• Title/Summary/Keyword: Midline

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Enzyme-Histochemical Study of Philtral Orbicularis Oris Muscle Fiber Types in Korean Male Cadaver (한국인 성인남성 사체에서 시행한 인중 구륜근 섬유들의 효소-조직화학적 분석)

  • Yu, Myung-Sook;Park, Jung-Min;Lee, Hee-Su;Lee, Suk-Keun;Kang, Ji-Young;Eo, Mi-Young;Lee, Jong-Ho;Kim, Soung-Min
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.2
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    • pp.47-56
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    • 2009
  • The orbicularis oris muscle (OOM) is a very important muscle that originate from the second branchial arch and is innervated by the facial nerve. The aim of this study was to elucidate distribution types of two muscle fibers that composing OOM by using enzyme-histochemical examinations and tried to make a basis for a clinical application. The fresh frozen tissues from the superior and inferior portions of the OOM were taken from post mortem 65-year-old Korean male adult. Total five different sagittal sections were used on the midline of the philtrum, the middle portion of lower lip, the mouth corner, and each midlateral side of upper and lower mouth. We used enzyme-histochemical staining such as Periodic Acid-Schiff (PAS), Succinic Dehydrogenase (SDHase), reduced Nicotinamide Adenine Dinucleotide-Tetrazolium Reductase (NADH-TR), Adenosine Triphosphatase (ATPase) in pH 9.4, 4.6 and 4.3, and Modified Gomori Trichrome. There were about 30.24 % type 1 muscle fiber and 65.40 % type 2 muscle fiber in the midline of the philtrum (p < 0.05). Enzyme-histochemical staining is very useful and innovative method to elucidate characteristics of muscle fibers. We expect that chiloplasty and reconstruction of the lip portions for cleft lip patients, based on these results, are better to recovery function and aesthetic. However, we have some problems as an intramuscular variability and the inter-individual variation etc. Therefore we have to make progress these studies continuously to overcome these problems.

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Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury

  • Lim, Tae Kyoo;Yu, Byug Chul;Ma, Dae Sung;Lee, Gil Jae;Lee, Min A;Hyun, Sung Yeol;Jeon, Yang Bin;Choi, Kang Kook
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.140-144
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    • 2017
  • Purpose: The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI). Methods: A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP). Results: The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were $24.2{\pm}6.1$ and $5.4{\pm}0.8$, respectively. The mean ONSD of the TBI group ($5.5{\pm}1.0mm$) was higher than that of the non-TBI group ($4.7{\pm}0.6mm$). Some significant differences in age ($55.3{\pm}18.1$ vs. $49.0{\pm}14.8$, p<0.001), GCS ($11.7{\pm}4.1$ versus $13.3{\pm}3.0$, p<0.001), and ONSD ($5.5{\pm}1.0$ vs. $4.7{\pm}0.6$, p<0.001) were observed between the TBI and the non-TBI group. An ROC analysis was used to assess the correlation between TBI and ONSD. Results showed an area under the ROC curve (AUC) value of 0.752. The same analysis was used in the TBI with midline shift group, which showed an AUC of 0.912. Conclusions: An ONSD of >5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.

Minimally Invasive Cardiac Surgery -Lower half sternotomy- (최소 침습적 심장수술 -흉골하부절개술에 의한-)

  • 최강주;김병훈;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.379-382
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    • 1999
  • Background: There are several advantages to the ministernotomy approach. The skin incision is much smaller than the traditional median sternotomy incision. This approach allows the patients to return to normal life more quickly and provide them with good self-image. Material and Method: From April to July 1998, we performed a ministernotomy via lower half sternum in 25 patients. There were 10 males(40%) and 15 females(60%) with a mean age of 30${\pm}$16 years(range 3 to 55 years). The body surface area ranged from 0.58 to 1.9 m2(mean 1.5 to 0.4 m2). A vertical skin incision of 11cm in mean length was made in the midline over the sternum extending inferiorly from the third intercostal space. The sternum was divided vertically in the midline from the xyphoid process to the level of second intercostal space using a standard saw and then transversely to the left(n=17) or to both sides(n=4) of the second intercostal space using an oscillating saw. The sternum was divided vertically only in children (n=4). Result: The ministernotomy was used in 25 consecutive patients undergoing mitral valve replacement(n=10), repair of ventricular septal defect(n=4) and atrial septal defect(n=11). There was no significant complication related to ministernotomy. The mean ICU stay time 20 hours. Patient and family acceptance was very high. Conclusion: We concluded that minimally invasive cardiac surgery via ministernotomy can be done safely. These methods may benefit the patients with lesser discomfort, smaller incision, and earlier ICU discharge than the traditional incision.

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A STUDY ON THE MANDIBULAR ECCENTRIC MOVEMENT OF THE SUBJECTS WITH TMJ CLICK IN HORIZONTAL PLANE (측두악관절 잡음자의 수평면상 하악 편위 운동에 관한 연구)

  • Na, Kyung-Seon;Kang, Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.2
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    • pp.237-248
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    • 1993
  • Although pantograph has been used to investigate whether the determinents of the mandibular movement were possible contributing factors of TMJ click, there was the problems to understand the role of tooth morphology upon the occurrence of click because of using appliance without tooth contacts. There Were advantages to evaluate the effects of tooth morphology upon the mandibular movements, because intraoral tracing device(Functiograph$^{(R)}$) had been obtained maintaining occlusal contact between the upper and lower natural teeth during mandibular movement. The purpose of this study was to record the mandibular eccentric movement quantitatively performed in 20 adult control subjects and 20 adult subjects with TMJ click and to investigate the effects of occlusion upon the occurrence of TMJ click. The obtained results were as follows : 1. The average ICP-P distance was $3.07{\pm}0.73mm$ in subjects with TMJ click, $2.14{\pm}0.85mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 2. The average ICP-P distance was $3.07{\pm}1.14mm$ in subjects with TMJ click, $2.61{\pm}0.96mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05). 3. The average distance of right and left lateral movement was not statistically significant between subjects with TMJ click and control subjects. 4. The average lateral displacement from midline during RCP was $0.75{\pm}0.54mm$ subjects with TMJ click, $0.16{\pm}0.17mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 5. The average lateral displacement from midline during protrusive movement was $0.88{\pm}0.54mm$ in subjects with TMJ click, $0.20{\pm}0.23mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 6. The average angle of right and left lateral movement was $144.2{\pm}20.20^{\circ}$ in subjects with TMJ click, $138.15{\pm}20.09^{\circ}$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05).

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A Study on the Cloth Design for Elderly Women to Mask Their Dorsal Curvature (노년기여성의 배면만곡도 감소효과를 위한 의복디자인 연구)

  • Kim Tae-Kyung;Lee Kyoung-Hi;Park Jung-Soon
    • Journal of the Korean Society of Clothing and Textiles
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    • v.14 no.3 s.35
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    • pp.183-195
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    • 1990
  • The author has studied the effect of clothes design to mask the dorsal curvature that is one of the commonest changes in elderly women. Body measurements including the body type and the status of dorsal curvature were perfor-med on 153 women of over 60 years of age, and then a body form to fit to the mean measure-ments was made to evaluate the effects of various designs to it. With 31 pattern designs modified by changing in their slash lines and gathers using darts, the diminishing effect of the rounded back were evaluated by means of sensory test. The results of this study can be summarized as follows: I . Results from the body measurements 1) The mean body type in elderly women was that of obesity. 2) With the advancement of age, the angle to indicate the degree of dorsal curvature as well as the angle to indicate the posture are increased. II . Concerning to the clothes design to diminish the shape of dorsal curvature 1) Among the designs by the position of darts, the basic pattern (Fig. 5-1-(1)) showed the best effect to mask the shape of dorsal curvature. 2) Out of the applied designs of princess lines, that in which the slash line is pointing toward the shoulder point (Fig. 5-2-(1)) seemed to be most effective. 3) What has angled princess line (Fig. 5-3-(1)) had the most diminishing effect among the waist darts and armhole princess lines. 4) Among the V-shaped designs, the slashed at the shoulder point (Fig. 5-4-(1)) had the best effect to lessen the shape of the dorsal cuuature. 5) Wider angle yoke had better effect to the narrow angle one among the designs with straight yoke, and that with downward direction (Fig. 5-5-(1)) showed the best effect. 6) Between straight wide angle yoke and curved yoke, that of curved one with downward direction (Fig. 5-6-(1)) had better effect as far as the masking effect of dorsal curvature is concerned. 7) Gathers around the neck showed better effect to those around the shoulder, and the more amount of gathers (Fig. 5-7-(1)), there was better effect. 8) The design with midline gathers at the level of horizontal slash line of armhole (Fig. 5-8-(1)) showed better effect to that with seperated gathers. 9) In case of design with gathers at the horizontal line of armhole, it showed the better effect with less amount of gathers in midline ones, but with more amount in the side ones. 10) Considering all 7 different designs with better effect in covering the shape of dorsal curvature, it was evident that the design with gathers was far better than the design with application of slash lines.

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Optimal Insertion Angle between the Skin and Needle in Ultrasound-Guided Internal Jugular Vein Catheterization with Trauma Patients (외상 환자에서 초음파 유도 내경정맥 도관 삽입 시 카테터 바늘과 피부 사이의 적정 각도)

  • Jeon, Hyun Min;Jung, Sung Min;Jung, Ru Bi;Jeon, Jin;Hong, Chong Kun;Shin, Tae Yong;Ha, Young Rock;Kim, Young Sik
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.183-189
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    • 2013
  • Purpose: The aim of this study was to identify the optimal insertion angle between the skin and the needle in ultrasound-guided internal jugular vein (IJV) catheterization with trauma patients. Methods: From March 2012 to December 2012, consecutive trauma patients who were planned to receive IJV catheterization were prospectively enrolled. We measured the distances from the skin to IJV's anterior-posterior (AP) vessel wall on the longitudinal scan's midline in supine-positioned patients. We calculated the AP diameter of IJV and the angle between skin and the imaginary line from the puncture site to the IJV's internal center on screen's midline (defined as optimal angle which is considered as the safest approach) on the longitudinal scan. We divided the patients into 3 groups based on the CVP (low CVP <5 $cmH_2O$, $5{\leq}$ middle CVP ${\leq}10\;cmH_2O$, and high CVP>10 $cmH_2O$) and compared their mean anterior posterior (AP) diameters and optimal angles. Results: A total of 56 patients were enrolled. Of these 21 were women(35.4%). The mean AP diameter of low CVP group was significantly lower than middle and high CVP groups($0.68{\pm}0.30$, $1.06{\pm}0.31$, and $1.23{\pm}0.49$ cm respectively, p=0.003 vs. 0.002). There was no significant difference among 3 groups' mean optimal angles ($28.1{\pm}6.1$, $30.1{\pm}4.5$, and $28.0{\pm}5.0$ degree respectively). Conclusion: The optimal angle between the skin and the needle in ultrasound-guided IJV catheterization with trauma patients is not changed as about 30 degrees regardless of CVP even though IJV's diameter is altered in proportion to the CVP.

Investigation about Esthetic Appreciation for the Esthetic Prosthesis (심미보철(審美補綴) 제작(製作)에 관계(關係)되는 심미적(審美的) 요소(要素)에 관(關)한 연구(硏究))

  • Chung, In-Sung
    • Journal of Technologic Dentistry
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    • v.18 no.1
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    • pp.95-115
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    • 1996
  • The esthetic factor for the esthetic prosthesis were studied on 300 persons. The praaticipants were 150 students registered under the Deparment of Dental Laboratoy Technology, Jisan Junior College at the present day of June, 1995 and their mothers. The results were as follows; 1. The number of persons with 28 teeth in their oralcatity was highest(P<0.01). They complained that they have only 28 teeth bacaues of the loss(deficiency) fo teeth due to their impacted teeth and dental caries. 2. The presons with feelings of dissatisfaction were large in number(P<0.01). They were dissatisfied with an abnormal tooth form(33.5%), tooth position(31.7%), tooth color(31.1%), and tooth size(3.7%) in order(P<0.01). 3. In their facial form, the most numerous were men with square form and women with ovoid form(P<0.01). Among the whloe number fo facial forms it appeared to decresae in the order of ovoied(41.8%), square(32.7%), square+tapered(20.5%), and tapered form(5%)(P<0.01). In a profile form, the most numerous were men with A form and women with B. Among the whole participants the most numerous were persons with B form and persons with A and C form were next in oder of numbers(P<0.01). 4. In discoloration of teeth, the most numerous were persons who have no discoloration. 5. In the esthetic recovery of anterior prosthesis the color matching of proximal teeth was not correct, but the outline of proximal teeth was to be reproduced correctly. 6. In the diastema of teeth, the number of persons who have no diastema was higher than that of persons who have a disatema(P<0.01) Among the persons who have diastema the most numerous were persons who have a diastema, and next were 2, 4, 3 and 5 diastemas in order. 7. In a meeting point of the midline of the body and the tooth the number of person hanving a meeting point was higher than that of persons who did not fit each other(P<0.01). The bias direction of midline teeth appeared to be affected by chewing direction, prosthesis location, and posterior location. 8. The length and width of teeth in the tooth size were suitable(P<0.01). The number of persons who have central teeth longer than lateral teeth was high(P<0.0). 9. In the results of smile analysis, the line form connected with incisal edge of upper canine were parallel(P<0.01). When smile the location fo upper lips should be in accord with the central area of teeth(P<0.01) and lower lip should be atteched to the edge of anterior teeth in order to be esthetic. 10. Among the number of upper teeth we can see the most numerous were 8 teeth and next were 10, 6 and 12 in order.

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A STUDY ON ACCURACY OF MAXILLARY REPOSITIONING BY EXTERNAL MEASURING TECHIQUE (외부계측법에 의한 상악골 이동의 위치적 정확도에 대한 평가 연구)

  • Park, Hyung-Sik;Cha, In-Ho;Park, Hyung-Rae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.44-52
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    • 1991
  • Internal measurement technique has been commonly and classically used to guide down-fractured maxilla by Le Fort I osteotomy into its new position during intraoperative procedure for correlating preoperative model works with surgery. However, It has been challenged now by several authors due to some problems as its inaccuracy in three-dimensional changes at surgery, difficulty to measure during surgery and impossibility of rechecking at the end of surgery etc. The purpose of this study was to evaluate the accuracy of maxillary movement by external measuring technique and to determine its accuracy between the prediction tracing and a new maxillary position. The results indicate that the external measuring technique was predictable in the vertical, horizontal and transverse change of the maxilla as its prediction, however, it has a tendency to shift the maxilla more anterior and inferior in overall direction than prediction. Post-operative canting difference were mimic, however Ehange of the maxillary dental midline was large and had a right-shifting tendency.1 The precise methods to keep maxillary dental midline as same as prediction and the avoidance of uneven force applied to the mandible for autorotation should be necessary during surgery in use of external measurement technique.

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Comparison of $LigaSure^{TM}$ and Bipolar Vessel Sealing System for Laparoscopic Ovariectomy in Cats (복강경을 이용한 고양이의 난소 절제술에서 지혈기구인 $LigaSure^{TM}$와 양극 전기 응고 장치(bipolar)의 비교)

  • Jin, So-Young;Lee, Seung-Yong;Park, Se-Jin;Kim, Young-Ki;Seok, Seong-Hoon;Hwang, Jae-Min;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.477-482
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    • 2014
  • The aim of this study was to investigate and compare technique, surgical time, and complications of laparoscopic ovariectomy using $LigaSure^{TM}$ and bipolar vessel sealing system in cats. Laparoscopic ovariectomy was performed under general anesthesia on 10 healthy female cats admitted for elective ovariectomy. Surgery was performed through three midline portals. Each ovary was randomly-assigned to removal by use of either $LigaSure^{TM}$ or bipolar vessel sealing system. Duration of predetermined surgery intervals and complications were compared. Bipolar OVE ($2:16{\pm}1:14$ minutes) took significantly longer surgical time compared to the $LigaSure^{TM}$ OVE ($1:24{\pm}0:59$ minutes, P = 0.021). The ovarian pedicle fat and obesity did not influence surgery duration. Intraoperative hemorrhage occurred with bipolar OVE in three cats, but had no significant influence on surgical time. The results suggest that both $LigaSure^{TM}$ and bipolar devices appear to be effective, but $LigaSure^{TM}$ can be used as a stand-alone device that decreases surgical time and complication compared with bipolar vessel sealing system.

Changes of Occlusion following the Placement of Preformed Metal Crown to the Permanent First Molar in Children and Adolescents (소아청소년에서 제1대구치의 기성금속관 수복 후 교합 변화)

  • Kim, Jiwoong;Lee, Nanyoung;Jih, Myeongkwan;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.1
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    • pp.45-56
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    • 2022
  • The purpose of this study is to evaluate changes of occlusion following the placement of preformed metal crown in the permanent first molar affected by severe caries or hypomineralization. The study was conducted on 24 patients who met the criteria among the patients with occlusion in the permanent first molar reaching the occlusal plane. Restorative treatment was performed on one first molar using preformed metal crown. Before treatment, immediately after treatment, after 4 weeks, and after 8 weeks, the T-scan III was used for measuring distribution of bite force at the maximum intercuspal position, and overbite was measured with digital vernier calipers and change of dental midline was surveyed. After 8 weeks, questionnaires survey was conducted. In most cases, immediately after treatment, the distribution of bite force between the restored side and non-restored side of arch was reversed compared to before treatment, and the overbite was decreased. However, after 4 weeks, bite force of the left and right side was balanced and the distribution of bite force on the restored and non-restored permanent first molars had similar values. Also, the changed overbite and midline were returned to pre-treatment status and there was no significant temporomandibular joint and masticatory discomfort after treatment. In this study, it was confirmed that spontaneous occlusal equilibrium was achieved one month after the placement of preformed metal crown.