• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.161-166
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• 2013

Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.347-358
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• 2013

When analyzing soft tissue of the profile, Subnasale is often used as an important reference point. But there are few studies on the ideal position of the Subnasale. Therefore, the purpose of this study is to present an objective reference of the esthetic face relating to the change of Subnasale position in Koreans' profile, and also to determine whether there is concordance between professionals and laypersons in their perception of facial attractiveness. The one determined as appropriate profile portion by experts of pictures taken in women in 20s was selected. The photograph was modified changing the Subnasale anteroposteriorly on the plane perpendicular to the true vertical line, while maintaining the nasolabial angle. The photographs were presented to a group of professionals (9 orthodontists) and 126 laypersons, who were asked to assess the facial attractiveness of the photographs on a VAS independently. The conclusion was obtained. 1. The ideal position of the Subnasale is when the ratio of the distance Lateral canthus~Subnasale : Subnasale~Pronasale is 1.769 : 1. 2. The ideal degrees between the true vertical line passing through Nasion and Subnasale is $5.5^{\circ}$ 3. The professionals recognized every change in the ratio, but the laypersons couldn't differentiate between the change from 1.571 : 1 to 1.769 : 1.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.623-628
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• 2009

Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.716-722
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• 2018

Objective : Lateral interbody fusion (LIF) is attractive as a less invasive technique to address anterior spinal pathology in the treatment of adult spinal deformity. Its own uses and benefits in treatment of adult degenerative scoliosis are undefined. To investigate the radiographic and clinical outcomes of LIF, and staged LIF and posterior spinal fusion (PSF) for the treatment of adult degenerative scoliosis patients, we analyzed radiographic and clinical outcomes of adult degenerative scoliosis patients who underwent LIF and posterior spinal fusion. Methods : Forty consecutive adult degenerative scoliosis patients who underwent LIF followed by staged PSF at a single institution were retrospectively reviewed. Long-standing 36" anterior-posterior and lateral radiographs were taken preoperatively, at inter-stage, 3 months, 1 year, and 2 years after surgery were reviewed. Outcomes were assessed through the visual analogue scale (VAS), 36-Item Short Form Health Survey (SF-36), and Oswestry Disability Index (ODI). Results : Forty patients with a mean age of 66.3 (range, 49-79) met inclusion criteria. A mean of 3.8 levels (range, 2-5) were fused using LIF, while a mean of 9.0 levels (range, 3-16) were fused during the posterior approach. The mean time between stages was 1.4 days (range, 1-6). The mean follow-up was 19.6 months. Lumbar lordosis was significantly restored from $36.4^{\circ}$ preoperatively up to $48.9^{\circ}$ (71.4% of total correction) after LIF and $53.9^{\circ}$ after PSF. Lumbar coronal Cobb was prominently improved from $38.6^{\circ}$ preoperatively to $24.1^{\circ}$ (55.8% of total correction) after LIF, $12.6^{\circ}$ after PSF respectively. The mean pelvic incidence-lumbar lordosis mismatch was markedly improved from $22.2^{\circ}$ preoperatively to $8.1^{\circ}$ (86.5% of total correction) after LIF, $5.9^{\circ}$ after PSF. Correction of coronal imbalance and sagittal vertebral axis did not reach significance. The rate of perioperative complication was 37.5%. Five patients underwent revision surgery due to wound infection. No major perioperative medical complications occurred. At last follow-up, there were significant improvements in VAS, SF-36 Physical Component Summary and ODI scores. Conclusion : LIF provides significant corrections in the coronal and sagittal plane in the patients with adult degenerative scoliosis. However, LIF combined with staged PSF provides more excellent radiographic and clinical outcomes, with reduced perioperative risk in the treatment of adult degenerative scoliosis.

• Journal of the Korean Society of Marine Environment & Safety
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• v.28 no.2
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• pp.414-421
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• 2022

Subsea oil and gas exploration is increasingly moving into deeper water depths, and typically, subsea pipelines operate under high pressure and temperature conditions. Owing to the difference in these components, the axial force in the pipe is accumulated. When a pipeline is operated at a high internal pressure and temperature, it will attempt to expand and contract for differential temperature changes. Typically, the line is not free to move because of the plane strain constraints in the longitudinal direction and soil friction effects. For a positive differential temperature, it will be subjected to an axial compressive load, and when this load reaches a certain critical value, the pipe may experience vertical (upheaval buckling) or lateral (snaking buckling) movements that can jeopardize the structural integrity of the pipeline. In these circumstances, the pipeline behavior should be evaluated to ensure the pipeline structural integrity during operation in those demanding loading conditions. Performing this analysis, the correct mitigation measures for thermal buckling can be considered either by accepting bar buckling but preventing the development of excessive bending moment or by preventing any occurrence of bending.

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.531-556
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• 1992

The majority of the commonly used protraction headgears for the protraction of small and/or retropositioned maxilla not allow a change in the point of force application or direction of the force delivery to attain predictable results because of the position of the upper and lower lips to avoid discomfort to the patient. The purpose of this study was to investigate the initial reaction of maxillofacial complex according to the change of force variables such as direction and point of force application with designing an antenna type-modified protraction head gear. A macerated human skull with well aligned upper teeth was used to experimental model and the investigation was done by double exposure holographic interferometry. Fringe patterns of each protraction conditions were compared and analized. The results were as follows. (Frontal view) 1. The Counterclockwise rotation of the maxilla was showed by parallel protraction to occlusal plane and the fringe was decreased in number as higher point of force application. 2. Generally, the number of fringe was increased in 500gm of protraction force than in 300gm. 3. When apply the protraction force to the maxilla with rapid palatal expansion, the direction of fringe patterns was differed from the protraction without expansion. 4. In most of cases, the counterclockwise rotation was decreased in case of the direction of the force is $20^{\circ}$ downward to occlusal plane compared to the parallel direction. 5. At the point of force application is 15mm above and the direction of force is 20 downward to occlusal plane , the translation of the maxillary complex was showed. (Lateral view) 6. The direction of fringe patterns of the facial bones were differed each other by the sutures, and showed almost parallel when apply the 300gm and 500gm of protraction force. 7. In case of rapid palatal expansion with protraction of the maxilla, the fringe patterns between the maxillary area and the area from the posterior of the maxillary first molar to the pterygomaxillary fissure were differed. In case without rapid palatal expansion, the changes of direction and point of the force application did not affect to the direction and the number of the fringe patterns.

• The korean journal of orthodontics
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• v.27 no.6 s.65
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• pp.881-889
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• 1997

The purpose of this study was to compare four groups of Oriental young adults (169 males and 174 females) with normal occlusion and well balanced faced. Lateral cephalograms of 100 Koreans, 100 Chinese, 72 Vietnamese and 71 Japanese were digitized and six profile measures were computed. Analyses of variance showed that total facial profile(Gl'-Pr'-Pg') of Chinese was significantly less convex than the profile of Koreans or Vietnamese. Facial profile(Gl'-Pr'-Pg') of Chinese was also significantly less convex than that of Vietnamese. Holdaway's soft tissue angle(Pg'-LS:N-B) was significantly greater in Vietnamese than Chinese and Koreans, who were in turn greater than Japanese. The upper lip of Vietnamese is significantly closer to Ricketts' esthetic plane, than Chinese; Koreans and Japanese are significantly further behind the plane than Chinese. The lower lip of Koreans and Japanese was close to the esthetic plane, while Chinese and Vietnamese were approximately 2mm ahead. The nasolabial angle was significantly smaller for Chinese and Japanese than Koreans and Vietnamese. Sex differences were primarily dependent on the nose; total facial convexity and the nasolabial angle wert significantly larger in females than males. The results of this study demonstrate that a single standard of facial Profile is not sufficient or appropriate for Oriental patients.

• The korean journal of orthodontics
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• v.40 no.4
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• pp.227-238
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• 2010

Objective: The purpose of this study was to analyze the effect of growth hormone treatment (GHT) on craniofacial growth in children of short stature. Methods: Nineteen untreated children of short stature were referred from the Pediatric Department, Yeungnam University Hospital as a subject group. All subjects had lateral cephalograms taken before, after 1 year and after 2 years of growth hormone treatment. As a reference group, we selected 19 normal children with paired sampling who matched the subjects' age and sex, from the Department of Orthodontics, Kyungpook National University Hospital. Results: Before GHT, anterior cranial base length and upper posterior facial height, posterior total facial height, mandibular ramus length, and mandibular corpus length were significantly smaller in the reference group. In angular craniofacial measurements, saddle angle and mandibular plane angle were larger. SNA and SNB were smaller in the reference group. After two years of GHT, growth hormone accelerated growth in several craniofacial components. The posterior total facial height, the anterior, posterior cranial base length, and the mandibular ramus length were increased. And the difference in mandibular plane angle and ANB values compared with the reference group was decreased. Conclusions: GHT over 2 years leads to a craniofacial catch-up growth tendency, which is pronounced in interstitial cartilage and condylar cartilage.

• The korean journal of orthodontics
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• v.31 no.4 s.87
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• pp.403-414
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• 2001

The purpose of this study was to evaluate treatment effects of the modified Teuscher appliance (MTA) in early Class II division 1 malocclusion. For this purpose, treatment effects of the bionator were compared with those of the MTA. The twenty subjects who were treated excellently with bionator and MTA were selected in each group. In pre- and post-treatment lateral cephalograms, 50 variables were measured, and then the differences between pretreatment and posttreatment data of the bionator and the MTA were statistically evaluated by t-test. The results were as follows : 1. The linear measurements that showed large difference between the bionator group and the MTA group are U1 to FH, U1 to PP, U6 to FH, U6 to PP, Ar-Pog, ramus height, L1 to A-Pog, L1 to facial plane (p<0.05). 2. The angular measurements that showed large difference between the bionator group and the MTA group are SNB, SNA, FABA, APDI (p<0.05). 3. The measurements of the growth pattern such as facial height ratio, FMA, SN-MP angle showed no difference between two groups (p>0.05). These results suggest that the bionator influence the mandiblar growth and lower dentoalveolar structures more than the MTA, and the MTA influence upper jaw and upper dentoalveolar structures more than the bionator comparatively in early Class II division I malocclusion.

• The korean journal of orthodontics
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• v.32 no.2 s.91
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• pp.91-105
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• 2002

In general, orthodontists make problem lists and treatment plans based on norms of several cephalometric standards. But consideration of dentoalveolar compensation, which tends to maintain normal dental arch relationship in various skeletal jaw relationships, helps orthodontists make more individualized treatment objectives and plans. The purpose of this study was to classify skeletal patterns of normal occlusion samples by cluster analysis and to investigate the dentoalveolar compensation according to skeletal patterns. The subjects were consisted of 125 subjects who were normal occlusion samples at Seoul National University Dental Hospital, Department of Orthodontics. Lateral cephalograms in centric occlusion were traced and digitized. The skeletal patterns of normal occlusion samples were classified into three horizontal groups and three vertical groups by cluster analysis and ANOVA on the skeletal and dentoalveolar measurements among the groups were carried out. The results were as follows ; 1. Anteroposterior and vertical skeletal relationships of normal occlusion samples were very variable. 2. As the mandibular position was anterior to the maxilla, the maxillary incisors inclined more labially, the mandibular incisors more lingually, and the occlusal plane was flattened due to the anteroposterior dentoalveolar compensation. dentoalveolar height was decreased and upper posterior teeth was uprighted to the palatal plane and lower incisors and lower posterior teeth to the mandibular plane. 4. Lower incisors were more strongly associated with the dentoalveolar compensation than upper incisors according to the anteroposterior and vertical skeletal relationship.