• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.489-494
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• 2003

Odontomas are the common type of odontogenic tumors and generally they are asymptomatic, depending upon size, location and their limited growth potential. they are rarely diagnosed before the second decade of life, and the frequently lead to impaction or delayed eruption of permanent teeth. Odontomas are classified of compound as compound or complex by morphology. Complex odontomas are unorganized masses of odontogenic tissues, morphologically not resembling the teeth, account for approximately 25 percent of all odontomas, 22 percent of odontogenic tumor of the jaws, and have a predilection for the posterior mandible in males. The etiology of odontomas is unknown, although local trauma, infection, and genetic factors have been suggested. Usually, treatment of odontoma is conservative sugical removal and their is little probability of recurrence. This paper describes two cases of complex odontomas diagnosed in children due to impaction of maxillary first molar in all cases, the surgical excision of the lesions was performed. Follow-up after 2 years, showed spontaneous eruption of the first permanent molar to the occlusal plane.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.200-203
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• 2012

Objective : The sub-axial injury classification (SLIC) and severity scale was developed to decide whether to operate the cervical injured patient or not, but the reliability of SLIC and severity scale among the different physicians was not well known. Therefore, we evaluated the reliability of SLIC among a spine surgeon, a resident of neurosurgery and a neuro-radiologist. Methods : In retrograde review in single hospital from 2002 to 2009 years, 75 cases of sub-axial spine injured patients underwent operation. Each case was blindly reviewed for the SLIC and severity scale by 3 different observers by two times with 4 weeks interval with randomly allocated. The compared axis was the injury morphology score, the disco-ligamentous complex score, the neurological status score and total SLIC score; the neurological status score was derived from the review of medical record. The kappa value was used for the statistical analysis. Results : Interobserver agreement of SLIC and severity scale was substantial agreement in the score of injury morphology [intraclass correlation (ICC)=0.603] and total SLIC and severity sacle (ICC value=0.775), but was fair agreement in the disco-ligamentous complex score (ICC value= 0.304). Intraobserver agreements were almost perfect agreement in whole scales with ICC of 0.974 in a spine surgeon, 0.948 in a resident of neurosurgery, and 0.963 in a neuro-radiologist. Conclusion : The SLIC and severity scale is comprehensive and easily applicable tool in spine injured patient. Moreover, it is very useful tool to communicate among spine surgeons, residents of neurosurgery and neuro-radiologists with sufficient reproducibility.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.127-135
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• 2003

The motions used in throwing place tremendous stresses on the soft tissues about the player's shoulder. In order to throw successfully, the shoulder complex must be capable of excessive motion, while maintaining stability of the glenohumeral joint. Injuries to the throwing player can result from acute trauma, but more commonly can be a result of overuse injuries from the repetitive throwing activity. Inbalance in the muscles and soft tissue about the shoulder can result in an injury secondary to abnormal biomechanics of the glenohumeral complex. The preventive measure a throwing player can take in order to maintain a healthy throwing shoulder is to participate in a regular shoulder strengthening program. It is when the muscles about the shoulder become imbalanced, secondary to either injury or relative weakness, that instability and injury can occur. By understanding the pitching motion and the relative contribution of the muscles, the treating physician has a framework on which to build knowledge regarding physical findings and diagnosis of shoulder injuries in throwing players. Once a diagnosis is made. a successful treatment plan may be developed for the player, including both conservative and , at time surgical means.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.159-164
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• 2008

Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• English & American cultural studies
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• v.10 no.2
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• pp.149-207
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• 2010

Written simultaneously with Prometheus Unbound, Shelley's "Julian & Maddalo" is a masterwork of dramatic poiesis, of doubling embedded in its couplets, dialogic debate on human nature and contrasted symbolic emblems. The emblems mirror each other and are themselves sites of generative paradox: the "heaven illumined" but "dreary tower" of the Maniac and the glorious sunsets on the "ever-shifting sand" of the Lido, a wasteland that is a place of self discovery but also of "abandonment" and barren mingling figured, inter alia, in its "amphibious weeds," a trope of the poem's personae. This essay also explores the poem's dramatic structure and various rhetorical devices, beginning with the Preface, a threshold of complex identity disguise that Shelley uses for veiled self-presentation, as in "Alastor," mirroring and literary references replete with nuanced ironies. I focus mainly on the complex figures of liminality Shelley uses to develop his own thoughts (as well as his ongoing debates with Byron) about man's potential for growth in thought, insight and empathy, in political reform and interpersonal and individual healing. Advancing Shelley's most optimistic ideas, Julian, escorted by Maddalo observes the Maniac, -- a living ruin whose pained eloquence reveals the link of eros to poiesis and the limits of the latter's ability to 'transform a world.' The Maniac is the core of muse-work (remembering, thinking and song) and Shelley presents him as its emblem. He also is prefigured in and reflects the quintessentially liminal Lido with its "barren embrace" of sea and land. Yet it is less the Maniac's feeling that his grief is "charactered in vain…on this unfeeling leaf" than Julian's rationales for leaving the site of pain that point to Shelley's final comment on poetry's transformative limits. As the primary haploids of the drama's meiosis re-combine and two of them, Maddalo and the maniac fall away, an analogy I briefly develop and embedded in the erotic dynamics of poiesis, Shelley suggests, as he did at the beginning of his poetic lyricism in "Alastor" and at its end in "the Triumph of Life"that images mislead and delude; that "the deep truth is imageless" and redemption is not in but beyond figuration.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.228-233
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• 2008

Objective : The standard treatment strategy of intracranial aneurysms includes either endovascular coiling or microsurgical clipping. In certain situations such as in giant or dissecting aneurysms, bypass surgery followed by proximal occlusion or trapping of parent artery is required. Methods : The authors assessed the result of extracranial-intracranial (EC-IC) bypass surgery in the treatment of complex intracranial aneurysms in one institute between 2003 and 2007 retrospectively to propose its role as treatment modality. The outcomes of 15 patients with complex aneurysms treated during the last 5 years were reviewed. Six male and 9 female patients, aged 14 to 76 years, presented with symptoms related to hemorrhage in 6 cases, transient ischemic attack (TIA) in 2 un ruptured cases, and permanent infarction in one, and compressive symptoms in 3 cases. Aneurysms were mainly in the internal carotid artery (ICA) in 11 cases, middle cerebral artery (MCA) in 2, posterior cerebral artery (PCA) in one and posterior inferior cerebellar artery (PICA) in one case. Results : The types of aneurysms were 8 cases of large to giant size aneurysms, 5 cases of ICA blood blister-like aneurysms, one dissecting aneurysm, and one pseudoaneurysm related to trauma. High-flow bypass surgery was done in 6 cases with radial artery graft (RAG) in five and saphenous vein graft (SVG) in one. Low-flow bypass was done in nine cases using superficial temporal artery (STA) in eight and occipital artery (OA) in one case. Parent artery occlusion was performed with clipping in 9 patients, with coiling in 4, and with balloon plus coil in 1. Direct aneurysm clip was done in one case. The follow up period ranged from 2 to 48 months (mean 15.0 months). There was no mortality case. The long-term clinical outcome measured by Glasgow outcome scale (GOS) showed good or excellent outcome in 13/15. The overall surgery related morbidity was 20% (3/15) including 2 emergency bypass surgeries due to unexpected parent artery occlusion during direct clipping procedure. The short-term postoperative bypass graft patency rates were 100% but the long-term bypass patency rates were 86.7% (13/15). Nonetheless, there was no bypass surgery related morbidity due to occlusion of the graft. Conclusion : Revascularization technique is a pivotal armament in managing complex aneurysms and scrupulous prior planning is essential to successful outcomes.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.656-658
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• 2007

Purpose: Prader-Willi Syndrome(PWS) is a congenital chromosomal disorder characterized by compulsive and early development of obesity. Obesity is identified as the main cause of morbidity in PWS individuals. Also, body change for rapid weight gain, such as gynecomastia, can cause considerable functional and psychological trauma, We corrected successfully gynecomastia in PWS patient, so we reported our experience of surgical method and literature reviews. Methods: A 16-year-old male patient presented with gynecomastia. He was diagnosed as with PWS at pediatric department. We performed reduction mammaplasty using inferior pedicle and Wise pattern. Excision amount was 1350g in right breast and 1415g in left breast. Also, we managed upper and lateral fullness of breast with liposuction. Results: There were no specific complications, such as hematoma, infection, nipple-areola complex necrosis, and so on. Also, aesthetic and functional outcome was acceptable Conclusion: We experienced successful correction of gynecomastia in PWS patient, and found advantages of conventional reduction mammaplasty using inferior pedicle and Wise pattern at this specific situation.

• Journal of Acupuncture Research
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• v.37 no.3
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• pp.187-192
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• 2020

Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and self-reported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

• Structural Engineering and Mechanics
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• v.60 no.3
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• pp.405-412
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• 2016

Bone is a living material with a complex hierarchical structure that gives it remarkable mechanical properties. Bone constantly undergoes mechanical. Its quality and resistance to fracture is constantly changing over time through the process of bone remodeling. Numerical modeling allows the study of the bone mechanical behavior and the prediction of different trauma caused by accidents without expose humans to real tests. The aim of this work is the modeling of the femur fracture under static solicitation to create a numerical model to simulate this element fracture. This modeling will contribute to improve the design of the indoor environment to be better safe for the passengers' transportation means. Results show that vertical loading leads to the femur neck fracture and horizontal loading leads to the fracture of the femur diaphysis. The isotropic consideration of the bone leads to bone fracture by crack propagation but the orthotropic consideration leads to the fragmentation of the bone.