 24%, and mandibular fracture 20% each by each. About the time from injury onset to operation, 55% of cases were less than a week while the others (45%) more than a week. 3 plates were used for operation : 2 for zygoma or maxilla fracture and 3 for zygomatiomaxillary complex fracture. especially 4 for Le Fort I fracture, 5.5 for Le Fort I, II ; I, III ; II, III fracture, 7 for Le Fort I,II,III fracture were used. 20 patients (8%) appealed their complication and the most common was reported as infection. Above results suggest that early diagnosis and treatment of fracture site, systemic condition and associated injuries are necessary, and coorperative treatment with medical department should be performed.

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COMPARISON OF SPEECH PATTERNS ACCORDING TO THE DEGREE OF SURGICAL SETBACK IN MANDIBULAR PROGNATHIC PATIENTS (하악골 전돌증 수술 후 하악골 이동량에 따른 발음 양상에 관한 비교 연구)

  • Shin, Ki-Young;Lee, Dong-Keun;Oh, Seung-Hwan;Sung, Hun-Mo;Lee, Suk-Hang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.1
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    • pp.48-58
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    • 2001
  • After performing mandibular setback surgery, we found some changes in patterns and organs of speech. This investigation was undertaken to investigate the aspect and degree of speech patterns according to the amount of surgical setback in mandibular prognathic patients. Thirteen patients with skeletal Class III malocclusion were studied preoperative and postoperative over 6 months. They had undergone the mandible setback operation via bilateral sagittal split ramus osteotomy(BSSRO). We split the patients into two groups. Group 1 included patients whose degree of mandibular setback was 6mm or less, and Group 2 above 6mm. Control group was two adults wish normal speech patterns. A phonetician performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the patients and the acoustic characteristics of the plosives, fricatives, and flaps were analyzed with a phonetic computer program (Computerized Speech Lab(CSL) Model 4300B(USA)). The results are as follows: 1. Generally, Patients showed longer closure duration of plosives, shorter VOT(voice onset time) and higher ratio of closure duration against VOT. 2. Patients showed more frequent diffuse distribution than the control group in frication noise energy of fricatives. 3. In fricatives, frequency of compact from were higher in group 1 than in group 2. 4. Generally, a short duration of closure for /ㄹ/ was not realized in the patient's flaps. Instead, it was realized as fricatives, sonorant with a vowel-like formant structure, or trill type consonant. 5. Abnormality of the patient's articulation was reduced, but adaptation of their articulation after surgery was not perfect and the degree of adaptation was different according to the degree of surgical setback.

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IMMEDIATE IMPLANT PLACEMENT AFTER EXTRACTION OF RETAINED DECIDUOUS TEETH AND IMPACTED CANINES: REPORT OF A CASE (상악 전치부 잔존 유치와 매복 견치 발치 후 즉시 임플란트 식립: 증례 보고)

  • Yoo, Ji-Yeon;Kim, Yeo-Gab;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Young-Ran;Baek, Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.330-333
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    • 2009
  • Alveolar bone resorption after extraction impairs the necessary bone volume and complicates the case for implant surgery and aesthetic implant prosthesis. Immediate implant surgery after extraction decreases the number of surgical procedures and the duration of treatment, while allowing minimum alveolar bone resorption and preserving the residual bone volume. Although immediate implant holds many advantages such as preservation of hard and soft tissue around the extraction socket, greater implant survival rate and higher patient satisfaction, various complications and high failure rate are discouraging factors for the clinicians. In this case report, severe alveolar bone resorption with soft tissue changes were predicted after the extraction of prolonged retained deciduous incisors and impacted maxillary canines and thus decided on immediate implant procedure. Immediate implant surgery after extraction was carried out with minimal bone reduction and tapered wide-neck implant to establish initial stability. Simultaneous bone graft was done by filling the defect area with iliac cancellous bone with additional onlay-type bone graft and absorbable membrane on the labial bone for upper lip support. A stable and esthetic result was obtained with shortened treatment period.

THE CEPHALOMETRIC ANALYSIS OF THE SOFT TISSUE CHANGES AT THE MIDDLE FACE IN THE SKELETAL CLASS III PATIENTS WITH THE ORTHOGNATHIC 2-JAW SURGERY (골격성 제3급 부정교합자의 양악 수술 후 중안면부 연조직 변화에 관한 두부 계측 방사선학적 연구)

  • Ahn, Je-Young;Kim, Ji-Yong;Joo, Bum-Ki;Kim, Min-Chul;Huh, Jong-Ki;Kim, Hyung-Gon;Park, Kwang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.21-26
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    • 2006
  • Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

MEDIAN CLEFT OF THE LOWER LIP AND MANDIBLE;A CASE REPORT (하순 및 하악골 정중열의 치험례)

  • Cha, Doo-Won;Kim, Hyun-Soo;Baek, Sang-Heum;Kim, Chin-Soo;Byeon, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.263-269
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    • 2001
  • Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.

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The Comparative Study of Effect on Speech before and after Orthognathic Surgery of Patients (악교정 환자의 악교정 수술전후 발음양상에 대한 비교연구)

  • Kwon, Kyung-Hwan;Kim, Soo-Nam;Lee, Dong-Keun;Cho, Yong-Min;Lee, Suk-Hyang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.191-205
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    • 2000
  • The purpose of this study was undertaken to determine the effects of orthognathic surgery on speech. The hyposis stated herein is that functional behaviors of the dentofacial complex, such as speech production, may be adversely affected by deviations of a structural nature(especially, Class III malocclusion). Twenty adults with Class III malocclusion(13 female and 7 male) were studied preoperative, immediate postoperative and either 6 or 12 months postoperative lateral cephalograms. They had mandibular prognathism and had undergone mandible setback operation. The position of tongue, soft palate(Uvula), hyoid bone, respiratory track width, and pharyngeal depth were assessed on lateral cephalograms with 23 cephalometric variables, ANOVA, Paired t-tests and Pearson's product-moment correlation coefficient tests were used to evalute the operative changes in all cephalometric parameters. A experienced speech and language pathologists performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the ninth patients and the recording tapes were analyzed by phonetic computer program(Computerized Speech Lab(CSL) Model 4300BI(U.S.A.)) These judges also recorded their ratings of each patient's overall consonants, hypernasality, hyponasality, and articulation proficiency. The results obtained are as follows; 1. There were significant changes in distance of posterior pharyngeal wall to tongue (TI-TW2, TS-TW3) after the surgery at 6 months postoperatively(each p<0.01 p<0.05). 2. The posterior tongue point(TI, TS, PPT) moved posteriorly after surgery and remained to its changed position at 6 months postoperatively(p<0.05). The displacement of tongue was correlated with the movement of mandibular setback amount(p<0.05). The hyoid bone moved posteriorly superiorly after immediate postoperative period. There was significant changes in hyoid bone movement after immediated postoperative period(p<0.05), but returned to its original position during the follow-up period(p>0.05) 3. The soft palate was displaced posteriorly superiorly after immediated operative period and remained to its changed position at 6 months postoperatively(p<0.05). ANS-PNS-SPT angle increasing, PPU-PPPo distance narrowing was showed after surgery, and remained its appearance 6 months postoperatively(p<0.05). 4. There were significant changes in formant value and squre diagram of vowel sound after the orthognathic surgery and the follow-up period. There were significant changes in /ㅅ/sound and posterior tongue sound. 5. The posterior movement of tongue and the posteriosuperior movement of soft palate was correlated with mandibular setback amount after orthognathic surgery. On the vowel squre diagram, the author found that the place of articulation after operation moved downward, backward, upward. 6. In assessing speech abnormalities, dental occlusion should be considered as a contributing factor. The vast majority of subjects with preoperative misarticulations eliminated or reduced their errors following orthognathic surgery. There was significant difference in speech impovement between pre- and postoperation.

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