• Title/Summary/Keyword: Anatomical Factor

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Practical stepwise approach to rhythm disturbances in congenital heart diseases

  • Huh, June
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.680-687
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    • 2010
  • Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.

THE PREVALENCE OF SENSORY DISTURBANCE AFTER IMPLANT SURGERY - RETROSPECTIVE SURVEY OF IMPLANT PRACTITIONERS (임플란트 식립후 하악 신경손상에 대한 후향적 연구)

  • Kwon, Tae-Geon;Kim, Shin-Yu;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.339-344
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    • 2004
  • The purpose of this study was to evaluate neurosensory disturbance associated with implant surgery performed by implant practitioner (n=47) composed of trained oral surgeon, periodontist, prosthodontist. The incidence, type and duration of sensory disorder were investigated. Anatomical factor of the patient and experience of operator were also evaluated. The result revealed high incidence of inferior alveolar nerve damage (45%) regardless of experience of implant practitioner. The sensory disturbance sustained within 6 months for 61% of cases, which revealed almost normal recovery of nerve function. Initial neurologic sign after nerve damage was not coincide with their consequence of recovery. Half of the practitioners tried surgical intervention to the implants such as removing the fixture, partial unscrewing or re-implant shorter fixture, of which trial regarded as effective measure for 53% of cases. The result indicates that the objective method of sensory nerve evaluation should be introduced to the implant practitioners and the importance of informed consent for possibility of nerve damage in mandibular implant fixation.

Rate and Regularity of Articulatory Diadochokinetic Performance in Healthy Korean Elderly via Acoustic Analysis (음향학적 분석을 통한 노년층 연령에 따른 조음교대운동의 속도 및 규칙성)

  • Cho, Yoonhee;Kim, Hyanghee
    • Phonetics and Speech Sciences
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    • v.5 no.3
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    • pp.95-101
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    • 2013
  • Aging is related to anatomical and physiological changes in respiratory and phonation organs. These changes influence articulation which leads to inaccurate speech and slow articulatory diadochokinesis(DDK). DDK indicates the range, rate, regularity, accuracy, and agility of articulation that reflect motor speech function. The purpose of this study is to investigate the rates and regularities of DDK in healthy Korean elderly through passive acoustic analysis (Praat). Thirty subjects between the ages of 65 and 94 participated in this study. Rate was observed for 5 seconds, while regularity was calculated based on the standard deviation on the following: 1) syllable duration of each task; 2) gap duration between syllables. Then, simple regression analysis was conducted in order to examine the effect of age on performance. The result showed that the slow rate was not a significant factor in terms of advancing age. Furthermore, regularity indicated a significant difference in the following: 1) /pʌ/, /kʌ/ and /pʌtʌkʌ/ in syllable duration; 2) /kʌ/ duration in the gap between syllables. In conclusion, articulatory coordination is reduced with the onset of aging. In particular, /kʌ/ would be a sensitive task for articulatory coordination.

Prevention of Lower Eyelid Complications Caused by a Subciliary Approach: Temporary Lower Eyelid Suspension (속눈썹밑 접근법에 의한 아래눈꺼풀 합병증의 예방: 일시적 아래눈꺼풀 걸기술)

  • Burm, Jin Sik;Kim, Boo Yeong;Kim, Yang Woo
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.465-468
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    • 2006
  • Purpose: Subciliary approaches to orbitozygomatic fractures have high incidence of complications such as scleral show and ectropion. Abnormal rearrangement of eyelid flaps may be a very important factor to induce abnormal cicatrical and consequent contracture. To prevent this problem, we used temporary lower eyelid suspension. Methods: A total of two hundred five patients were investigated for lower eyelid complication of orbitozygomatic fractures that underwent reconstruction with subciliary approach. The lower eyelid margin was pulled up toward the forehead using lower eyelid suspension suture to stretch the lower lid flaps. The lid suspension was maintained for one day after surgery. Results: The complications of the lower eyelid were in 15 cases(7.3%); seven cases(3.4%) of visible depressed scar, three cases(1.4%) of scleral show, two cases(1%) of ectropion, two cases(1%) of conjunctival swelling and one case(0.5%) of hematoma. Conclusions: The lower eyelid suspension seems to allow adhering lid flap in proper anatomical position and in the status of the maximal stretch and consequently preventing the severe complications such as scleral show and ectropion caused by scar contraction after subciliary approach.

Myiasis Associated with Oral Squamous Cell Carcinoma - A Literature Review

  • Al-Maweri, Sadeq Ali;Al-Sufyani, Ghadah A;Tarakji, Bassel;Abdulrab, Saleem
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4997-4999
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    • 2015
  • Advanced oral squamous cell carcinoma (SCC) is a possible risk factor for myiasis, a parasitic infestation of vital tissue of humans or other mammals by dipterous larvae (maggots). Oral myiasis is a rare entity, and is mostly associated with various medical and anatomical conditions, such as neglected mandibular fracture, lip incompetence, cerebral palsy, poor oral hygiene, suppurative lesions, and cancerous wounds. Larvae cause itching and irritation due to their crawling movements and can destroy vital tissues, inducing serious or even life-threating hemorrhage. The aim of the present article was to highlight the occurrence of oral myiasis in association with squamous cell carcinoma and also to highlight the treatment and preventive approaches for such cases. A literature search was performed using MEDLINE for articles published in English relating to the occurrence of oral myiasis in oral SCC. Our search revealed 6 reports on myiasis associated with oral SCC. The surgical debridement of infected tissue with the removal of maggots is the treatment of choice in most cases of oral myiasis.

Investigation of the association of idiopathic male infertility with polymorphisms in the methionine synthase (MTR) gene

  • Tanoomand, Asghar;Hajibemani, Abolfazl;Abouhamzeh, Beheshteh
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.3
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    • pp.107-111
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    • 2019
  • Objective: Spermatogenesis is a complex process that is regulated by a number of genes, some of which are involved in folate-dependent 1-carbon metabolism. Methionine synthase (encoded by MTR) is a key enzyme participating in this pathway. This study aimed to investigate the relationship of the MTR 2756A > G polymorphism with idiopathic male fertility in the Iranian population. Methods: The participants of this study included 100 men with idiopathic infertility and 100 healthy men as the control group. Genotyping of MTR 2756A > G was performed using the polymerase chain reaction and restriction fragment length polymorphism technique. The obtained data were analyzed using SPSS ver. 20.0 with a level of confidence of p< 0.05. Results: The frequencies of the A and G alleles at this locus were 77% and 23% in infertile patients and 84% and 16% in the control group, respectively. The frequencies of the GG, GA, and AA genotypes were 5%, 36%, and 59% in the infertile patients versus 3%, 27%, and 70% in the control group, respectively. No significant difference was observed in any genetic models. Conclusion: In general, the findings of this study suggest that the MTR 2756A > G single-nucleotide polymorphism is not a predisposing factor for idiopathic infertility in men.

Current strategies for aesthetic soft tissue refinement in nasal reconstruction

  • Kim, Min Ji;Lim, Hyoseob;Park, Dong Ha
    • Archives of Craniofacial Surgery
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    • v.23 no.3
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    • pp.95-102
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    • 2022
  • The challenges of successful nasal reconstruction, which are related to the anatomical complexity of the region, have been extensively studied. Revisional operations are often required to achieve proper nasal reconstruction, with results resembling the premorbid nasal status. This is necessary to ensure the quality of life of skin cancer patients. Fundamental nasal reconstruction requires both proper soft tissue coverage and proper function. However, earlier studies in the field primarily focused on the functional aspect of nose reconstruction, although the cosmetic aspect is also an important factor to consider. In response to this need, many recent studies on nose reconstruction have proposed various refinement strategies to improve aesthetic satisfaction. Most plastic surgeons accept the nasal aesthetic subunit principle as a standard for nasal reconstruction. This review outlines the commonly used surgical refinement options and management strategies for postoperative complications based on the subunit principle. In patients with nasal defects, a proper technical strategy might help minimize revision operations and optimize the long-term results.

Patellofemoral Instability in Children: Imaging Findings and Therapeutic Approaches

  • Hee Kyung Kim;Shital Parikh
    • Korean Journal of Radiology
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    • v.23 no.6
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    • pp.674-687
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    • 2022
  • Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

A comparison of the implant stability among various implant systems: clinical study

  • Kim, Jae-Min;Kim, Sun-Jong;Han, In-Ho;Shin, Sang-Wan;Ryu, Jae-Jun
    • The Journal of Advanced Prosthodontics
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    • v.1 no.1
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    • pp.31-36
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    • 2009
  • PURPOSE. To determine the change in stability of single-stage, three different design of implant systems in humans utilizing resonance frequency analysis for early healing period(24 weeks), without loading. MATERIAL AND METHODS. Twenty-five patients were included into this study. A total of 45 implants, three different design of implant systems(group A,C,R) were placed in the posterior maxilla or mandible. The specific transducer for each implant system was used. ISQ(implant stability quotient) reading were obtained for each implant at the time of surgery, 3, 6, 8, 10, 12, 24 weeks postoperatively. Data were analyzed for different implant type, bone type, healing time, anatomical locations. RESULTS. For each implant system, a two-factor mixed-model ANOVA demonstrated that a significant effect on ISQ values(group A=0.0022, C=0.017, R=0.0018). For each implant system, in a two-factor mixed model ANOVA, and two-sample t-test, the main effect of jaw position(P > .005) on ISQ values were not significant. CONCLUSIONS. All the implant groups A, C and R, the change patterns of ISQ over time differed by bone type. Implant stability increased greatly between week 0 and week six and showed slow increase between week six and six months(plateau effect).

Anatomic Feasibility of Posterior Cervical Pedicle Screw Placement in Children : Computerized Tomographic Analysis of Children Under 10 Years Old

  • Lee, HoJin;Hong, Jae Taek;Kim, Il Sup;Kim, Moon Suk;Sung, Jae Hoon;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.475-481
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    • 2014
  • Objective : To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement. Methods : A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011. Results : For the C1 screw placement, entry point height (EPH) was the most restrictive factor (47.3% patients were larger than 3.5 mm). All C2 lamina had a height larger than 3.5 mm and 68.8% (51/74) of C2 lamina had a width thicker than 3.5 mm. For C2 pedicle width, 55.4% (41/74) of cases were larger than 3.5 mm, while 58.1% (43/74) of pedicle heights were larger than 3.5 mm. For pedicle width of subaxial spine, 75.7% (C3), 73% (C4), 82.4% (C5), 89.2% (C6), and 98.1% (C7, 1/54) were greater than 3.5 mm. Mean lamina width of subaxial cervical spine was 3.1 (C3), 2.7 (C4), 2.9 (C5), 3.8 (C6), and 4.0 mm (C7), respectively. Only 34.6% (127/370) of subaxial (C3-7) lamina thickness were greater than 3.5 mm. Mean length of lateral mass for the lateral mass screw placement was 9.28 (C3), 9.08 (C4), 8.81 (C5), 8.98 (C6), and 10.38 mm (C7). Conclusion : C1 lateral mass fixation could be limited by the morphometrics of lateral mass height. C2 translamina approach is preferable to C2 pedicle screw fixation. In subaxial spines, pedicle screw placement was preferable to trans-lamina screw placement, except at C7.