• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권6호
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• pp.395-400
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• 2017

Objectives: The aim of this study was to evaluate different anatomical variants of the anterior loop of the inferior alveolar nerve (IAN) via cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 71 patients (36 males and 35 females) were evaluated. We used the classification described by Solar for IAN evaluation. In this classification, three different types of IAN loops were introduced prior to emerging from the mental foramen. We classified patients according to this system and introduced a new, fourth type. Results: Type I was seen in 15 sites (10.6%), type II in 39 sites (27.5%), and type III in 50 sites (35.2%). We found a new type in 38 sites (26.8%) that constituted a fourth type. Conclusion: We found that type III was the most common variant. In the fourth type, the IAN was not detectable because the main nerve was adjacent to the cortical plate and the incisive branch was thinner than the main branch and alongside it. In this type, more care is needed for surgeries including inferior alveolar and mental nerve transposition.

• 대한의용생체공학회:의공학회지
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• 제32권3호
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• pp.230-236
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• 2011

The aim of this study was to investigate the alteration of lumbar spine and trunk postures on different load-carrying types and amounts under static loading. Two load-carrying types(unilateral carrying: UC vs. bilateral carrying: BC) and four different loads(0, 5, 10, and 15 kg) were randomly tested in this study. Carrying a heavy bag would affect human body posture, specifically lumbar spine curvature, which is considered as one of sources of back problems. Previous studies have not paid attention to the approach of the multisegment model of the lumbar spine and trunk. This study separated two compartments of trunk segment(the lumbar and thorax) in the analysis. The multisegment model of the lumbar spine in addition to Helen-Hayes marker set was used. Eight motion analysis cameras and a force plate were utilized. Ten male subjects(mean mass, $70.6{\pm}3.97$ kg; mean height, $178{\pm}4.18$ m) having no musculoskeletal disease participated in this study. We analyzed trunk angles in three anatomical planes and the spinal curvature in sagittal and frontal planes. Increased loading in both UC and BC significantly resulted in increases in trunk forward lean but only UC induced increases in trunk lateral lean. In addition, increased loading in BC produced flatten lumbar curvature in sagittal plane. As far as coupling motion, subjects tended to use axial rotation of the lumbar spine in transverse plane in response to increased UC loading. Finally, it is concluded that the increased static loading in UC rather than in BC tends to causes combined alterations of the spinal postures(sagittal and transverse planes together), which would be vulnerable to improper mechanical stresses on the spine.

• 대한치과보철학회지
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• 제27권1호
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• pp.55-81
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• 1989

Recently the instantaneous center concept has been to understand the biomechanics by which a tissue derangement causes a mechanical derangement in human joint. Therefore, to understand the biomechanics of temporomandibular joint (T.M.J.) as a part of human joint, it is necessary to clarify the instantaneous center of rotation (I.C.R.) in the mandibular movement. Twenty male subjects without T.M.J. disorder and mandibular deviation during the mandibular movement were selected for this study. The habitual opening and closing paths were recorded on the paper of the sagittal metal plate by two pencil markers connected to the resin open clutch attached on the lower teeth, which was designed for this study. The coordinates of the 33-target points and the 109-anatomical landmarks were obtained using a Summagraphic digitizer connected to a 18AT computer. The original raw data of the opening and closing paths were smoothed by B-spline curve fitting technique and then the I.C.R. pathways were determined mathematically by the computer using algorithm for finding the I.C.R. of a planer rigid body model. Also the opening and closing movements of the mandible were simulated according to the determined I.C.R. The results obtained from this study were as follows. 1. At the early opening and the last closing, I.C.R's were almost distributed around the mastoid process outside the mandibular body without the presence in the region of the mandibular condyle. 2. The I.C.R. pathway showed variable patterns to each subject at the opening and closing movements. 3. The K constant with uniform pattern was obtained by the rotation angle times the radius, which was assumed to the index of the mandibular movement. 4. The opening and closing movements of the mandible were simulated by the I.C.R. pathways at the habitual opening and closing movements. 5. The mandibular condyle was rotated or translated accordng to the relative rotation angle and radius of the determinant factors of K contant.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.574-579
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• 2000

Chordomas are rare central nervous system tumors that are found predominantly in the sacrococcygeal(50%) and basiosphenoidal region(35%). Most of the remainder are related to the vertebral bodies and only 1 to 2% of them are known to occur in the thoracic vertebrae. A 15-year-old girl was admitted because of paraparesis. Three months prior to admission, she underwent a lumbar laminectomy at other hospital for the treatment of herniated lumbar disc but paraparesis became rather aggravated after the operation. At admission, MRI showed a low signal T1WI, high signal T2WI mass compressing the cord at T2 vertebral body. The tumor was subtotally removed via costotransversectomy but as the tumor was proven to be a chordoma, a second stage operation via anterior route was followed. At second operation, T2 corpectomy and T1-T3 plate fixation with autogeneous ileac bone graft was performed. Shortly after the operation, preoperative paraparesis disappeared completely and no evidence of tumor recurrence was noticed both clinically and radiologically for next 2 years. Spine surgery at cervicothoracic junction may be technically demanding due to anatomical complexity and hindering large vessels. The authers reviewed this case with special emphasis on the surgical procedure in this region.

• 한국산림과학회지
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• 제76권4호
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• pp.317-329
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• 1987

본(本) 연구(硏究)에서 한국산(韓國産) 녹나무과(科) 식물(植物) 6속(屬) 7종(種)의 뿌리와 줄기의 이기목부(二期木部)를 비교해부학적(比較解剖學的)으로 연구(硏究)하였다. 도관요소(導管要素) 및 목섬유(木纖維)의 직경(直徑)과 길이는 뿌리가 줄기보다 더 넓고, 더 길었다. 계단상(階段狀) 천공판(穿孔板)을 갖는 도과요소(導管要素)의 말단벽(末端壁) 각도(角度)나 횡대수(橫帶數)는 줄기에 비해 뿌리가 더 사각(斜角)이고 다수(多數)였다. 방사조직(放射組織)의 폭(幅)과 높이는 뿌리에서 줄기보다 넓고 높았다. 이런 특징(特徵)들은 계통발생적(系統發生的)인 면(面)에서 볼 때, 도관요소(導管要素)의 직경(直徑)을 제외(除外)한 대부분의 형질(形質)들은 뿌리가 줄기보다 더 원시적(原始的)인 경향(傾向)을 보인다.

• 대한소아치과학회지
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• 제48권3호
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• pp.352-358
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• 2021

Molar-incisor malformation (MIM)은 치관은 정상이나 치근의 비정상적인 형태를 보이는 것이 특징적이다. 제1대구치에 가장 많이 발생하며, 제2유구치나 상악 중절치도 때때로 이환된다. 이 증례 보고에서는 제1대구치를 포함해, 제2유구치에 MIM이 나타난 환자의 증례를 보고하고, 치근이 건전하게 발거된 제2유구치의 micro computed tomography (CT)를 이용한 형태학적 분석을 시행하였다. 발거된 치아에서는 MIM의 외형적 특징인 치관 - 치근 이행부의 cervical constriction을 육안상으로 확인할 수 있었으며, micro CT 분석에서 백악법랑경계부의 광화된 부위 (Cervical Minelarized Diaphragm), 많은 부근관과 막힌 근관 등의 복잡한 근관 형태, 근관 내 석회화 물질, 영구치에 비해 상대적으로 협착된 치관부 치수강이 관찰되었다.

• Clinics in Shoulder and Elbow
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• 제25권3호
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• pp.230-235
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• 2022

Background: Unstable distal clavicles experience high non-union rates, prompting surgeons to recommend surgery for more predictable outcomes. There is a lack of consensus on the optimal method of surgical fixation, with an array of techniques described in the literature. We describe an alternative method of fixation involving the use of a distal clavicular anatomical locking plate with Fibertape cerclage augmentation in our series of patients. Methods: Nine patients (8 males and 1 female), with a mean age of 36 years, who sustained unstable fracture of the distal clavicle in our institution were treated with our described technique. Postoperative range of motion, functional and pain scores, and time to radiographic union were measured over a mean follow-up period of 10 months. Incidences of postoperative complications were also recorded. Results: At the last patient consult, the mean visual analog scale score was 0.88±0.35, with a mean Disabilities of the Arm, Shoulder, and Hand (DASH) score of 1.46±0.87 and American Shoulder and Elbow Surgeons (ASES) score of 94.1±3.57. The mean range of motion achieved was forward flexion at 173°±10.6°, abduction at 173°±10.6°, and external rotation at 74.4°±10.5°. All patients achieved internal rotation at a vertebral height of at least L2 with radiographical union at a mean of 10 weeks. No removal of implants was required. Conclusions: Our described technique of augmented fixation of the distal clavicle is effective, produces good clinical outcomes, and has minimal complications.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.168-175
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• 2003

근위 상완골 골절은 골절의 형태에 따라 크게 관절편 또는 해부학적 경부, 대 결절, 소 결절, 상완골 간부 또는 외과적 경부의 4개의 골절편으로 나눌 수 있다. 현재 널리 사용되고 있는 Neer의 근위 상완골 골절의 분류는 골절선에 의해 골절편을 나누는 분류가 아니며, 1 cm이상전이나 45$^{\circ}$ 이상의 각형성 이 있는 경 우를 전 이 골절편으로 생각하였다. 골절에 대한 관혈적 정 복 및 내고정술의 일차적 적응증은 골다공증이 없는 젊은 환자에서 발생된 튼튼한 내고정물을 시행할 수 있는 삼분 골절로 만족할 만한 결과를 위해 술후 오랜 기간동안 시행할 재활치료에 잘견딜수 있는 활동력 이 좋은 환자여야 한다. 수술적 치료의 절대적 적응증은 개방성 골절 ,혈관이 나 신경 손상이 동반될 때 , 정복이 불가능한 골절 탈구등이다. 반대로 환자가 골다공증이 심하거나, 근위 상완 골절편의 분쇄정도가 심하며 , 튼튼한 내고정을 시행할 가능성 이 희박한 나이가 많은 경 우에는 관혈적 정복 및 내고정술보다 일차적 인공삽입물을 이 용한 관절성형 술을 시행한 후 조기 재활 치료를 시행하는 것을 고려할 수 있다. 상완골 근위부 골절의 수술적 요법에는 다양한 수술 기법과 이에 따른 여러 합병증이 발생할 수 있으며 지속적 이고 체계적 인 재활 치 료가 꼭 필요하다. 여러 수술 기 법 중 관혈적 정복 및 장력 대 강선 기법을 시행할 때 만족할 만한 결과를 얻 을 수 있다. 이 방법 은 수술적 기법이 어렵지 않고, 골에 대한 고정과 함께 회전근 개의 건부착 부위에 대한 봉합을 추가할 수 있으나 역시 여러 가지 합병증이 있으므로 골절의 양상이 나 환자의 상태 ,환자의 활동력 등을 고려하여 치료 방법을 결정하여야 할것으로 사료된다.EX>46N으로, 슬개건-티타늄 간섭나사군이평균 1067.4$\pm$145N에서평균 601.8$\pm$134N으로, 슬개건-생체흡수성간섭나사군이평균 987.1$\pm$168N에서588.7$\pm$124N으로각각40$\%$, 39$\%$, 50$\%$, 24$\%$, 44$\%$, 40$\%$가감소하였다. 결론: 수술후초기고정력은슬괵건을LA나사(R) 또는Semifix(R)로고정하는방법과슬개건을티타늄및생체흡수성간섭나사로고정하는방법등이우수하였으며, 슬괵건을생체흡수성간섭나사나Endobutton(R)으로 고정하는 방법 등은고정력이 상대적으로매우약함을 알수있었다. 최대인장력은단순인장검사로는이상의대퇴골측고정방법의고정력이초기부하를견뎌내는데충분하다고생각되었으나주기성부하실험후현저히감소되어충분한초기안정성을제공하지못함을알수있었다.를 나타내었다. 또한 3m깊이에서의 측방 선량분포에서 Spoiler의 거리변화(6, 10cm)는 심부선량의 변화에 영향을 주지 않는 것으로 확인할 수 있었다. 그리고 위의 실험측정치를 치료계획 시스템에 입력하여 선량분포를 확인한 결과 Spoiler를 사용하는 경우 OPEN에 비해 선량분포 영역을 표면으로 끌어 올릴 수 있으며 Bolus 보다 피부 보호효과는 어느 정도 유지가 되는 것을 보여주었다. 4.결론 이와 같이 Spoiler는 Bolus와 비교하여 6MV 광자선의 build up 영역을 표면으로 증가시키는 동시에 Skin Sparing(피부보호)효과를 유지할 수 있으며 두경부암의 치료에서 Spoiler의 사용이 가능한 조건으로는 조사면이

• Archives of Plastic Surgery
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• 제38권6호
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• pp.851-860
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• 2011

Purpose: Reduction by simply assembling bones is recognized as treatment for a zygoma fracture. However, in patients who originally had a protruding zygoma, the fractured parts look like malarplasty after the edema subsides, giving a soft impression which patients notice. Thus, we created symmetry through simultaneous contralateral malar reduction in a unilateral zygoma fracture. Methods: In this study, the patients who had surgery between July, 2008 and December, 2009 with admission were object. In 76 patients with a zygoma fracture, the patients with bilateral zygoma fractures were excluded. Among 48 patients who had a reduction only after a unilateral zygoma fracture, the patients hoping for a reduction of their rough protruding zygoma were analyzed with front cephalometry. The study progressed on 22 patients who had simultaneous contralateral malar reduction in a unilateral zygoma fracture with consent. After fixing the fracture, we did a straight zygoma osteotomy through a 1.5 cm intraoral incision. After that, we created symmetry with a special ruler and fixed the broken zygomatic arch with a screw and plate. We evaluated the facial index and satisfaction with a statistical analysis before and after the surgery. Results: In 22 patients, there was no reoperation except for 1 patient who had a zygoma fracture. None of the patients were treated for infection or hematoma. Two patients complained of paresthesia after the malar reduction operation, but this subsided in 4 months. Most of them were satisfied with the malar reduction, especially the women, and we obtained a better mid facial contour with decreased facial width ($p$ <0.05). Conclusion: Existing zygoma fracture surgery focuses on anatomical reduction. However, we need to have a cosmetic viewpoint in fractures as interests of face contour arise. Thus, contralateral malar reduction got a 4.7 (range 0~5) from patients who had malar reduction surgery in our hospital. Although adjusting to all zygoma fractures has limitations, it can be a new method in zygoma fractures when there are limited indications of protruding zygoma and careful attention is given to patients' high demands.

• 대한구순구개열학회지
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• 제3권1호
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• pp.11-16
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• 2000

구순열 수술에서 인중의 해부, 형태, 기능적 재건에 도움을 받고자 상순 및 하순의 전층표본을 가지고 미세구조를 관찰하였으며, 자연스럽고 미적인 인중을 재건하기 위해서는 정상적 근육 부착의 재건과 구륜근 표층의 진피 부속물들의 회복과 장력 없는 상순의 접합, 진피 부속물들을 포함한 인중융기의 두께 회복 및 비탄력성 흉터 조직의 최소화가 필요하다고 사료되었다.