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THREE-DIMENSIONAL FINITE ELEMENT STRESS ANALYSIS OF THE JAWS AT THE SIMULATED BILATERAL AND UNILATERAL CLENCHINGS (양측성 및 편측성 이악물기시 상하악골 응력변화 및 변위에 관한 3차원 유한요소법적 연구)

  • Heo, Hoon;Kang, Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.1
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    • pp.71-92
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    • 1999
  • This study is to analyze the stress and displacement on the jaws during the bilateral and unilateral clenching task on three dimensional finite element model of the dentated skull. For this study, the computed tomography(G.E.8800 Quick, USA) was used to scan the total length of human skull in the frontal plane at 1.9mm intervals. The CAD data were extracted from the tomograms through digitizer(Summa Sketch III, USA) and then reconstructed by means of the spline method in the CAD program. In this project, a commercial software I-DEAS(Master Series ver-sion 3.0, SDRC Inc, USA) was used for three-dimensional stress analysis on the finite element model. which consists of articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. The results are as follows. ; 1. During the bilateral clenching, each major muscle forces caused high stresses on various areas of skull: masseter muscle on articular disc and teeth ; temporal muscle on mandible and periodontal ligament ; medial pterygoid muscle on the temporomandibular joint. During the unilateral clenching, masseter muscle induced the maximum stress ; medial pterygoid muscle the minimum stress. 2. During the bilateral clenching, higher compressive stresses on articular disc were generated by the masseter muscle and higher deformation occurred on the most front outer sites. And during the unilateral clenching, temporal muscle and medial pterygoid muscle exerted their forces to twist temporomandibular joint area of the balancing side and induced a higher compressive stresses on the front outer sites of articular disc. 3. During the bilateral clenching, the masseter muscle bended the mandible outwardly, and then caused tensile stresses on the lingual surface of mandibular symphysis. And the medial pterygoid muscle caused tensile stresses on the labial surface of mandibular symphysis. 4. When each muscles were simultaneously applied on jaws, a high stress and displacement took place on mandible rather than on the maxilla. Also, a high stress and displacement took place during the unilateral clenching rather than during the bilateral clenching.

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CASE OF BILATERAL DENTIGEROUS CYSTS TREATED BY MARSUPIALIZATION (양측에서 발생된 함치성 낭종의 치험례)

  • Yoo, Jung-Eun;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.2
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    • pp.196-203
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    • 2002
  • Most dentigerous cysts are solitary. Bilateral and multiple dentigerous cysts are rare and occur typically in association with a number of syndromes such as Maroteaux-Lamy syndrome, Hunter's syndrome, Basal cell nevus syndrome, Marfan syndrome, cleidocranial dysplasia. The presented case is of bilateral nonsyndromic, dentigerous cysts associated with mandibular right and left first premolars. A marsupialization procedure may be a choice of treatment for a large sized dentigerous cyst rather than an enucleation. The marsupialization procedure is recommended during the age when the erupting force of the teeth is still strong. We can expect the unerupted tooth to erupt normally. Although most of bilateral or multiple dentigerous cysts which are not associated with syndromes are rare, a bilateral dentigerous cyst without syndrome is seen. Therefore, it is wise to explain a possibility of development of new one to patient / parents in advance.

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COMPARATIVE ELECTROMYOGRAPHIC ANALYSIS OF MASTICATORY MUSCLES BETWEEN BILATERAL AND UNILATERAL MASTICATORS

  • Na Sun-Hye;Kang Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.40 no.6
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    • pp.577-589
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    • 2002
  • There are several variations in normal mastication. In them, unilateral mastication is chewing, predominantly on a preferred side of the dentition and hardly on e non-preferred side. Continual unilateral mastication may alter the coordination of masticatory muscles. Although they studied about these EMG of masticatory muscles, there were no information about characteristics of masticatory muscle activity in unilateral mastication. Therefore, In this study, we investigated the activity of the masseter and anterior temporal muscles during rest, clenching in maximum intercuspation and gum chewing in habitually unilateral mastication group compared with normal group and tried to know effects of continual unilateral mastication on activity of masticatory muscles. The results of this study were as follows 1. In electromyographic activity during rest, in bilateral mastication group pattern of muscle activity of right and left side was symmetrical. But, in unilateral mastication group, records of anterior part of temporal muscle was higher than that of bilateral mastication group (p<.01) and patterns of muscle activity of right and left side in both muscle were asymmetrical.(p<.05) 2. In electromyographic activity during clenching in maximum intercuspation, records of superficial part of masseter muscle were higher than anterior part of temporal muscle in both group. Muscle activity of temporal muscle in unilateral mastication group was a little higher han bilateral mastication group and asymmetry of activity pattern in temporal and masseter muscle was shown but these differences were not statistically significant. (p<.05) 3. In electromyographic activity during gum chewing, temporal muscle was activated earlier than masseter muscle and maximum bite force is derived from masseter muscle in both group. In unilateral mastication group, electromyographic activity of masseter and temporal muscle of preferred chewing side, regardless of right or left side chewing, was higher than that of bilateral mastication group and especially, difference in masseter muscle was statistically significant. (p<.01) Based on the above results, our study suggested that recording of masticatory muscle activity will be helpful in the effective diagnosis and treatment of some types of the parafunctional habits.

Objective photographic assessments and comparisons of immediate bilateral breast reconstruction using deep inferior epigastric perforator flaps and implants

  • Han, Hyun Ho;Choi, Jin Mi;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.473-482
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    • 2021
  • Background The increasing number of bilateral breast cancer patients has been accompanied by a growing need for bilateral mastectomy with immediate reconstruction. However, little research has investigated the complications and aesthetic outcomes related to bilateral reconstruction. Therefore, we analyzed retrospective data comparing the outcomes of bilateral reconstruction using deep inferior epigastric perforator (DIEP) flaps or implants. Methods This study included 52 patients (24 DIEP group and 28 implant group) who underwent bilateral mastectomy with immediate reconstruction between 2010 and 2020. Patient demographics, surgical characteristics, and complications were recorded. The difference between the left and right position of the nipple-areolar complex with respect to the sternal notch point at the clavicle was measured, and breast symmetry was evaluated. Results The average weight of breasts reconstructed with DIEP flaps (417.43±152.50 g) was higher than that of breasts with implants. The hospitalization period and operation time were significantly longer in the DIEP group. Early complications were significantly more common in the implant group (36.53%) than in the DIEP group. The angles between the nipples and the horizontal line were 1.09°±0.71° and 1.75°±1.45° in the DIEP and implant groups, respectively. Conclusions Although the surgical burden is lower, breast reconstruction using implants requires greater attention with respect to implant positioning, asymmetry, and complications than DIEP flap reconstruction. DIEP flap reconstruction has a prolonged operation time and a high risk of flap failure, but yields excellent cosmetic results and does not require intensive follow-up. Patients should be consulted to determine the most suitable option for them.

Empirical Analysis on the Effects of FTAs and FTA Spillover on the Bilateral Trade using GMM, Fixed and Random Panel Model, and PPML Estimation (GMM, 패널, PPML 비교분석을 통한 FTA와 FTA파급효과 분석)

  • Lee, Soon-Cheul
    • International Area Studies Review
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    • v.22 no.2
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    • pp.3-18
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    • 2018
  • This paper analyzes both the FTA effects and FTA spillover effects on bilateral trade using 62 countries' panel data during the period of 2003 ~ 2013. To this end, we construct a FTA dummy variable for the effect of FTA in the model and the weighted FTA matrix interacted with export and import for the spillover effect of FTA. Gravity model is applied to the empirical analysis with GMM, fixed and random effects, and PPML estimation. As a result of the analysis, FTA variables have positive relationships with bilateral export and import. The weighted FTA matrix interacted with export and import also have positive signs on the bilateral export and import in all estimations. Thus, we conclude that various FTAs of neighbor or 3rd countries increase the bilateral export and import. We provide some implications that a country to increase the amount of trade has a trade relationship with the countries having various FTAs and for the FTA effect analysis, the three-country model is better than to the two-country model.

Does bilateral uterine artery ligation have negative effects on ovarian reserve markers and ovarian artery blood flow in women with postpartum hemorrhage?

  • Verit, Fatma Ferda;Cetin, Orkun;Keskin, Seda;Akyol, Hurkan;Zebitay, Ali Galip
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.1
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    • pp.30-35
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    • 2019
  • Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply. Methods: This prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and $anti-M\ddot{u}llerian$ hormone (AMH) levels. Results: There were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p> 0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p> 0.05 for all). Conclusion: In this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.

Long-Term Evaluation of the Lip and Nose in Bilateral Complete Cleft Lip Patients following Lip Adhesion and Secondary Nose Correction

  • Kim, Ryuck Seong;Seo, Hyung Joon;Park, Min Suk;Bae, Yong Chan
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.510-516
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    • 2022
  • Background Surgical correction of bilateral cleft lip deformities remains one of the most challenging areas in facial plastic surgery. Many surgical techniques and conservative devices have been offered for the early management of bilateral cleft lip in infants. The purpose of this study was to evaluate the effect of lip adhesion on the lip and nose of patients with bilateral cleft lip. Methods A retrospective review of 13 patients with bilateral cleft lip was performed and compared with age-matched noncleft children. Patients underwent lip adhesion at a mean age of 2.8 months, and cheiloplasty at 6.6 months of age using a modification the Mulliken method. Secondary rhinoplasty was performed at the age of 6 in 13 patients. The surgical results were analyzed using photographic records obtained at the age of 1 and 7 years. Twelve length measurements and one angle measurement were obtained. Results All measurements were not statistically different from those of the noncleft age-matched control group at the age of 1. At 7 years of age, upper lip height and vermilion mucosal height were shorter (p < 0.05) than in the control group. Nasal tip protrusion and the nasolabial angle were greater (p < 0.05) than in the control group. Conclusion Lip adhesion followed by secondary rhinoplasty resulted in an acceptable lip and nasal appearance. Although nasoalveolar molding is now widely used, lip adhesion can be an appropriate alternative if an orthodontist is not available due to geographical or economic constraints.

A Rare Case of Acute Pyelonephritis Leading to Bilateral Subcapsular Renal Hematoma: A Case Report (급성 신우신염에 의한 양측 신피막하혈종 1예)

  • Hae Won Park;Minsuk Seo;Chung Sik Lee
    • The Korean Journal of Medicine
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    • v.99 no.3
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    • pp.158-163
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    • 2024
  • This case underscores the rarity of bilateral subcapsular renal hematoma (SCH) as a complication of acute pyelonephritis, and this is the first reported case in South Korea. SCH can have various underlying causes, including cysts, bleeding tendencies, cancer, vascular diseases and, less commonly, infections. A patient with uncontrolled diabetes mellitus and alcohol dependency presented with weakness. Bilateral SCH from acute pyelonephritis was diagnosed and treated with antibiotics and renal replacement therapy. Despite improved renal function, 30-day bilateral percutaneous drainage was necessary due to a persistent fever and elevated infection markers, resulting in a bloody, pus-like discharge. This case report sheds light on the rare etiology of bilateral SCH as a result of acute pyelonephritis. It serves as a reminder of the critical importance of timely intervention, to prevent deteriorating outcomes.

Unilateral approach for bilateral clipping of posterior communicating artery aneurysms in a hybrid operating room: A technical note

  • Juan Luis Gomez-Amador;Pablo David Guerrero-Suarez;Jaime Jesus Martinez-Anda;Jorge Fernando Aragon-Arreola;Andrea Castillo-Matus;Ricardo Marian-Magana;Marcos V Sangrador-Deitos;Alan Hernandez-Hernandez;Ernesto Javier Delgado-Jurado;Ricardo Santiago Villagrana-Sanchez;Abraham Gallegos-Pedraza;Jorge Luis Diaz-Espinoza
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.468-472
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    • 2023
  • Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.

Effects of Occupation-Based Bilateral Upper Extremity Training for Chronic Stroke: Pilot Study (뇌졸중 환자의 작업기반 양측성 상지훈련 효과: 예비연구)

  • Kim, Sun-Ho;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.6 no.2
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    • pp.47-58
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    • 2017
  • Objective : The purpose of this study is to observe effects of Occupation-Based bilateral UE training for chronic stroke. Methods : 4 patients with hemiplegic stroke were divided into two groups: experimental group and control group. From May to August 2016, we conducted a occupation - based bilateral UE training and a traditional bilateral UE training for 5 weeks, 3 times a week, and 60 minutes per session for each subject. EMG, accelerometer, ARAT, Y-BAT, SIS, and COPM were performed before and after the intervention. Results : The experimental group showed a large changes before and after intervention in ECR, DA and all items except for hand function and memory of SIS, compared with the control group. Also, the experimental group showed a large change before and after the intervention compared to the control group in the accelerometer measuring the amount used of bilateral hand and grasp, pinch, and gross movement items of ARAT and COPM, Y-BIT. Conclusions : Occupation-based bilateral upper extremity training was effective in the recovery of upper limb function and social participation through neurological changes. Future research will be required development studies to ensure a high content validity of the Occupation-based bilateral upper extremity training protocol.