• Archives of Plastic Surgery
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• 제49권5호
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• pp.633-641
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• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• Archives of Plastic Surgery
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• 제48권3호
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• pp.269-277
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• 2021

Background The Sunnybrook facial grading scale is a comprehensive scale for the evaluation of facial paralysis patients. Its results greatly depend on subjective input. This study aimed to develop and validate an automated Sunnybrook facial grading scale (SBface) to more objectively assess disfigurement due to facial paralysis. Methods An application compatible with iOS version 11.0 and up was developed. The software automatically detected facial features in standardized photographs and generated scores following the Sunnybrook facial grading scale. Photographic data from 30 unilateral facial paralysis patients were randomly sampled for validation. Intrarater reliability was tested by conducting two identical tests at a 2-week interval. Interrater reliability was tested between the software and three facial nerve clinicians. Results A beta version of the SBface application was tested. Intrarater reliability showed excellent congruence between the two tests. Moderate to strong positive correlations were found between the software and an otolaryngologist, including the total scores of the three individual software domains and composite scores. However, 74.4% (29/39) of the subdomain items showed low to zero correlation with the human raters (κ<0.2). The correlations between the human raters showed good congruence for most of the total and composite scores, with 10.3% (4/39) of the subdomain items failing to correspond (κ<0.2). Conclusions The SBface application is efficient and accurate for evaluating the degree of facial paralysis based on the Sunnybrook facial grading scale. However, correlations of the software-derived results with those of human raters are limited by the software algorithm and the raters' inconsistency.

• 한국정보과학회논문지:소프트웨어및응용
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• 제27권6호
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• pp.618-631
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• 2000

본 논문에서는 2차원 얼굴 영상의 움직임을 추출하여 3차원 얼굴 모델에 합성하는 방법을 연구하였다. 본 논문은 동영상에서의 움직임을 추정하기 위하여 광류를 기반으로 한 추정방법을 이용하였다. 2차원 동영상에서 얼굴요소 및 얼굴의 움직임을 추정하기 위해 인접한 두 영상으로부터 계산된 광류를 가장 잘 고려하는 매개변수화된 움직임 벡터들을 추출한다. 그리고 나서, 이를 소수의 매개변수들의 조합으로 만들어 얼굴의 움직임에 대한 정보를 묘사할 수 있게 하였다. 매개변수화 된 움직임 벡터는 눈 영역, 입술과 눈썹 영역, 그리고 얼굴영역을 위한 서로 다른 세 종류의 움직임을 위하여 사용하였다. 이를 얼굴 모델의 움직임을 합성할 수 있는 단위행위(Action Unit)와 결합하여 2차원 동영상에서의 얼굴 움직임을 3 차원으로 합성한 결과를 얻을 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.35.1-35.6
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• 2020

Background: Miescher's cheilitis granulomatosa (MCG) is a rare chronic inflammatory disease and is known as the monosymptomatic clinical form of Melkersson-Rosenthal syndrome (MRS). It is characterised by swelling of one or both lips and more frequently affects the upper lip. Histopathological findings show the presence of numerous inflammatory infiltrates and granuloma formations. Pharmacological treatments and surgery have provided results that are positive yet insufficiently stable in the long term. The clinical case described is of a 68-year-old female patient with a diagnosis of MCG of the upper lip. Case presentation: The patient was diagnosed and treated at the Oral Medicine and Oral Pathology outpatient clinic of Maxillofacial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico. The patient was recommended localised treatments of photobiomodulation (PBM) using a diode laser with a 635 nm and 980 nm dual-wavelength (λ) approach, a 600-micron fibre, and a handpiece with a 1-cm-diameter lens at 300 mW. Three treatments a week were administered for four weeks for a total of 12 treatment sessions (T₁-T₁₂). After that, the patient had a long follow-up period of about 2 years. The therapeutic results were clear from the initial stages of treatment. There was an immediate, gradual, and consistent reduction in labial swelling. A reduction in the size of the lip by about 35% at T₁₀-T₁₂ was observed, returning the size and volume of the upper lip within the normal clinical range. The painful symptoms subsided after the seventh treatment (T₇). The histopathological check at 3 months and the follow-up in particular confirmed the disease was in remission with satisfactorily stable treatment results. Moreover, the patient did not use any other treatments on the area from the early laser treatments through to the end of the follow-up period. Conclusions: Our experience describes a clinical case of MCG treated with PBM and effectively resolved with a reduction of the lip swelling. The real success of the treatment emerged over time, showing that the tissue healing was stable. In absence of any collateral phenomena, this confirms the effective and documented therapeutic potential of PBM for chronic inflammatory infiltrates.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제13권11호
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• pp.5546-5559
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• 2019

Facial action units (AUs) have recently drawn increased attention because they can be used to recognize facial expressions. A variety of methods have been designed for frontal-view AU detection, but few have been able to handle multi-view face images. In this paper we propose a method for multi-view facial AU detection using a fused multilayer, multi-task, and multi-label deep learning network. The network can complete two tasks: AU detection and facial view detection. AU detection is a multi-label problem and facial view detection is a single-label problem. A residual network and multilayer fusion are applied to obtain more representative features. Our method is effective and performs well. The F1 score on FERA 2017 is 13.1% higher than the baseline. The facial view recognition accuracy is 0.991. This shows that our multi-task, multi-label model could achieve good performance on the two tasks.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.2.1-2.9
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• 2016

Background: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. Method: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. Results: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. Conclusions: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to $1200{\mu}m$ had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.

• 동의생리병리학회지
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• 제22권5호
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• pp.1057-1061
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• 2008

For the purpose of investigating the reasonable logics contained in physiognomy of east and old western medicine. hypothetical researches based on hydromechanics theory were performed concerning facial types of form and pathologic features, especially 4 types of Dr. Jisan-Essence, Qi energy. Emotional Activity and Blood(EQAB). In order to infer the functional relation between facial type forming and EQAB factors, EQAB were supposed as fluid grounded on their continual flowing or periodical change and pressure effect from its congestion. and a premise that there's a linear corresponding relationship between the appearance of organ and its physical conditions of its inner vessels is formed too. Through this work, the unit fluid model(UFM) of Essence can be assumed as circle shape formed by the high viscosity and surface tension, the UFM model of Qi energy as quadrangular shape by the scattering features to outer four directions, and the UFM of emotional activity as inverted triangular shape by the flippant and uprising features, and the UFM of blood as ellipsoid triangle by the heavy and descending features in spite of circulation. The shapes made from each UFM are reproduced in the process of human development and manifest respective facial shape through the self-reproduction method like fractal theory in the last. Conclusively. it is said that the facial form analysis method like EQAB type theory can be the useful methodology to understand the human pathological and physiological features in view of hydromechanics.

• 한국컴퓨터정보학회논문지
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• 제10권3호
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• pp.55-64
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• 2005

사이버 공간 내에서 텍스트나 영상 이외에 보조적인 통신 수단으로써, 아바타 통신을 이용할 수 있다. 실시간 아바타 영상 통신을 위하여, 전체 영상이나 압축 영상을 전송하는 대신에 아바타의 애니메이션 파라미터(팔의 동작 및 제스처를 위한 각도 또는 얼굴 표정을 위한 파라미터 등)만을 전송하는 지적 통신방식을 이용하기도 한다. 본 논문에서는 팔, 다리 등의 파라메타 등의 몸의 동적 움직임을 보조할 수 있는 수단으로써, 송신자의 감정을 표현할 수 있는 아바타의 얼굴 표정 생성에 대하여 제안한다. 얼굴 표정은 AU(Action Unit)에 의하여 표현할 수 있으며, 여기에서는 모양과 구조가 다른 아바타 모델에서 표정을 생성하기 위한 AU를 찾아내는 방법을 제안한다. 그리고, 감정 표현의 극대화를 위하여 얼굴 표현의 효율을 위하여, 눈썹, 눈, 코, 입에 대한 코믹 스타일을 가지는 아바타 모델을 제안한다. 또한, 얼굴 표정 합성을 위한 파라메타들도 제시하도록 한다.

• 한국지능시스템학회논문지
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• 제21권3호
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• pp.395-400
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• 2011

본 논문에서는 얼굴 표정에서 나타나는 동적인 정서상태 변화를 고려한 얼굴 영상 기반 정서 인식 연구를 제안한다. 본 연구는 얼굴 영상 기반 정서적 특징 검출 및 분석 단계와 정서 상태 분류/인식 단계로 구분할 수 있다. 세부 연구의 구성 중 첫 번째는 Facial Action Units (FAUs)과 결합한 Active Shape Model (ASM)을 이용하여 정서 특징 영역 검출 및 분석기법의 제안이며, 두 번째는 시간에 따른 정서 상태의 동적 변화를 고려한 정확한 인식을 위하여 Hidden Markov Model(HMM) 형태의 Dynamic Bayesian Network를 사용한 정서 상태 분류 및 인식기법의 제안이다. 또한, 최적의 정서적 상태 분류를 위한 HMM의 파라미터 학습 시 Harmony Search (HS) 알고리즘을 이용한 휴리스틱 최적화 과정을 적용하였으며, 이를 통하여 동적 얼굴 영상 변화를 기반으로 하는 정서 상태 인식 시스템을 구성하고 그 성능의 향상을 도모하였다.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.419-422
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• 2008

Purpose: Absorbable bone fixation materials for operation of facial bone fracture are composed of poly- lactic acid(PLA) & poly-glycolic acid(PGA). These materials are absorbed after facial bone healing period. Therefore, these materials are harmless in human body. But because of it's radioopacity, the number and the location of the materials are not checked in follow-up X-ray examination. We studied absorbable bone fixation materials checked radiological examination. So, we made the absorbable plate composed of PLA, Hydroxyapatite (HA) and Gold(Au). Methods: Plate 1 was consisted of pure PLA. Plate 2 was consisted of PLA(50%) and HA(50%). Plate 3 - 7 were consisted of PLA(50%), and variable composition of HA & Au. The ratio of Au was as following. From the plate 3 to plate 7, the Au ratio was 1%, 5%, 10%, 17%, and 25%, respectively. Total 3 examinations were used-naked eye examination, simple X-ray examination, and Haunsfield unit of plate in CT examination. Results: Naked eye examination found out that the color of plate 1 was most white. As the Au ratio increases, the color of plate was getting close to khaki color. the radioopacity of plate 2 was similar cortical bone of face in simple X-ray. The Haunsfield unit of cortical bone of face was 1000 HU. Haunsfield unit of titanium plate was 2900 HU. Haunsfield unit of plate 1 through plate 7 were -242, 1489, 1776, 3052, 3092, 3095, and 3095, respectively. Conclusion: Radioopacity of plate 2 was similar to cortical bone of face. In CT examination, Hanusfield unit of plate 2 was similar to Hanusfield unit of cortical bone of face. Hanusfield unit of plate 4 - 7 were similar to Hanusfield unit of titanium plate. So to trace bone fixation materials after facial bone surgery, the best ratio of Au is about 1 - 5%. If this study is applied to facial bone surgery, radiologic follow up would be easy after facial bone surgery.