• Archives of Plastic Surgery
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• 제38권4호
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• pp.376-382
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• 2011

Purpose: In patients with unilateral cleft lip and nose deformity, alar retraction is commonly seen on the non-cleft side after cleft side is corrected. Spacer graft was used to drag down the inferior border of the alar cartilage of the non-cleft side so as to match the cleft side. By performing spacer graft and septal extension graft together, symmetry and cosmetic improvements were achieved. Methods: Seven unilateral cleft lip and nose deformity patients underwent surgery for alar retraction correction. The median age was 24 years (ranged from 15 to 34 years), and the median follow-up period was 7.4 months (ranged from 6 to 12 months). The perpendicular length from the longitudinal axis of the nostril to the alar rim, the nasolabial angle and the ala-labial angle were measured in the lateral view photo. The longest perpendicular length from the cephalic border of the alar rim to the parallel line of the alar base was measured in the frontal view photo. Results: Improvement in alar retraction was seen after the surgery. There were no specific complications during the follow-up and the symmetry of both nostrils was satisfactory. No increase in the nasolabial angle or exposure of the nostrils was seen after the tip projection via tip plasty. Conclusion: The fundamental factor in correcting alar retraction with secondary cleft lip and nose deformity is repositioning the alar rim with spacer graft, which seems to be more physiologic than other methods. The method combining spacer graft with septal extension graft will bring symmetry as well as more cosmetic improvement in correction of alar retraction with secondary cleft lip and nose deformity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.307-311
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• 2007

Purpose: The aim of this study was simply assessing linear measurements in the lateral and medial approach, respectively, for bone harvesting using anatomic and three-dimensional(3D) computed tomographic(CT) analyses on a dried cadaveric proximal tibia. In addition, the availability of the three-dimensional computed tomographic(3D-CT) analysis was also estimated. Materials and methods: Ten dried proximal tibia were obtained from five Korean cadavers. Four the reference points, the SM(superior-medial), IM(inferior-medial), SL(superior-lateral), and IL(inferior-lateral) were marked around the tibial tuberosity. The PM(posterior-medial) and PL(posterior-lateral) points were randomly marked at points farthest from the lateral and medial reference points, respectively, in the posterior border of the superior articular surface of both condyles. All measurements were obtained on the dried proximal tibia. After computed tomography had been performed, the three dimensional images were reconstructed using V works $4.0^{TM}$(Cybermed Inc., Seoul, Korea), and the length between the reference points were measured three dimensionally using the method described above. The error between the mean actual and mean 3D-CT measurements was calculated in order to determine the availability of the three dimensional computed tomographic analysis. Results: The length between the reference points was greatest at the IL-PM, which averaged $65.39mm{\pm}10.35$. This was followed by the SL-PM with $63.24mm{\pm}8.10$, the IM-PL with $58.09mm{\pm}10.02$, and the SM-PL with $51.99mm{\pm}9.06$. The differences between the IL-PM and SM-PL were 13.4 mm. The mean values were 55.04 mm in the medial approach and 64.32 mm in the lateral approach, and the differences between medial and lateral were 9.28 mm. The error between the mean actual and mean 3D-CT measurements was 0.31% and the standard deviation was 0.28%. Conclusion: The anatomical and three dimensional computed tomographic analysis indicates that there was only a 9.28 mm linear difference between the lateral and medial approach. This is consistent with previous studies, which showed that there was little difference between the two approaches in terms of the bone volume. In addition, the error(0.31%) and the standard deviation(0.28%) were considered low, demonstrating high accuracy of 3D-CT. Therefore it can be used in preoperative treatment planning.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권6호
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• pp.263-268
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• 2013

Objectives: The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods: We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results: From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion: When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.

• Imaging Science in Dentistry
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• 제37권4호
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• pp.197-203
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• 2007

Purpose: To provide diagnostic information by evaluation of the positional relationship between the mandibular third molar and the mandibular canal. Materials and Methods: Eighty-nine mandibular third molars were classified as mesioangular, horizontal, vertical, distoangular groups. The distances between the mandibular third molar and the mandibular canal were measured in cone-beam computed tomographs. The height and width ratios of distances from the mandibular third molar and the mandibular canal to the mandibular inferior border and to the lingual cortical plate were calculated. Results: The vertical and buccolingual distances between the mandibular third molar and the mandibular canal were 0.03 mm, 2.96 mm in the mesioangular, 0.37 mm, 3.38 mm in the horizontal, -1.50 mm, 1.38 mm in the vertical, -1.10 mm, 4.20 mm in the distoangular group. There were significant differences in vertical (P < 0.05), but not in buccolingual (P>0.05). The height and width ratios of distances on the mandibular third molar were 47.1 %, 36.1 % in the mesioangular, 47.4%, 34.4% in the horizontal, 37.0%, 46.7% in the vertical, 40.9%, 37.4% in the distoangular group. There were significant differences between the mesioangular and the vertical group, and the horizontal and the vertical group in height ratio (P < 0.05), and also between the mesioangular and the vertical group in width ratio (P < 0.05). The height and width ratios of distances on the mandibular canal showed no significant differences between groups (P > 0.05). Conclusion : The mesioangular group showed the nearest distance between the mandibular third molar and the mandibular canal vertically. The root apex of the mandibular third molar was positioned more buccally in the vertical group than in the mesioangular group.

• Journal of Acupuncture Research
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• 제20권5호
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• pp.133-150
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• 2003

Objective: Recently. many studies have showed the evidences of the effect of the Electro-acupuncture treatment through scientific. Methods : One of these methods is functional MRI. We performed electro-acupuncture on Zusanli(St36) and observed the change of brain activation using fMRI. Zusanli(St36) is located on the lateral side of the lower leg. 3 cun(寸) inferior to the Patella of the lower border. Theoretically and clinically. this point has been considered very important for gynecological disorders. spleen and stomach disorders. and psychological disorders. To see the effects of electro-acupuncture stimulation on Zusanli(St36). the experiment was carried out on twelve healthy volunteers. using the gradient echo sequence with the 3.0T whole-body fMRI system(ISOL). After the needle insertion on right Zusanli(St36). 2 Hz of electric stimulation was given for 30 seconds. repeated five times. with 30 seconds' intervals. The Image analysis including motion correction. talairach transformation, and smoothing was done with SPM99. Results ad conclusion : The electro-acupuncture stimulation on Zusanli(St36) activates Brodmann Area 6, 13, 2, 19, 21, 22, 39, 40, 38, 3which indicates the pathways of the electro-acupuncture stimulation on Zusanli(St36) and the possibility of the relationship of the electro-acupuncture stimulation on Zusanli(St36) with autonomic nervous system, internal organic system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.467-473
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• 2009

Purpose: The aim of this study is to compare volume and revascularization of autogenous block bone grafts in simultaneously cortical perforation of recipient beds and grafts, and only cortical perforation of recipient beds. Materials and methods: Two block bone in 8mm diameter was harvested in both skull using trephine bur on 20 New Zealand white rabbits. Harvested block bone was grafted on both inferior border of mandible. On the left side(experimental side), cortical bone of recipient beds and graft were perforated, and on the right side(control side), the only recipient bed was perforated. The rabbits had been sacrificed and infused the India ink for the observation of revascularization at 20 day and 40 day after surgery. The specimens were processed for H-E staining and quantitative analysis(independent t-test, p<0.01) was made under an optical microscope. In additional, specimens were processed for the observation of revascularization. Results: After 20 days, more bone volume was observed in experimental group, but no significant difference between two groups(p=0.106). There were significantly more bone volume in the experimental group at 40 days after surgery(p<0.01). After 20 days, more discrete vascular sprouts were observed in experimental side, but no difference at 40 days after surgery. Conclusion: We conclude that the cortical perforation of both the recipient beds and grafts improve revascularization at early stage and overall graft persistence.

• Imaging Science in Dentistry
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• 제47권1호
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• pp.39-44
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• 2017

Purpose: Insufficient knowledge of the anatomy of the maxillary sinuses prior to sinus graft surgery may lead to perioperative or postoperative complications. This study sought to characterize the position of the posterior superior alveolar artery (PSAA) within the maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods: A total of 300 patients with edentulous posterior maxillae, including 138 females and 162 males with an age range of 33-86 years, who presented to a radiology clinic between 2013 and 2015 were enrolled in this retrospective cross-sectional study. The distance from the inferior border of the PSAA to the alveolar crest according to the residual ridge classification by Lekholm and Zarb, the distance from the PSAA to the nasal septum and zygomatic arch, and the diameter and position of the PSAA were all assessed on patients' CBCT scans. The data were analyzed using the Mann-Whitney test and the t-test. Results: The PSAA was detected on the CBCT scans of 87% of the patients; it was located beneath the sinus membrane in 47% of cases and was intraosseous in 47% of cases. The diameter of the artery was between 1 and 2 mm in most patients (72%). The mean diameter of the artery was $1.29{\pm}0.39mm$, and the mean distances from the PSAA to the zygomatic arch, nasal septum, and alveolar crest were $22.59{\pm}4.89mm$, $26.51{\pm}3.52mm$, and $16.7{\pm}3.96mm$, respectively. Conclusion: The likelihood of detecting the PSAA on CBCT scans is high; its location is intraosseous or beneath the sinus membrane in most patients. Determining the exact location of the PSAA on CBCT scans preoperatively can help prevent it from being damaged during surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권1호
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• pp.83-88
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• 2011

The goal of this treatment is the surgical-orthodontic eruption of impacted permanent teeth associated with a large dentigerous cyst in a preadolescent patient. Although enucleation of the entire cyst and the extraction of impacted teeth are common treatments, missing permanent teeth cause several problems in young patients. In this report, an 11-year-old female visited with the chief complaint of a large radiolucent lesion from the mandibular anterior area to the left mandibular posterior area. The permanent left canine and premolars were displaced toward the mandibular inferior border area. The extraction of infected deciduous teeth and marsupialization were performed. After 4 months, orthodontic buttons for forced eruption were applied to the impacted permanent teeth. The teeth emerged into the oral cavity 3 months after the orthodontic treatment. Although the root form was abnormal, there were no other pathogenic signs. The alveolar bone had a normal trabecular pattern and the teeth appeared to be well maintained at postoperative 24 months.

• Archives of Reconstructive Microsurgery
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• 제16권1호
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• pp.48-51
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• 2007

There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.

• 한국지역지리학회지
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• 제12권6호
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• pp.656-670
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• 2006

우리나라 대다수의 농촌 지역에서는 초 중등학교 학생 수 감소에 따라 교육기반이 붕괴 위기에 직면해 있으나, 경남 거창군에서는 외부에서 유입한 학생 수가 전체 고등학교 학생 수의 약 25%에 달하는 특이한 현상이 나타나고 있다. 거창군의 중등교육세력권은 1980년대에는 거창군의 접경지역에만 국한되었으나, 1990년대에 들어서부터 점차 전국적으로 확대되었다. 그러나 거창군의 중등교육세력권 확대는 전국적인 명문 고등학교로서의 위상을 확보한 사립 인문계 고등학교인 거창고등학교와 거창대성고등학교에 제한된 현상이라는 점에서 거창군 교육세력권은 불완전한 전국화로 특징지을 수 있다. 이러한 거창군 교육세력권의 시 공간적 변화에는 교육 정책 및 제도의 변화와 학교별 특성이 주요한 요인으로 작용하였다.