• 제목/요약/키워드: Advancement

검색결과 2,695건 처리시간 0.031초

뮐러근과 올림근널힘줄로 구성된 복합피판의 전진술에 의한 눈꺼풀처짐의 치료 (Treatment of Blepharoptosis by the Advancement Procedure of the Müller's Muscle-Levator Aponeurosis Composite Flap)

  • 백봉수;석정훈;최원석;양완석
    • Archives of Plastic Surgery
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    • 제36권2호
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    • pp.211-220
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    • 2009
  • Purpose: Even in a small levator resection for blepharoptosis, 10 ~ 13 mm of $M{\ddot{u}}ller^{\prime}s$ muscle and levator aponeurosis is resected. To solve the problem, $M{\ddot{u}}ller^{\prime}s$ muscle was detached from the superior tarsal border and conjunctiva, and the muscle with overlying levator aponeurosis was advanced on the upper tarsus as a composite flap. The purpose of this study was to evaluate the effectiveness of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique for the correction of blepharoptosis. Methods: Between 2003 and 2008, 107 patients(183 eyes) underwent the advancement procedure of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis composite flap for blepharoptosis. The advanced composite flap was fixed 3 mm below the superior tarsal border and 2 ~ 3 mm of distal flap stump was left after trimming up to 5 mm. The results of the operations were evaluated. Results: The mean age of the patients was 35.2 years and 83 patients(145 eyes) were followed up for a mean of 16.7 months. 128 eyes (88.3%) showed a normal level of upper eyelid margin (MRD1 4.1 ~ 5.0 mm) or less than 1 mm ptosis (MRD1 3.1 ~ 4.0 mm). 10 eyes(6.9%) showed 1 ~ 2 mm ptosis (MRD1 2.1 ~ 3.0 mm). 7 eyes(4.8%) showed more than 2 mm ptosis which required secondary correction. About 80% of the 183 eyes needed no trimming of the flap stump with 5 ~ 6 mm of composite flap advancement and 20% had about 3 mm of the flap stump trimmed with 8 ~ 9 mm of composite flap advancement(shortening of the levator complex). Conclusion: $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique offers several advantages: There is no, or minimal, sacrifice of the normally functioning $M{\ddot{u}}ller^{\prime}s$ muscle; it is more physiological; it is reproducible and it is predictable - with gratifying results for blepharoptosis.

폐쇄성 수면무호흡증 환자의 상하악 전진술 후 상기도 내 유동해석 (Flow Analyses of Upper Airway Before and After Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea Patient)

  • 김형호;서상호;최진영;김태윤
    • 대한기계학회논문집B
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    • 제39권5호
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    • pp.443-448
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    • 2015
  • 폐쇄성 수면무호흡증은 수면중 간헐적으로 반복되는 상기도 폐쇄 증상을 말한다. 상하악전진술은 폐쇄성 수면무호흡 치료에 가장 효과적인 외과적 수술 중 하나이다. 상하악 전진술을 통해 상기도의 부피가 증가되어 상기도의 막힘을 치료할 수 있다. 본 연구의 목적은 상하악전진술 전후의 상기도 내 유동해석을 수행하여 폐쇄성 수면무호흡증 환자의 흡기 및 호기 시의 유동현상을 분석하는 것이다. 생체내 CT 이미지로부터 상기도 모델링을 만들고, 상기도 내 상하악전진술 전 후 환자에 대한 단면적 변화 및 음압 효과에 대해 전산유체역학적 방법으로 연구하였다. 연구결과, 수술 후 SMA (section of minimum area)의 면적변화가 가장 컸으며 압력변화와 속도변화가 커진다는 것이 확인되었다. 수면무호흡증 환자에 대한 CFD 해석을 통한 연구는 치료효과에 대한 분석이 가능함을 임상적으로 확인하였다.

외안각 절개술과 Y-V 피판술을 이용한 외안각 성형술 (Lateral Canthoplasty Using Lateral Cantotomy and Y-V Advancement)

  • 한병기;정현석
    • Archives of Plastic Surgery
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    • 제34권5호
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    • pp.641-646
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    • 2007
  • Purpose: Lateral canthoplasty is utilized in aesthetic surgery to lengthen the lateral palpebral fissure of the lateral canthal area. However, complication such as recurrence, contour deformity or hypertrophic scar make its results doubtful. Therefore, we developed lateral canthoplasty with lateral canthotomy and Y-V advancement to effectively lengthen the palpebral fissure without recurrence. Methods: A total number of 117 patients were reviewed from March 1991 to April 2005. The operative procedure was lateral canthoplasty with lateral canthotomy and Y-V advancement. To prevent recurrence, we dissected lateral conjunctiva of lower eyelid. The author believes that by this procedure, V flap would be able to advance laterally without tension. Results: We performed lateral canthoplasty in 117 patients. There were no recurrence and patients were satisfied with the results. There were 12 patients who presented with complication. Complication included hypertrophic scar in 4 patients, web formation in 3 patients and over-correction in 5 patients. Conclusion: Lateral canthoplasty with lateral canthotomy and simple Y-V advancement may be used as an effective method to lengthen palpebral fissure without recurrence.

Biocontrol of root diseases of fruit trees with fungal viruses

  • Matsumoto, Naoyuki;Nakamura, Hitoshi;Ikeda, Kenichi;Arakawa, Masao;Uetake, Yukari
    • 한국식물병리학회:학술대회논문집
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    • 한국식물병리학회 2003년도 정기총회 및 추계학술발표회
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    • pp.19-20
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    • 2003
  • Helicobasidium mompa Tanaka and Resellinia necatrix Prillieux cause violet root rot and white root rot of various crops, respectively. Intensive cultural practices, such as the use of dwarf stock, glasshouse cultivation, etc., predispose plants to the diseases. The diseases can be controlled only by biennial drench of 50100L of chemicals for each tree. Biocontrol with soil microorganisms proved ineffective under field conditions. Long-term control may be hampered by the perennial growth of hosts and by the difficulty in the establishment of antagonists in soil. Crop rotation or soil amendment is not applicable, either. Fungal viruses with dsRNA genome (Buck 1986) are promising against root diseases of fruit trees since they exist within the cytoplasm of fungal hyphae and need no effort to help them persist in the field. The viruses are considered to spread though the network of fungal mycelia in the soil once they enter the fungal cytoplasm. Here, we present preliminary results from a project to control the root diseases of fruit trees with dsRNA.(중략)

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이부전방이동술, 하설골근절개술 및 설골현수법을 이용한 폐쇄성 수면 무호흡증 환자의 치료:증례보고 (GENIAL ADVANCEMENT, INFRAHYOID MYOTOMY AND SUSPENSION IN TREATMENT OF OBSTRUCTIVE SLEEP APNEA SYNDROME)

  • 김재진;김은석;김태섭
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제27권2호
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    • pp.162-166
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    • 2001
  • Obstructive sleep apnea syndrome(OSAS) is a complex sleep disorder characterized by intermittent apnea secondary to sleep-induced obstruction of the upper airway. It occurs because of an airway obstruction anywhere between the trachea and the oronasal apparatus. The hallmark of OSAS is snoring, which is caused by vibration of the tissues of the pharynx as the airway narrows. The consequences of OSAS have focused on excessive daytime sleepiness resulting from sleep fragmentation and the cardiovascular derangements producing hypertension and arrhythmias. The primary method of controlling OSAS has been surgery. The current surgical procedures used for OSAS are tracheostomy, tonsillectomy, nasal septoplasty, uvulopalatopharyngoplasty, anterior mandibular osteotomy with hyoid myotomy and suspension, and maxillary, mandibular and hyoid advancement. We report a case of OSAS that was improved by genial advancement with infrahyoid myotomy and suspension. The patient was objectively documented by polysomnography, cephalometric analysis, and physical examination before the surgical procedure. The patient underwent genial advancement with infrahyoid myotomy and suspension. Patient had a good response from surgery.

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이부골성형으로 전방이동된 하악이부의 골개조성 변화 (REMODELLING CHANGES OF THE CHIN ADVANCED BY GENIOPLASTY)

  • 한세우;김명래;김재화;배종고
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권1호
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    • pp.48-54
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    • 2005
  • This is to evaluate the postoperative cephalometric changes of the chin advanced by the genioplasty. Thirty-eight patients who underwent advancement genioplasties at Ewha Womans University Mokdong Hospital between January of 2001 and February of 2003. They were followed up for at least 12 months with lateral cephalographs. The remodelling changes of the horizontal linear measurement between the Pogonion and Perpendicular line to FH plane were measured and analysed by Independent sample tests. The chin advancement resulted in $1.3{\pm}0.3mm$ resorption (28.2% of advancement) after 6 months, but in $1.4{\pm}0.2mm$ after 1 year. If the chin was advanced less than 3 mm, remodelling followed by $1.2{\pm}0.2mm$ reduction, but $1.3{\pm}0.3mm$ reduction followed after chin advanced over 4 mm. There were no significant differences in the amount of bone resorption by the gender, number of genial cut-steps and acompanied osteotomies.

머리뼈 붙음증에서의의 자가 두개 미립뼈 이식술 (Autogenous Calvarial Particulate Bone Grafting in Craniosynostosis)

  • 정승문
    • Archives of Plastic Surgery
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    • 제38권3호
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    • pp.222-227
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    • 2011
  • Purpose: Autogenous particulate bone grafting is a type of autogenous bone graft that consists of small particles of cortical and cancellous bone. Autogenous particulate bone grafting has been used for calvarial bone defect after calvarial defect of craniosynostosis and prevention of temporal depression after fronto-orbital advancement. The results were followed up and studied for effectiveness of autogenous calvarial particulate bone grafting. Methods: Cranial vault remodeling and fronto-orbital advancement was performed for six craniosynostosis patient from August 2005 to October 2007. Autogenous particulate bone grafting was harvested from endocortex of separated cranial vault and if insufficient, from extocortex of occipital region using Hudson brace & D'Errico craniotomy bit and was grafted on the calvarial bone defect of cranial vault and temporal hollow. Fibrin glues were added to the harvested particulated bone for adherence and shaping of paticles. Results: Autogenous particulate bone grafting was followed-up at least longer than I year. The calvarial bony defects following primary cranial remodeling were successfully covered and postoperative temporal depressions after fronto-orbital advancement were also well prevented by grafted particulated bone. Conclusion: Autogenous calvarial particulate bone graft can be harvested in infants and young children with minimal donor site morbidity. It effectively heals cranial defects in children and during fronto-orbital advancement reduces the prevalence of osseous defects independent of patient age. It's easy and effective method of reconstruction of calvarial defect.

Three-dimensional assessment of nasal changes after maxillary advancement with impaction using stereophotogrammetry

  • Coban, Gokhan;Yavuz, Ibrahim;Karadas, Busra;Demirbas, Ahmet Emin
    • 대한치과교정학회지
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    • 제50권4호
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    • pp.249-257
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    • 2020
  • Objective: To evaluate the changes in the nose in three dimensions after Le Fort I osteotomy in patients with skeletal Class III malocclusion. Methods: The subjects were 40 adult patients (20 females and 20 males; mean age, 20.3 ± 3.0 years; range, 17.0 to 31.1 years) who underwent one-piece Le Fort I osteotomy with maxillary advancement and impaction treatment for maxillary hypoplasia. The mean maxillary advancement was 4.56 ± 1.34 mm, and the mean maxillary impaction was 2.03 ± 1.04 mm. Stereophotogrammetry was used to acquire three-dimensional images before and at least 6 months after surgery. Results: Alare (Al) and alare curvature (Ac) points had moved vertically and anterolaterally postoperatively. A significant increase was observed in the nasal ala width and alar base width, and no changes were noted in the columellar length, nasolabial angle, and nasal area. There was a significant relationship between maxillary impaction and nasal ala width and horizontal and sagittal positions of the bilateral Al and Ac. The only relationship found was between maxillary advancement and postoperative sagittal location of the subnasale and pronasale. Conclusions: Nasal soft tissues were highly affected by the vertical movement of the maxilla; however, the soft tissue responses were individual-dependent.

폐쇄성 수면무호흡증(Obstructive Sleep Apnea)의 외과적 처치 (Surgical approach for treatment of obstructive sleep apnea)

  • 김태경;이덕원
    • 대한치과의사협회지
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    • 제53권12호
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    • pp.926-934
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    • 2015
  • Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.

0.002% 보론첨가 저탄소강의 미세조직 및 기계적 성질에 미치는 열처리의 영향 (Effects of Heat Treatment on the Micro-structures and the Mechanical Properties of 0.002% Boron-added Low Carbon Steel)

  • 임종호;김종식;박병호;이진현;최정묵
    • 한국재료학회지
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    • 제21권6호
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    • pp.303-308
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    • 2011
  • The effect of heat treatment on the micro-structures and the mechanical properties of 0.002% boron added low carbon steel was investigated. The tensile strength reached the peak at about $880-890^{\circ}C$ with the rising quenching temperature and then the hardness decreased sharply, but the tensile strength hardly decreased. The tensile and yield strength decreased and the total elongation increased with a rising tempering temperature, but the tensile and yield strength sharply fell and the total elongation prominently increased from above a $400-450^{\circ}C$ tempering temperature. Tempered martensite embrittlement (TME) was observed at tempering condition of $350-400^{\circ}C$. In the condition of quenching at $890^{\circ}C$ and tempering at $350^{\circ}C$, the boron precipitates were observed as Fe-C-B and BN together. The hardness decreased in proportion to the tempering temperature untill $350^{\circ}C$ and dropped sharply above $400^{\circ}C$ regardless of the quenching temperature.