• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.194-199
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• 2011

There is still debate over which method of the surgery is the most appropriate for the treatment of scaphocephalic infants. In addition, change in psychomotor development following these procedures is a very complex issue that has not yet been resolved. In this paper, the authors describe a surgical technique for immediate spontaneous shape correction of infantile scaphocephaly. There were significant differences between pre- and postoperative cephalic index. We also describe an improvement in the developmental quotient following surgery. Therefore, this expantile zigzag craniectomy should be recommended to correct for isolated sagittal craniosynostosis in infants.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.6-11
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• 2011

Purpose: The cephalic index (CI) is used to classify the head and every race has its unique characteristics. Previous studies published in Korea were limited to demonstrating the periodical change of the CI. This study was done to determine the CI change in 0 to 20 year-old Koreans by sex and age. Methods: The measurement was done on 1,222 Koreans ranging from 0 to 20 years of age, randomly selected from 2,156 who were diagnosed with simple concussion, had no other diseases or anomalies, and took cephalographs from January, 2000 to July, 2008. The files were obtained from $Marosis^{(R)}$ and then photogrammetry was done by $Photoshop^{(R)}$. To standardize the cephalograph, the Frankfort horizontal line was selected as the reference line on lateral view and the line connecting both lateral-orbitales on AP view. The maximal length was obtained from the lateral cephalograph and the maximal breadth from the AP cephalograph. Results: The CI showed no difference by sex (p=0.4848). The CI and age showed negative correlation (p<0.0001). Analyzed separately by the male and the female, the CI showed statistical significance in the male (p<0.0001), but not in the female (p=0.4741) group. Comparing the CI above the age of 11, the CI of the female became greater than that of the male. Conclusion: This study contributes to the standardization of CI measurement and the authors were able to obtain the average CI by age. We concluded that the CI decreased according to age and most Koreans belonged to barchycephalic or hyperbrachycephalic.

• 동의신경정신과학회지
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• 제18권1호
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• pp.37-61
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• 2007

Objective : By examining EEG status in Korean Traditional Medicine (KTM) from the viewpoint of 'form-qi theory(形氣論)', We wish to prepare for the fundamentals of applicability of KTM diagnoses to EEG. In addition, through reinterpretation of existing Western Medicine reports from the viewpoint of KTM, We tried to find out interrelationship between them. Method : In this paper, a methodology applicable to KTM diagnoses of EEG is presented from the EEG features in waveform characteristics, personalized diversity, and cognitive activity reflection. Results : Frequency bands are assigned to corresponding one of the eight trigrams in terms of yin/yang balance, which is analogous with EEG spectrum analysis mostly used in EEG quantification. The amplitude ratio of each EEG for each frequency band gives meaningful index numbers which can be used in EEG data interpretation, and every index number is named after the sixty four hexagrams. These approaches are adopted through both '4-band classification system and '6-band classification system', and applied to pre-existing reported EEG data obtained from normal adults. These analyses show that changes and distribution pattern in the index numbers are observed as a whole on both left-right line and front-back line connecting EEG measurement cephalic electrodes. And differences in distribution pattern of three index numbers deduced from '6-band classification system' are discussed according to constitution. Conclusion : The index numbers introduced here, which are the spectral power ratio for each EEG, are based on KTM yin/yang balance. These index numbers vary according to cephalic location, so its application in terms of traditional meridian theory is strongly expected. The index number distribution also shows different patterns according to constitution.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.77-80
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• 2011

Purpose: We report a patient with DiGeorge syndrome who was later diagnosed as mild metopic synostosis and received anterior 2/3 calvarial remodeling. Methods: A 16-month-old boy, who underwent palatoplasty for cleft palate at Chungnam National University Hospital when he was 12 months old of age, visited St. Mary's Hospital for known DiGeorge syndrome with craniosynostosis. He had growth retardation and was also diagnosed with hydronephrosis and thymic agenesis. His chromosomal study showed microdeletion of 22q11.2. On physical examination, there were parieto-occipital protrusion and bifrontotemporal narrowing. The facial bone computed tomography showed premature closure of metopic suture, orbital harlequin sign and decreased anterior cranial volume. The interorbital distance was decreased (17 mm) and the cephalic index was 93%. Results: After the correction of metopic synostosis by anterior 2/3 calvarial remodeling, the anterior cranial volume expanded with increased interorbital distance and decreased cephalic index. Fever and pancytopenia were noted at 1 month after the operation, and he was diagnosed as hemophagocytic lymphohistiocytosis by bone marrow study. He however, recovered after pediatric treatment. There was no other complication during the 12 month follow up period. Conclusion: This case presents with a rare combination of DiGeorge syndrome and metopic synostosis. When a child is diagnosed with DiGeorge syndrome soon after the birth, clinicians should keep in mind the possibility of an accompanying craniosynostosis. Other possible comorbidities should also be evaluated before the correction of craniosynostosis in patients as DiGeorge syndrome. In addition, postoperative management requires a thorough follow up by a multidisciplinary team of plastic surgeons, neurosurgeons, ophthalmologists and pediatricians.

• Journal of Chest Surgery
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• 제37권4호
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• pp.342-348
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• 2004

말기 신부전 환자의 생명 유지를 위한 혈액투석 치료에 있어서 지속적으로 개존상태가 유지되고 충분한 혈액이 관류되는 투석 경로의 확보는 매우 중요하다. 동정맥루 조성술 시행 후 조기 폐쇄로 인해 투석을 시행하지 못하는 경우, 환자는 경정맥 또는 대퇴정맥 등의 중심 정맥 삽관을 반복적으로 시행 받아 혈액투석을 유지해야 하며 경제적, 시간적 손실을 감수해야 하는 어려움을 겪게 된다. 대상 및 방법: 자가 혈관을 이용한 동정맥루 조성술에 있어 조기개존율에 영향을 미치는 요인을 파악하고, 이를 향상시키기 위해서 2002년 6월부터 2003년 5월까지 1년 간 말기 신부전 환자에게 시행한 총 85예의 동정맥루 수술 중 두부정맥(cephalic vein)과 요골동맥(radial artery)의 단측문합(end-to-side anastomisis)을 시행한 49예를 대상으로 임상분석을 하였다. 걸과: 연구대상 49예에서 조기개존율은 79.6%였다. 환자의 나이나 성별, 고혈압과 당뇨병 유무에 따른 개존율의 차이는 없었으며 환자의 체질량지수 및 고혈압과 당뇨의 유병기간, 술 전 듀플렉스 검사로 측정한 요골동맥의 직경에 따른 조기개존율의 차이는 통계적으로 유의하지 않았다. 수술 전 듀플렉스 검사로 측정한 두부정맥의 직경과 수술 시 측정한 동정맥루의 혈류량이 조기개존율과 유의한 양의 상관관계를 나타내었고, 특히 혈관직경 2.7mm가 초과되는 군에서는 조기 폐쇄 없이 개존율이 100%로 유지되었으며 동정맥루의 혈류량이 100mL/min 이하인 군에서는 조기개존율 33.3%로 100 mL/min초과인 군의 82.2%와 비교할때 유의하게 조기개존율이 낮았다. 결론: 동정맥루에 사용되는 정맥의 직경은 개존율과 밀접한 관련이 있어 가능한 한 직경이 큰 정맥을 선택해야 하며 연구에 따라 다양한 기준이 보고되어 왔으나 보다 정확한 예후 판단을 위해서는 정맥의 직경뿐 아니라 혈관 유출로의 혈류와 협착상태 등에 대한 파악이 필요할 것으로 생각된다. 본 연구에서 측정한 수술 시 동정맥루의 혈류량을 기준으로 판단할때, 100 mL/min 이하의 혈류량을 나타내는 radiocephalic fistula에서는 혈류량 감소의 원인을 찾아 교정술을 시행하고 그 이후에도 혈류량이 증가하지 않을 경우 다른 부위의 혈관 또는 인조혈관의 사용을 고려하여야만 할 것이다.

• 한국의류산업학회지
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• 제12권5호
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• pp.650-656
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• 2010

To present a 6-piece baseball cap pattern with good wearing sensation and with good reflection of head shape, this study conducted direct measurement using martin's anthropometer and indirect measurement using surgical tape among women of 20 to 24 years old. For a crown, correlation analysis was carried out between direct measurements and surface shell measurements of each section on the head to set main items for prototype design, along with regression analysis to complete design formula; for a cap pattern, draping design was used on the finished crown to compete cap pattern design formula. The results showed that main measurement items to design a baseball cap included head circumstance and bitragion arc for a crown and the cephalic index for a cap. For the crown pattern reflecting the shape of the head, 6 pieces were designed with different sizes and types of front (F), side (S), and back (B) patterns; hemline was also designed diagonally and completed by reflecting the curve of the head.

• Journal of International Society for Simulation Surgery
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• 제3권1호
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• pp.22-27
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• 2016

Background Craniosynostosis management using distraction osteogensis represent a challenge for surgeons due to the great variability of the skull deformity even within the same etiology. The ability to apply the simulation surgery for improving the preoperative planning for distraction osteogensis could improve the results.Planning and Simulation 14 patients presented with craniosynostosis had been subjected to simulation surgery prior to real surgery. 3D CT scans was obtained upon patient admission. Adjustment of all skull position to Frankfort horizontal plane was done. 3 different distraction osteogensis plans were done for each patient according to the skull morphology. For each plane, movement for each bone segment was done according to the pre-planned distraction vectors. Also the distances of distractions were pre-determined according to the cephalic index as well as brain volume. Intraoperatively, we choose the most appropriate plan for the patient by the surgeon. At the end of distraction, 3D CT scan was obtained, and was compared to the simulation plan. Also the distance and the direction of distraction was compared to that of the plan. Accordingly, the distance was almost matching that of the simulation surgery, however the vector of distraction was not matched.Conclusion Preoperative stimulation planning for craniosynostosis patient is very valuable tool in the surgical management of craniosynostosis patients.

• 대한소아치과학회지
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• 제30권4호
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• pp.563-575
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• 2003

호흡기능 또는 근기능이 얼굴의 구조적 관계에 미치는 영향을 평가하고자 어려서부터 한가지 운동종목을 전공하여 온 체육대학 학생 137명을 운동의 유형에 따라, 지속적으로 심폐지구력이 많이 요구되는 운동군(1군), 심폐지구력이 많이 요구되기는 하나 1군보다는 적게 요구되는 운동군(2군), 그리고 순간적인 근력이 크게 요구되는 운동군(3군)으로 분류하고, 정모 및 측모 방사선사진을 계측학적으로 평가하여 다음과 같은 결론을 얻었다. 1. 머리너비길이지수는 모두 단두개에 속하였으며, 각 군간에 유의한 차이가 없었다(p>0.05). 2. 1군과 2군의 얼굴지수는 유의한 차이가 없었으나(p>0.05), 1군과 3군간, 2군과 3군간에는 현저한 차이가 있었다(p<0.05). 3. 얼굴지수와 높은 상관관계를 지닌 각 군의 계측항목은 전하안면높이(상관계수: $0.63{\sim}0.69$, p<0.001), 총안면높이, 전상치조높이, 전하치조높이 및 총안면두개높이 등이었다. 4. 3군의 두개계측치는 전상안면높이(상관계수: $0.36{\sim}0.55$, p<0.001) 및 전하안면높이(상관계수: $0.31{\sim}0.56$, p<0.001)와 높은 상관관계를 나타냈다. 5. 1군과 2군은 얼굴의 수직 계측치가 전반적으로 컸고, 3군은 수평 계측치가 크게 나타나는 경향을 보였다.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.681-687
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• 2006

Purpose: The nose of most Koreans is characterized as a low nasal dorsum, retracted columella, and an acute columella-labial angle. For the surgical correction of the tip and columella, a modified septal extension graft, along with augmentation rhinoplasty has been developed. Methods: With this technique, a septal extension graft is fixed on the entire caudal margin of the septum (the cephalic-caudal axis) and at the same time, it is placed above the anterior nasal spine, in the membranous portion of the septum and at the base of the columella(the anterior-posterior axis). The present report describes the results obtained in 13 patients and offers an analysis of the results as judged by the columella-labial angle and 4 proportional indices(nose height index, nasal bridge length index, nasal tip projection index, columella length index), measured by photogrammetry. Results: The postoperative values obtained in these 5 categories increased significantly compared to the preoperative ones, thus confirming that the projection of tip was augmented, the nose was lengthened, and the columella was advanced caudally and lengthened. Moreover, these positive outcomes were still maintained during the follow-up period, and no side effects, such as saddle nose deformity, were reported. Conclusion: A modified septal extension graft can be considered as an effective method for the surgical correction of the nasal tip and columella in Koreans.

• Journal of Chest Surgery
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• 제53권5호
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• pp.297-300
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• 2020

Background: This study aimed to assess the effect of vessel size and flow characteristics on the maturation of autogenous radiocephalic arteriovenous fistulae (RCAVFs). Methods: We retrospectively reviewed records of patients undergoing RCAVF creation at a single medical center from January 2013 to December 2019. Operative variables were compared between patients whose fistulae matured and those whose fistulae failed to mature. Results: Overall, 152 patients (33 of whom were women) with a mean age of 62.6±13.6 years underwent RCAVF creation; functional maturation was achieved in 123. No statistically significant differences were observed between patients in whom maturation was or was not achieved in terms of the following variables: female sex (20.3% vs. 25.0%), radial artery size (2.5 vs. 2.4 mm), and pulsatility index (0.69 vs. 0.62). Low intraoperative transit time flowmetry (TTF; 150.4 vs. 98.1 mL/min) and small vein size (2.4 vs. 2.0 mm) were associated with failure of maturation. The best cutoff diameter for RCAVF TTF and cephalic vein size were 105 mL/min and 2.45 mm, respectively. Conclusion: In patients who undergo RCAVF creation, vein diameter on preoperative ultrasonography and intraoperative TTF are predictors of functional maturation. We identified an intraoperative TTF cutoff value that can be used for intraoperative decision-making.