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Switching Genioplasty- a New Genioplasty Technique in Order to Resolve Asymmetry of Chin Area: Case Report (이부 비대칭 치료를 위한 새로운 이부 성형술의 소개 - 전환 이부성형술: 증례보고)

  • Seo, Hyun-Soo;Lee, Young-Joo;Byeon, Kwang-Seob;Hong, Soon-Min;Park, Jun-Woo;Hong, Ji-Sook;Park, Yang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.55-61
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    • 2011
  • Conventional slinding genioplsty has the risk of mental nerve injury after operation and difficult to correct vertical asymmetry of chin. So, authors propose a new genioplasty to correct asymmetry of chin. Switching genioplasty is a modification method of conventional genioplasty. Between mandibular right and left canine, osteotomy line of triangular shape make until mandibular lower border. In large side, osteotome line of wedge shape is added to reduction. After osteotomy, segment of wedge shape was separated from chin. Distal segment was rotated to reduction side. Because of rotation of distal segment, space is made in opposite side. Seperated segement of wedge shape from large side is switched this space to fill. So, stability of distal segment is achieved. Authors applied to swiching genioplasty the patients who was remained the chin asymmetry after both sagittal split ramus osteotome was done because mandible asymmetry. After operation, patient and operator were satisfied with excellent esthetic results without any other complication. The switching genioplasty is effective surgical technique for chin asymmetry because it has more advantages than conventional sliding genioplasty. First, other donor side does not need for bone graft. Second, the switching genioplasty can reduce infection, bone resroption, dehiscence, capsular contraction after allograft. Third, have little mental nerve damage. Forth, anteroposterior correction is possible. Fifth, operation time is less than other genioplasty for chin asymmetry.

Arthroscopic Stabilization Using Remplissage Technique In Recurrent Shoulder Instability with Large Hill-Sachs Lesion - Minimum Six Months Follow-Up Results - (광범위한 Hill-Sachs 병변에서 Remplissage 술기를 이용한 관절경적 재건술 - 최소 6개월 이상 추시 결과 -)

  • Ko, Sang-Hun;Jung, Kwang-Hwan;Jeon, Hyung-Min;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.47-52
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    • 2010
  • Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.

Arthroscopic Treatment of Septic Arthritis of the Shoulder: Technical Pearls to Reduce the Rate of Reoperation

  • Kwon, Ji Eun;Park, Ji Soon;Park, Hae Bong;Nam, Kyung Pyo;Seo, Hyuk Jun;Kim, Woo;Lee, Ye Hyun;Jeon, Young Dae;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.3-10
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    • 2020
  • Background: The aim of this study was to evaluate clinical experience with arthroscopic debridement for septic arthritis of the shoulder joint and to report on our patient outcomes. Methods: The retrospective analysis included 36 shoulders (male:female, 15:21), contributed by 35 patients (mean age, 63.8 years) treated by arthroscopy for septic arthritis of the shoulder between November 2003 and February 2016. The mean follow-up period was 14.3 months (range, 12-33 months). An additional posterolateral portal and a 70° arthroscope was used to access the posteroinferior glenohumeral (GH) joint and posteroinferior subacromial (SA) space, respectively. Irrigation was performed with a large volume of fluid (25.1±8.1 L). Multiple suction drains (average, 3.3 drains) were inserted into the GH joint and SA space and removed 8.9±4.3 days after surgery. Intravenous antibiotics were administered for 3.9±1.8 weeks after surgery, followed by oral antibiotic treatment for another 3.6±1.9 weeks. Results: Among the 36 shoulders, reoperation was required in two cases (5.6%). The average range of motion achieved was 150.0° for forward flexion and T9 for internal rotation. The mean simple shoulder test score was 7.9±3.6 points. Nineteen shoulders (52.8%) had acupuncture or injection history prior to the infection. Pathogens were identified in 15 shoulders, with Staphylococcus aureus being the most commonly identified pathogen (10/15). Both the GH joint and the SA space were involved in 21 shoulders, while 14 cases involved only the GH joint and one case involved only the SA space. Conclusions: Complete debridement using an additional posterolateral portal and 70° arthroscope, a large volume of irrigation with >20 L of saline, and multiple suction drains may reduce the reoperation rate.

Reversed Cyclic Load Tests on Deep Beam-and-Exterior Column Joints (깊은보-외부기둥 접합부의 반복 횡하중 실험)

  • Ko, Dong-Woo;Lee, Han-Seon
    • Journal of the Korea Concrete Institute
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    • v.19 no.3
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    • pp.265-273
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    • 2007
  • The most common structural system for apartment buildings in Korea is adopted to combine structural systems: for example, a moment-resisting frame will be used for lower stories and bearing wall system for the upper stories. This type of buildings have soft and/or weak stories in lower stories, and it may lead to collapse of those buildings during the large earthquake. Reversed cyclic load tests were conducted to estimate the performance and behavioral characteristics of deep beam and exterior column Joints. Experimental parameter is the amount of transverse reinforcement (designed by ACI code and Sheikh's procedure). The results of this study are as follows: (1) The required transverse reinforcement of column designed by Sheikh's procedure requires 2.9 times larger than that designed by ACI procedure. Large amount of transverse reinforcement increase the ductility of the column. (2) Most of the lateral drift in the column is due to the flexural deformation in the joint and plastic hinge region and up-lift rotation. (3) Transverse reinforcement in the exterior column shall be required not only in the hinge region but also in the joint.

Camera Motion Estimation using Geometrically Symmetric Points in Subsequent Video Frames (인접 영상 프레임에서 기하학적 대칭점을 이용한 카메라 움직임 추정)

  • Jeon, Dae-Seong;Mun, Seong-Heon;Park, Jun-Ho;Yun, Yeong-U
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.39 no.2
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    • pp.35-44
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    • 2002
  • The translation and the rotation of camera occur global motion which affects all over the frame in video sequence. With the video sequences containing global motion, it is practically impossible to extract exact video objects and to calculate genuine object motions. Therefore, high compression ratio cannot be achieved due to the large motion vectors. This problem can be solved when the global motion compensated frames are used. The existing camera motion estimation methods for global motion compensation have a large amount of computations in common. In this paper, we propose a simple global motion estimation algorithm that consists of linear equations without any repetition. The algorithm uses information .of symmetric points in the frame of the video sequence. The discriminant conditions to distinguish regions belonging to distant view from foreground in the frame are presented. Only for the distant view satisfying the discriminant conditions, the linear equations for the panning, tilting, and zooming parameters are applied. From the experimental results using the MPEG test sequences, we can confirm that the proposed algorithm estimates correct global motion parameters. Moreover the real-time capability of the proposed technique can be applicable to many MPEG-4 and MPEG-7 related areas.

Maxillary Distraction Osteogenesis Using $TS-MD^{(R)}$ (Trans-sinusoidal Maxillary distractor) on Cleft Patients (Trans-sinusoidal maxillary distractor($TS-MD^{(R)}$)를 이용한 구순구개열 환자에서의 상악골 골신장술)

  • Paeng, Jun-Young;Lee, Il-Gu;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choe, Jin-Yeong;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.2
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    • pp.71-79
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    • 2005
  • Purpose: Maxillary hypoplasia is a common developmental problem of cleft lip and palate. Fair results with distraction osteogenesis have been reported especially when these patients need a large amount of maxillary advancement, instead of orthognathic surgery. The purpose of this study is to evaluate the clinical results with a relatively new distractor, $TS-MD^{(R)}$ (Trans-sinusoidal maxillary distractor, KLS Martin, Tuttlingen, Germany) which was used for the advancement of the maxilla in the cleft patients. Patients and Method: Distraction osteogenesis using $TS-MD^{(R)}$ was performed for four CLP patients (three males and one female) who had maxillary hypoplasia. All patients were over 16 years old. As three patients showed mandibular prognathism as well, bilateral sagittal split ramus osteotomy for mandibular setback was performed at the same time. After consolidation periods of 4 to 12 weeks, the distraction devices were removed and miniplates were placed for simultaneous internal fixation. Results: Three patients showed a large amount of incisal overbite but one patient did not have sufficient maxillary advancement. Le Fort I osteotomy, maxillary advancement and internal fixation should have been performed for the patient when removing the distraction devices. Different from the $clinician{\box}s$ expectation, the amount of maxillary advancement using $TS-MD^{(R)}$ was not sufficient, although the device has rigid mechanical property. Rotation of maxilla during distraction forward and downward was also observed. Conclusion: Even though the maxillary advancement with $TS-MD^{(R)}$ device could be achieved, the clinical control of some characteristics related with the device was necessary. More clinical studies on $TS-MD^{(R)}$ should be performed.

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LATEST RESULTS OF THE MAXI MISSION

  • MIHARA, TATEHIRO
    • Publications of The Korean Astronomical Society
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    • v.30 no.2
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    • pp.559-563
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    • 2015
  • Monitor of All-sky X-ray Image (MAXI) is a Japanese X-ray all-sky surveyer mounted on the International Space Station (ISS). It has been scanning the whole sky since 2009 during every 92-minute ISS rotation. X-ray transients are quickly found by the real-time nova-search program. As a result, MAXI has issued 133 Astronomer's Telegrams and 44 Gamma-ray burst Coordinated Networks so far. MAXI has discovered six new black holes (BH) in 4.5 years. Long-term behaviors of the MAXI BHs can be classified into two types by their outbursts; a fast-rise exponential-decay type and a fast-rise flat-top one. The slit camera is suitable for accumulating data over a long time. MAXI issued a 37-month catalog containing 500 sources above a ~0.6 mCrab detection limit at 4-10 keV in the region ${\mid}{b}{\mid}$ > $10^{\circ}$. The SSC instrument utilizing an X-ray CCD has detected diffuse soft X-rays extending over a large solid angle, such as the Cygnus super bubble. MAXI/SSC has also detcted a Ne emission line from the rapid soft X-ray nova MAXI J0158-744. The overall shapes of outbursts in Be X-ray binaries (BeXRB) are precisely observed with MAXI/GSC. BeXRB have two kinds of outbursts, a normal outburst and a giant one. The peak dates of the subsequent giant outbursts of A0535+26 repeated with a different period than the orbital one. The Be stellar disk is considered to either have a precession motion or a distorted shape. The long-term behaviors of low-mass X-ray binaries (LMXB) containing weakly magnetized neutron stars are investigated. Transient LMXBs (Aql X-1 and 4U 1608-52) repeated outbursts every 200-1000 days, which is understood by the limit-cycle of hydrogen ionization states in the outer accretion disk. A third state (very dim state) in Aql X-1 and 4U 1608-52 was interpreted as the propeller effect in the unified picture of LMXB. Cir X-1 is a peculiar source in the sense that its long-term behavior is not like typical LMXBs. The luminosity sometimes decreases suddenly at periastron. It might be explained by the stripping of the outer accretion disk by a clumpy stellar wind. MAXI observed 64 large flares from 22 active stars (RS CVns, dMe stars, Argol types, young stellar objects) over 4 years. The total energies are $10^{34}-10^{36}$ erg $s^{-1}$. Since MAXI can measure the spectrum (temperature and emission measure), we can estimate the size of the plasma and the magnetic fields. The size sometimes exceeds the size of the star. The magnetic field is in the range of 10-100 gauss, which is a typical value for solar flares.

Comparison of the Outcomes according to the Injury Type of the Short Radiolunate Ligament in Fracture-Dislocation of the Radiocarpal Joint (요수근 관절의 골절-탈구에서 단요월상인대의 손상 형태에 따른 치료 결과의 비교)

  • Heo, Youn Moo;Kim, Tae Gyun;Song, Jae Hwang;Jang, Min Gu;Lee, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.51-60
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    • 2021
  • Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

A Fluid Analysis Study on Centrifugal Pump Performance Improvement by Impeller Modification (원심펌프 회전차 Modification시 성능개선에 관한 유동해석 연구)

  • Lee, A-Yeong;Jang, Hyun-Jun;Lee, Jin-Woo;Cho, Won-Jeong
    • Journal of the Korean Institute of Gas
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    • v.24 no.2
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    • pp.1-8
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    • 2020
  • Centrifugal pump is a facility that transfers energy to fluid through centrifugal force, which is usually generated by rotating the impeller at high speed, and is a major process facility used in many LNG production bases such as vaporization seawater pump, industrial water and fire extinguishing pump using seawater. to be. Currently, pumps in LNG plant sites are subject to operating conditions that vary depending on the amount of supply desired by the customer for a long period of time. Pumps in particular occupy a large part of the consumption strategy at the plant site, and if the optimum operation condition is not available, it can incur enormous energy loss in long term plant operation. In order to solve this problem, it is necessary to identify the performance deterioration factor through the flow analysis and the result analysis according to the fluctuations of the pump's operating conditions and to determine the optimal operation efficiency. In order to evaluate operation efficiency through experimental techniques, considerable time and cost are incurred, such as on-site operating conditions and manufacturing of experimental equipment. If the performance of the pump is not suitable for the site, and the performance of the pump needs to be reduced, a method of changing the rotation speed or using a special liquid containing high viscosity or solids is used. Especially, in order to prevent disruptions in the operation of LNG production bases, a technology is required to satisfy the required performance conditions by processing the existing impeller of the pump within a short time. Therefore, in this study, the rotation difference of the pump was applied to the ANSYS CFX program by applying the modified 3D modeling shape. In addition, the results obtained from the flow analysis and the curve fitting toolbox of the MATLAB program were analyzed numerically to verify the outer diameter correction theory.

Factors Affecting Patient Waiting Times at the Outpatient Pharmacy Department in a Tertiary Care Hospital (3차진료기관 외래약국 투약대기시간에 영향을 주는 요인)

  • Park, Hayoung;Han, Ok-Youn;La, Hyun-Oh
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.60-72
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    • 1994
  • Background: The number of outpatients visiting large university teaching hospitals has increased drastically with the introduction of a nationwide health care insurance in 1989 and the improvement of the socio-economic status of the population. This resulted in long waiting times for services, particularly prescribed drugs, which have been patients' chief complaints. Hospitals have tried to solve the problem with limited success because their approach lacked comprehensive research. The objective of this study is to investigate associations between waiting times and variables defining a total work system. Methods: Data for the outpatient pharmacy department in a tertiary care university teaching hospital located in Seoul was analyzed to achieve the study objective. Associations of pharmacy system variables -- work load, work force, pharmacist work schedule, machine problems, and inventory control -- with mean and 99th percentile of waiting times were examined by the hierarchical stepwise regression method. Day was a unit of the analyses. Results: The regression models explained 65.8% of variance in the mean waiting time and 61.34% in the 99th percentile of waiting times. The break-down of the printer for drug envelops, Automatic Tablet Counters (ATCs), and main computer system lasted longer than 30 minutes increased the mean for 7.7 minutes, 4.5 minutes, and 7.0 minutes, respectively, and the 99th percentile for 14.8 minutes, 9.0 minutes, and 15.7 minutes, respectively. Concerning the work force, study results showed that there were significant differences in the productivity of pharmacists with work experience more than three years, one to three years, and less than one year, and showed that peak time aid work by pharmacists at job assignments other than the outpatient pharmacy, part-time pharmacists, and the installation of ATCs were effective in reducing waiting times, Finally, study findings indicated that the operational policy of work assignment and rotation schedule, supply and inventory of drugs at work tables, and readiness for undisrupted work during the work hours could have a significant effect on waiting times. Conclusion: The study results indicated that efforts to reduce waiting times for prescribed drugs should be geared toward every components of the pharmacy work system ranging from work schedule of pharmacists and supply of dugs at work tables. These findings should provide hospital managers with right directions in battling the problem.

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