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Repair of Complete Atrioventricular Septal Defect with Surgical Modification (변형술식에 의한 완전방실중격결손의 교정)

  • 김웅한;김수철;이택연;한미영;정철현;박영관;김종환
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.628-636
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    • 1999
  • Background: Recent advances in understanding the anatomy of the complete atrioventricular septal defect(including right-dominant unbalanced atrioventricular septal defect) have led to alternative methods of repairing these defects. Material and Method: From May 1997 to July 1998, 8 consecutive infants(age range, 2 to 28 months, mean body weight 6.0$\pm$2.2 kg) received a single-stage intracardiac repair of the complete atrioventricular septal defect with modified surgical methods. Depending on the specific anatomic structure, the procedure was simplified in 3 patients by a direct closure of the ventricular element of the defect(Group I). Two patients judged unsuitable for direct closure due to a potential left ventricular outflow tract obstruction had received a standard two-patch repair(Group II). The remaining 3 patients with right-dominant unbalanced complete atrioventricular septal defect underwent biventricular repair; to enlarge the orifice of the left atrioventricular valve, the ventricular septal patch was placed slightly more to the right of the ventricular crest, a left sided bridging leaflet was augmented with an autologous pericardial patch, and the leaflet was repaired with a double- orifice(Group III . Result: In all 8 patients, the postoperative echocardiography demonstrated good hemodynamics. Seven patients were weaned from the ventilators after a mean 3$\pm$1 days, and 1 patient was weaned after 24 days due to a reoperation and emphysematous lung problem. A reoperation was performed in 1 patient for progressive left atrioventricular valve regurgitation due to leaflet tearing. There were no early and late mortalities. At the time of the latest review, judging from the echocardiographic criteria, left atrioventricular valve stenosis was mild in 1 patient(mean pressure gradient 6.5 mmHg, 13.5%), left atrioventricular valve regurgitation was absent or grade I in 7 patients(87.5%). The right atrioventricular valve regurgitation was absent or grade I in all 8 patients(100%). Conclusion: Infants with complete atrioventricular septal defect were treated with either a simplified approach with direct closure of the ventricular element of the defect or a modified surgical technique for a right-dominant unbalanced atrioventricular septal defect, depending on the anatomic structure. The results were no operative mortalities and low morbidity.

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Photoelastic evaluation of Maxillary Posterior Crossbite Appliance (Maxillary Posterior Crossbite Appliance의 적용시 응력 분포에 관한 광탄성법적 연구)

  • Jang, Sung-Ho;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.549-558
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    • 2001
  • This study was undertaken to demonstrate the forces in the maxillary alveolar bone generated by the activation of the maxillary posterior crossbite appliance In the treatment of posterior buccal crossbite caused by buccal ectopic eruption of the maxillary second molar. A photoelastic model was fabricated using a Photoelastic material (PL-3) to simulate alveolar bone and ivory-colored resin teeth. The model was observed throughout the anterior and posterior view in a circular polariscope and recorded photographically before and after activation of the maxillary posterior crossbite appliance. The following conclusions were reached from this investigation : 1. When the traction force was applied on the palatal surface of the second molar, stresses were concentrated at the buccal and palatal root apices and alveolar crest area. The axis of rotation of palatal root was at the root apex and that of the buccal root was at the root li4 area. In this result, palatal tipping and rotating force were generated. 2. When the traction force was applied on the buccal surface of the second molar, more stresses than loading on the palatal surface were observed in the palatal and buccal root apices. Furthermore, the heavier stresses creating an intrusive force and controlled tipping force were recorded below the buccal and palatal root apices below the palatal root surface. In addition, the axis of rotation of palatal root disappeared whereas the rotation axis of the buccal root moved to the root apex from the apical 1/4 area. 3. When the traction force was simultaneously applied on the maxillary right and left second molars, the stress intensity around the maxillary first molar root area was greater than the stress generated by the only buccal traction of the maxillary right or left second molar. As in above mentioned results, we should realize that force application on the palatal surface of second molars with the maxillary posterior crossbite appliance Produced rotation of the second molar and palatal traction, which nay cause occlusal Interference. That is to say, we have to escape the rotation and uncontrolled tipping creating occlusal interference when correcting buccal posterior crossbite. For this purpose, we recommend buccal traction rather than palatal traction force on the second molar.

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Photoelastic evaluation of Mandibula Posterior Crossbite Appliance (Mandibular Posterior Crossbite Appliance의 적용시 응력 분포에 관한 광탄성법적 연구)

  • Jung, Won-Jung;Jang, Sung-Ho;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.559-566
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    • 2001
  • This study was undertaken to demonstrate the forces in the mandibular alveolar bone generated by activation of the mandibular posterior crossbite appliance in the treatment of buccal crossbite caused by lingual eruption of mandibular second molar. A three-dimensional photoelastic model was fabricated using a photoelastic material (PL-3) to simulate alveolar bone. We observed the model from the anterior to the posterior view in a circular polariscope and recorded photogtaphically before and after activation of the mandibular posterior crossbite appliance. The following results were obtained : 1. When the traction force was applied on the buccal surface of the mandibular second molar, stress was concentrated at the lingual alveolar crest and root apex area. The axis of rotation also was at the middle third of the buccal toot surface and the root apex, so that uncontrolled tipping and a buccal traction force for the mandibular second molar were developed. 2. When the traction force was applied on the lingual surface of the mandibular second molar more stress was observed as opposed to those situations in which the force application was on the buccal surface. In addition, stress intensity was increased below the loot areas and the axis of rotation of the mandibular second molar was lost. In result, controlled tipping and intrusive tooth movements were developed. 3. When the traction forte was applied on either buccal or lingual surface of the second molar, the color patterns of the anchorage unit were similar to the initial color pattern of that before the force application. So we can use the lingual arch for effective anchorage in correcting the posterior buccal crossbite. As in above mentioned results, we must avoid the rotation and uncontrolled tipping, creating occlusal interference of the malpositioned mandibular second molar when correcting posterior buccal crossbite. For this purpose, we recommend the lingual traction force on the second molar as opposed to the buccal traction.

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STRESS ANALYSIS OF SUPPORTING TISSUES ACCORDING TO IMPLANT FIXTURE DIAMETER AND RESIDUAL ALVEOLAR BONE WIDTH (치조골 폭경과 임플랜트 고정체의 직경에 따른 지지조직의 응력분포)

  • Han, Sang-Un;Vang, Mong-Sook;Yang, Hong-So;Park, Sang-Won;Park, Ha-Ok;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.4
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    • pp.506-521
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    • 2007
  • Statement of problem: The cumulative success rate of wide implant is still controversial. Some previous reports have shown high success rate, and some other reports shown high failure rate. Purpose: The aim of this study was to analyze, and compare the biomechanics in wide implant system embeded in different width of crestal bone under different occlusal forces by finite element approach. Material and methods: Three-dimensional finite element models were created based on tracing of CT image of second premolar section of mandible with one implant embedded. One standard model (6mm-crestal bone width, 4.0mm implant diameter central position) was created. Varied crestal dimension(4, 6, 8 mm), different diameter of implants(3.3, 4.0, 5.5, 6.0mm), and buccal position implant models were generated. A 100-N vertical(L1) and 30 degree oblique load from lingual(L2) and buccal(L3) direction were applied to the occlusal surface of the crown. The analysis was performed for each load by means of the ANSYS V.9.0 program. Conclusion: 1. In all cases, maximum equivalent stress that applied $30^{\circ}$ oblique load around the alveolar bone crest was larger than that of the vertical load. Especially the equivalent stress that loaded obliquely in buccal side was larger. 2. In study of implant fixture diameter, stress around alveolar bone was decreased with the increase of implant diameter. In the vertical load, as the diameter of implant increased the equivalent stress decreased, but equivalent stress increased in case of the wide implant that have a little cortical bone in the buccal side. In the lateral oblique loading condition, the diameter of implant increased the equivalent stress decreased, but in the buccal oblique load, there was not significant difference between the 5.5mm and 6.0mm as the wide diameter implant. 3. In study of alveolar bone width, equivalent stress was decreased with the increase of alveolar bone width. In the vertical and oblique loading condition, the width of alveolar bone increased 6.0mm the equivalent stress decreased. But in the oblique loading condition, there was not a difference equivalent stress at more than 6.0mm of alveolar bone width. 4. In study of insertion position of implant fixture, even though the insertion position of implant fixture move there was not a difference equivalent stress, but in the case of little cortical bone in the buccal side, value of the equivalent stress was most unfavorable. 5. In all cases, it showed high stress around the top of fixture that contact cortical bone, but there was not a portion on the bottom of fixture that concentrate highly stress and play the role of stress dispersion. These results demonstrated that obtaining the more contact from the bucco-lingual cortical bone by installing wide diameter implant plays an important role in biomechanics.

EARLY HISTO(PATHO)LOGIC CHANGES AND RECOVERY OF TOOTH AND PERIODONTAL TISSUE IN INTRUSION OF PREMOLAR ON YOUNG ADULT DOGS (유성견의 소구치 압하시 초기 치아 및 치주 조직의 조직학적 변화와 재생에 관한 연구)

  • Ahn, Byeong-Kyo;Cha, Kyung-Suk;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.297-310
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    • 1998
  • The purpose of this study was to investigate the initial tissue change, to repair on the teeth & surrounding tissue under the intrusive orthodontic forces by use of elastic chain, through the microscopic findings. For this study, three young adult mongrel dogs were used, and were divied into three group : the control group was deliveried only casting crown and the experimental group 1 was equipped with energy chain during 1 week and experimental 2 group was deliveried using energy chain during 1 week and 3 weeks observation. All experimental groups and control groups were sacrificed to make the samples for microscopic findings on premolar teeth. All samples were examed and compared the histologic changes through the microscopic with H-E stain. The obtained results were as follows. 1. In hematoxylin-eosin stain of the control group, the periodontal ligament was constant width from apical third to cervical third of the root, and the periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle and apical third of the root. 2. In Masson Trichrome stain of the control group, osteoblast and osteoclast appeared in cervical third of root, and bone resorption and new bone formation was observed in middle and apical third of the root. 3. In experimental 1, osteoclasts were increased highly, and hyperemia of blood vessels and new bone formation and bone resorption by reversal line in apical third of the root were seen. PDL width was increased apprarently from crest to apex of the root and more in apical third. 4. In experimental 2, osteoclasts and hyperemia of blood vessels were more increased than control material in apical third of the root. PDL width was increased more than control group in root apex, and was seen less than experimental 1. PDL arrangement was similar to experimental 1 and was mixed only in root apex. Therefore, in premolar intrusion of the young adult dog, there were increased osteoclast, hyperemia and dilation of blood vessel, resorption of alveolar bone and cementum and different arrangement of PDL in initial tissue change. There was not observed complete repair after remove intrusive force.

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Effect of a Pulsed Nd:YAG laser irradiation on human gingival tissues (파동형 Nd:YAG 레이저조사가 인체 치은조직에 미치는 영향)

  • Kang, Kyung-Dong;Kim, Chun-Suk;Kim, Hyung-Soo;Kim, Hyun-Seop;Kim, Byung-Ock;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.26 no.4
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    • pp.989-1002
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    • 1996
  • The purpose of this study was to determine the effect of a pulsed Nd:YAG laser irradiation on human gingival tissues. The patients, who were planned to be treated by clinical crown lengthening procedure and gingivectomy, were selected. All the patients received oral hygiene instruction, scaling and root planing at preoperation. The crest of gingival tissue on upper and lower anterior teeth was irradiated by a pulsed Nd:YAG laser(El. EN. EN060, Italy) with a fiber optic of 300 m in contact mode for 20 seconds. Gingival tissues were divided into 4 groups according to the laser power of 1.0W(10Hz, 100mJ), 2.0W(20Hz, 100mJ), 3.0W(30Hz, 100mJ) and 4.0W(40Hz, 100mJ). Immediately after the laser irradiation, the specimens were excised, fixed 10% neutral formalin, sectioned $4-6{\mu}m$ thick, stained by Hematoxylin-Eosin and Periodic Acid Schiff stain and observed under light microscope. The removed tissue depth and the coagulated layer depth due to a laser irradiation by a laser irradiation were measured on the microphotographs. The difference of measurements according to the different laser power was statistical1y analyzed by Kruskal Wallis Test with SAS program. The results were as follows : 1. In histologic findings of irradiated gingival tissues; a. In the irradiated gingival specimen with 1.0W laser power, some vesicles were observed in limited superficial layer of gingival epithelium. b. In the irradiated gingival specimen with 2.0W and 3.0W laser power, the epithelium was almost removed except for the traces of viable basal cell remnants at ret peg, and coagulation necrosis related with the thermal effect of laser was noted. c. In the irradiated gingival specimen with 4.0W laser power, complete removal of epithelium, partial removal of underlying connective tissue, and the coagulation necrosis of subjacent gingival tissue were shown. 2. The removed tissue depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of removed tissue depth between 1.0W group ($44.54{\pm}6.99um$) and 3.0W group ($99.75{\pm}6.64{\mu}m$), and between 1.0W group($44.54{\pm}6.99{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$), and between 2.0W group($98.01{\pm}4.53{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$)(P<0.05). 3. The coagulated layer depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of coagulated layer depth between 1.0W group($31.82{\pm}8.99{\mu}m$) and 3.0W group($55.99{\pm}20.94{\mu}m$), and between 1.0W group($31.82{\pm}8.99{\mu}m$) and 4.0W group($83.68{\pm}10.34{\mu}m$)(P<0.05). From this study, the results demonstrated that the effects of a pulsed Nd:YAG laser irradiation on gingival tissues seemed to depend on the laser power and that the irradiation with high power could be harmful to adjacent healthy tissue.

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THE CLINICAL APPLICATION OF BUCCAL ACRYLIC APPLIANCES (Buccal acrylic appliance의 임상적 적용)

  • Noh, Hong-Seok;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.315-321
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    • 2007
  • Removable appliance has many utilities in pediatric dentistry in the fields of space maintainance or occlusal guidance. In contrast to maxilla, many problems have occurred with mandible in using removable appliance such as deteriorated retention, inconvenience and patient's unwillingness to wear. It is probably due to adapting several retentive clasps at buccal side of the tooth, where there is actually little or no undercut especially in young children having the erupting teeth Moreover, acrylic base plate of conventional removable appliance is located at lingual parts, which leads to the conflict with alveolar crest undercut and sublingual soft tissues. Moreover, young children frequently do not follow the dentist's direction to elevate tongue properly during the impression taking process. Throughout this study, the position of clasps and acrylic baseplate was changed opposite to the traditional Hawley acrylic appliance in order to make a buccal acrylic appliance with buccal base plate and lingual clasp into primary dentition and early mixed dentition. This study was performed for the purpose of evaluating the buccal acrylic appliance in regards of patient compliance, retention and efficiency compared with traditional lingual acrylic appliance along with its merits and demerits. Buccal and lingual acrylic appliance were applied to 5 cases respectively which required space maintaining and tooth movement, and drew a comparison in relevance to patients' compliance, combination with the tongue's function and clinical effectiveness. According to this study, in every case buccal appliance was proved superior to lingual appliance in terms of retention and patients' compliance. Moreover, buccal appliance has shown to be similar to lingual appliance with respect to clinical effectiveness. Throughout this study, it was thought that, if removable appliance is to be applied to mandible, several drawbacks related to conventional lingual appliance shall be resolved. Conclusively, the buccal acrylic appliance is thought to be a good alternative in designing a mandibular appliance in young children and recommended to clinical applications.

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Development of an Aerodynamic Simulation for Studying Microclimate of Plant Canopy in Greenhouse - (2) Development of CFD Model to Study the Effect of Tomato Plants on Internal Climate of Greenhouse - (공기유동해석을 통한 온실내 식물군 미기상 분석기술 개발 - (2)온실내 대기환경에 미치는 작물의 영향 분석을 위한 CFD 모델개발 -)

  • Lee In-Bok;Yun Nam-Kyu;Boulard Thierry;Roy Jean Claude;Lee Sung-Hyoun;Kim Gyoeng-Won;Hong Se-Woon;Sung Si-Heung
    • Journal of Bio-Environment Control
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    • v.15 no.4
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    • pp.296-305
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    • 2006
  • The heterogeneity of crop transpiration is important to clearly understand the microclimate mechanisms and to efficiently handle the water resource in greenhouses. A computational fluid dynamic program (Fluent CFD version 6.2) was developed to study the internal climate and crop transpiration distributions of greenhouses. Additionally, the global solar radiation model and a crop heat exchange model were programmed together. Those models programmed using $C^{++}$ software were connected to the CFD main module using the user define function (UDF) technology. For the developed CFD validity, a field experiment was conducted at a $17{\times}6 m^2$ plastic-covered mechanically ventilated single-span greenhouse located at Pusan in Korea. The CFD internal distributions of air temperature, relative humidity, and air velocity at 1m height were validated against the experimental results. The CFD computed results were in close agreement with the measured distributions of the air temperature, relative humidity, and air velocity along the greenhouse. The averaged errors of their CFD computed results were 2.2%,2.1%, and 7.7%, respectively.

Characteristic of Wave Diffraction and Reflection for Irregular Waves in SWASH Model Around Small Port Structures (소규모 항만 구조물 주변에서 불규칙파에 대한 SWASH 모형의 반사 및 회절)

  • Kwon, Kyong Hwan;Park, Chang Wook;Park, Il Heum;Kim, Jong Hoon
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.31 no.6
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    • pp.468-477
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    • 2019
  • The numerical model of Boussinesq approximation, which is mainly used for evaluating the port calmness due to the irregular waves, has a limit of applicability of lattice size in ports such as marinas with narrow port openings of around 30m. The SWASH model controls the partial reflection according to the depth, porosity coefficient and structure size when applying the reflected wave incident on the structure and terrain. In this study, the partial reflection evaluation at the front of the structure according to the bottom shape and the shape of the structure are examined. In order to evaluate the reproducibility of the model due to the diffraction waves entering the term, the area of incidence at right angles and inclination of the structure is constructed and compared with the diffraction theory suggested by Goda et al. (1978). The experimental results of the sectional structure reflectances calculated as the depth mean show reflectances similar to the approximate values of the reflectances presented by Stelling and Ahrens (1981). It is considered that the reflected wave is well reproduced according to the control of the reflected wave at the boundary and the shape and topography of the structure. Compared with previous studies to examine the diffraction of the wave incident from the breakwater opening, the wave incidence angle and the shape of the diffraction wave are very similar to the theoretical values, but both oblique and rectangular incidence In the case where the direction concentration is small, the diffraction degree is underestimated in some sections with the crest ratio of 0.5 to 0.6.

Morphology of Larvae, Egg Development and Spawning Behavior of the Blenniid Fish, Pictiblennius yatabei (Jordan et Snyder) (청베도라치, Pictiblennius yatabei의 산란습성(産卵習性), 난발생과정(卵發生過程)및 부화자어(孵化仔魚)의 형태(形態))

  • Kim, Yong-Uk;Myoung, Jung-Goo;Han, Kyeong-Ho;Kang, Chung-Bae
    • Korean Journal of Ichthyology
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    • v.4 no.2
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    • pp.44-54
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    • 1992
  • The blenniid fish, Pictiblennius yatabei(Jordan et Snyder) is ditributed in the central and southern Japan and southern Korea. The fish grows to a maximum size of 9cm in total length, and it seems to be matured in two years. Sex dimorphisms of the fish appear in the crest and the anal fin. Five egg masses of the fish were collected in Tongyoung Bay near Kyeong Nam on June 16 and 20, 1991. The eggs were laid on inner surface of empty shells of the oyster, Crassotrea gigas and blue mussel, Mytilus edulis. Each egg mass was guarded by the male parent. Numbers of eggs in each of masses were as about 450~1000.The eggs were spherical but somewhat oval in shape and ranged from 0.72 to 0.80mm in longer axis and from 0.55 to 0.65mm in shorter axis. Each egg was provided with an adhesive pedestal. Hatching took place in 105 hours after formation of embyo at the water temperature varying from 20.0 to $21.4^{\circ}C$. Melanophores appearing on the yolk remarkably changed in form during the embryonic development.The newly hatched larvae, having 32~34 somites, were from 2.71 to 3.35mm in total length. The larvae absorbed the yolk material and oil globule completely in 7 days after hatching and became postlarvae. Nine days after hatching, the larvae averaged 5.35mm in TL and the caudal notochord flex at $45^{\circ}$ Total lengths of the larvae reached 6.00 and 6.58mm in 11 and 13 days after the hatching, respectively.

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