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Surgical treatment of the aortic aneurysm (대동맥류의 수술요법)

  • Park, Pyo-Won;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.301-309
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    • 1983
  • Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

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A PHOTOELASTIC STUDY ON THE INITIAL STRESS DISTRIBUTION OF 3 TYPES TMA MULTI-VERTICAL LOOP ARCH WIRE (TMA wire로 제작된 3종류의 MVLAW(Multi-Vertical Loop Arch Wire)의 초기응력분포에 관한 광탄성학적 연구)

  • Lee, Hyeong-Chul;Chun, Youn-Sic
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.73-85
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    • 1995
  • Multi-Vertical Loop Arch Wire(MVLAW) is a kind of appliance for uprighting the mesially inclined posterior teeth axes simultaneously. In this study MVLAW was classified as 3 types by modifing the vertical loop design and named type A, B and C. Each MVLAW was fabricated from .017'x.025' TMA wire and preactivated at the distal end of the open vertical loop with 10 degree tip-back bend(type B has an electric welding stop at the distal end of each loop and type C has no electric welding stop). Type A MVLAW was preactivated at the apex of each open vertical loop with 10 degree tip-back bend(the electric welding stop of type A is positionod at the mesial side of each loop). The aim of the present study was to identify when and which MVLAW is more effective to correct the buccal segment axes simultaneously. The Photoelastic overview of the upper and lower right quadrant showed that stress concentrations were observed in its photoelastic model. The obtained results were as follows : 1. Higher level compression can be seen clearly at the distal curvature of the lower 1st and 2nd molar when A type MVLAW was applied without short class m elastic, but mild compression cannot be seen at the distal curvature of lower anterior teeth using the class m elastic. 2. Higher concentration was presented at the mesial curvature from the lower 1st premolar to the 2nd molar than the anterior teeth when B type MVLAW without short class III elastic was applied, but using the short class III elastic, higher concentration of compression was presented in the anterior teeth area. 3. Areas of higher compression and tension were not observed at the mesial and distal curvature of the entire 1ower teeth except lower central and lateral incisors in C type MVLAW without short class III elastic, but using the short class III elastic, higher concentration was seen at the mesial curvature of the lower 1st premolar and 1ower anterior teeth.

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Stress analysis of Multiloop Edgewise Arch Wire with various degree of tip back bend : a study using the finite element method (Multiloop Edgewise Arch Wire의 tip back 정도에 따른 응력 분포에 관한 유한요소법적 연구)

  • Lee, Young-Il;Cha, Kyung-Suk;Ju, Jin-Won;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.127-142
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    • 2000
  • This study have been carried out to find out the mechnical effect of Multiloop Edgewise Arch Wire(MEAW) making use of the finite element method. The tip back bend of MEAW taken in this analysis is $5^{\circ},\;10{\circ}\;and\;15{\circ}$. In addition, Class II or up & down elastic is applied to find out stress distribution and their values in PDL. A adult male of normal occlusion was selected to create the models of teeth and PDL. And the model of MEAW was also created using commercial finite element code (ANSYS version 5.2). The MEAW is forcibly engaged with a class II or up & down elastic, to determine the initial stress generated in PDL. Comparing the compressive and tensile stress at each reference-planes, following results are obtained. 1. When a MEAW of $5^{\circ},\;10{\circ}\;15{\circ}$ tip back bend was engaged with Class II or up & down elastic, the distribution of compressive, tensile stress in entire PDL is similar in each case. 2. The values of compressive and tensile stress in PDL is higher in $15{\circ}$ tip back bend case than in $10{\circ}\;or\;15{\circ}$ tip back bend case. 3. In the distal PDL of 1st and 2nd molar, compressive stress appears. The compressive area is more wide and its values is higher in PDL of 2nd molar than those in 1st molar. The compressive area and its values become more wide and higher according to the increase of the tip back bend. 4. The values of compressive stress are comparatively smaIIer in PDL of molars than those in premolars. 5. Comparing class II and up & down elastic case, tensile stress values in anterior teeth PDL are smaller md their distribution is more wide in up & down elastic case than class If elastic case. On another hand, there is no difference in distribution and stress values in PDL of posterior teeth between two cases. 6. Comparing the tensile area in PDL of anterior teeth, tensile stress values are maximum in PDL of canine.

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Regional load deflection rate of multiloop edgewise archwire (Multiloop edgewise arch wire의 부위별 하중변형률)

  • Kim, Byoung-Ho;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.29 no.6 s.77
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    • pp.673-688
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    • 1999
  • This study was conducted in order to analyze the mechanical characteristics of multiloop edgewise archwire (MEAW). The purposes were 1) to compare load deflection rate (LDR) of MEAW with that of various other arch wires in the individual interbracket span, 2) to compare the wire stiffness in the interbracket span with that in the multi-L-loop region (the span from distal border of the bracket of the lateral incisor to the mesial border of the buccal tube of the second molar), and 3) to verify the experimental results with theoretically derived formula. The single L-loops of five different horizontal lengths and multi-L-loops for the upper and lower arches were made out of .$016\times.022$ permachrome stainless steel wire. Straight segment of plain stainless steel, TMA and NiTi wire of the same dimension were prepared. The LDR was measured using Instron model 4466 with the load cell of 50N capacity at cross head speed of 1.0mm/min, and maximum deflection of 1.0mm. Five specimens were tested under each experimental condition. The wire stiffness number for each interbracket region and multi-L-loop region was calculated from the LDR and the interbracket spans. By dividing the theoretical model of multi-L-loop into 35 linear segments, the energy stored in each segment was obtained. Then the LDR and wire stiffness of single L-loop and multi-L-loop were calculated and compared. The findings were as follows : 1) The average LDR of MEAW in the individual interbracket region was 1/1.53 of that of the NiTi,1/2.47 of TMA and 1/5.16 of the plain stainless steel wire. 2) The wire stiffness of MEAW in the multi-L-loop region was 1.53 times larger than that in the interbracket region, and the LDR was almost twice as large as that of NiTi in that region. 3) According to the theoretically derived equation, the wire stiffness of the single L-loop was lower than that of multi-L-loop. The results of this study suggest that MEAW has the unique mechanical Property which could allow individual tooth movement and transmit elastic force effectively through the entire arch wire.

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The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

  • Hong, Mihee;Kook, Yoon-Ah;Kim, Myeng-Ki;Lee, Jae-Il;Kim, Hong-Gee;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.199-211
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    • 2016
  • Objective: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. Methods: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or -1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report (심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례)

  • Kim, Seong-A;Noh, Kwantae;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.79-87
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    • 2017
  • The open bite malocclusion is a common clinical entity and has multifactorial causes. Development of effective treatment plan and management is dependent on proper diagnosis. The skeletal open bite patient requires a coordinated orthodontic and orthognathic surgical approach to achieve stable occlusion, acceptable esthetics, and improved function. But in case of open bite with severely decayed dentition, restoration in the entire dentition is necessary. Using the facial analysis and diagnostic wax-up, the most effective treatment was prosthetic rehabilitation. The provisional restorations were fabricated to satisfy esthetic and functional requirements, which result in the uniformly distributed occlusal force, anterior and canine guidance. The inter-arch relationship, labio-dental harmony, and the soft tissue aspect, which is important to estimate the longevity were evaluated. Definitive restorations of monolithic zirconia were made by replicating provisional restorations by using the latest CAD/CAM technology. They were delivered to the patient and clinical follow-up observation was satisfactory.

Finite element analysis of effectiveness of lever arm in lingual sliding mechanics (Lingual sliding mechanics의 lever arm 효과에 대한 유한요소분석)

  • Kim, Kyeong-Hee;Lee, Kee-Joon;Cha, Jung-Yul;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.41 no.5
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    • pp.324-336
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    • 2011
  • Objective: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. Methods: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. Results: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. Conclusions: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.

Implant-supported prosthetic rehabilitation for the edentulous maxilla using the additive manufacturing technology: A case report (레이저 적층 제조 기술을 이용한 상악 무치악 환자의 임플란트 고정성 보철 수복 증례)

  • Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.173-178
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    • 2018
  • The direct metal laser sintering (DMLS) technique would be promising for the full-arch implant-supported restorations due to reduced cost and manufacturing time without potential human errors and casting defects. The aims of this case report were to describe the successful outcome of an implant-supported fixed dental prosthesis in the edentulous maxilla by using the DMLS technology and computer-aided design and computer-aided manufacturing (CAD/CAM) monolithic zirconia crowns, and to describe its clinical implications. A healthy 51-year-old Korean woman visited Seoul National University Dental Hospital and she was in need of a rehabilitation of her entire maxilla due to severe tooth mobility. In this case, all maxillary teeth were extracted and an implant-supported fixed dental prosthesis was fabricated that involved a cobalt-chromium (Co-Cr) framework with the DMLS technique and CAD/CAM monolithic zirconia crowns. Six months after delivery, no distinct mechanical and biological complications were detected and the prosthesis exhibited satisfactory esthetics and function. In this case report, with the DMLS system, the three-dimensional printed prosthesis was created without additional manual tooling and thus, reliable accuracy and passive fit were obtained.

Application of Teeth Whitening LED for Prevention of Dental Caries : Antimicrobial Photodynamic Therapy Approach (치아우식 예방을 위한 치아미백기의 활용 : 광역동 치료로서의 접근)

  • Park, Choa;Park, Howon;Lee, Juhyun;Seo, Hyunwoo;Lee, Siyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.70-77
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    • 2020
  • The present study is aimed to assess the effect of antimicrobial photodynamic therapy (aPDT) on Streptococcus mutans biofilm through teeth whitening light emitting diode (LED). Planktonic and dynamic biofilm state cultures of S. mutans were used. Erythrosine 20 μM/L was used as the photosensitizer. Irradiation was performed by exposing cultures to clinic and homecare whitening LEDs for 15 minutes. The viability was measured through Colony Forming Unit counts and confocal laser scanning microscopy. aPDT using whitening LEDs and erythrosine significantly decreased the CFU count of S. mutans compared to that in the control group. Dynamic biofilm group showed more resistant features to aPDT compared with planktonic state. Clinic and homecare whitening LED device showed similar antimicrobial effect. The whitening LED, which could irradiate the entire oral arch, showed a significant photodynamic effect on cariogenic S. mutans biofilm. aPDT mediated by erythrosine and LEDs used for teeth whitening exhibited promising antimicrobial activity.

Effect of the Member Joint on Structural Performance of an Arch-type Multi-span Greenhouse: A Full-scale Experimental and Numerical Study (부재 접합부가 아치형 연동온실의 구조 성능에 미치는 영향: 실대형 실험적 및 해석적 연구)

  • Choi, Man-kwon;Ryu, Hee-ryong;Cho, Myeong-whan;Yu, In-ho
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.402-410
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    • 2017
  • The effect of the steel pipe member joint on the design performance of a plastic multi-span greenhouse was analysed through the comparing full-scale experiment and numerical analysis. The design performance of the greenhouse is generally evaluated through numerical analysis, but it is rare to consider the characteristics of the connections or joints of the members. In this study, the effect of the column-gutter beam-rafter-wind break wall joint on the design performance of the whole structure of a plastic multi-span greenhouse was analysed. The numerical results with assuming that the member joint are rigid condition were compared with the full-scale load test results using member joints used in the field. The stiffness of the entire structure was compared using the load-displacement relationship and the change of the load sharing ratio that the main members such as column, rafters, and wind break wall was analysed. The results of the load test were about 40% larger than the numerical result and the member stress was more than twice as large as those of the loaded columns. In order to increase the reliability of the design performance of the greenhouse, it is necessary to develop a numerical analysis model which can consider the characteristics of various joints.