• 대한구순구개열학회지
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• 제12권2호
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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.

• Journal of Trauma and Injury
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• 제30권4호
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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.

• Journal of Chest Surgery
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• 제32권4호
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• pp.379-382
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• 1999

배경: 최소 흉골절개술에 의한 심장수술은 전통적인 정중흉골절개술보다 절개창의 크기가 작고 환자에게 술후 빠른 회복과 상처에 대한 만족감을 줄 수 있는 장점이 있다. 대상 및 방법: 인제대학교 부산백병원 흉부외과에서는 1998년 4월부터 7월까지 최소 흉골절개술에 의한 심장수술 25례를 시행하였다. 대상환자의 평균나이는 30세, 평균체표면적은 1.5m2이었고 성별로는 남자 10명, 여자 15명이었으며 10세 미만 소아도 4명이었다. 수술은 승모판막질환 10례, 심실중격결손증 4례, 심방중격결손증 11례를 대상으로 하여 피부를 3번 늑간에서부터 검상돌기의 끝까지 정중 흉부선을 따라 절개하였다. 결과: 피부절개창의 길이는 평균 11cm이고 흉골은 2번 늑간에서 하부까지 정중절개하였는데 대상환자중 4례에서는 좌우 2번 늑간으로 T형, 17례에서는 좌측 2번 늑간으로 J형 횡절개를 하였고, 소아 4례에서는 횡절개를 하지않았다. 최소절개에 의한 합병증은 없었고 통증이 적으며 수술후 중환자실 치료시간은 평균 20시간으로 짧아 환자와 가족들의 만족도는 높았다. 결론: 최소 흉골절개술에 의한 심장수술은 전통적인 정중흉골 절개술보다 환자의 회복이 빠르고 미용적 만족도도 높을 뿐만 아니라 최소절개로 인한 합병증도 없어 향후 이러한 수술법의 적용이 증가할 것으로 예상된다.

• 대한치과보철학회지
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• 제31권2호
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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).

• 한국의류학회지
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• 제14권3호
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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.

• Journal of Trauma and Injury
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• 제26권3호
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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.

• 대한치과기공학회지
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• 제18권1호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.44-52
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• 1991

하악골의 발육이상과 더불어 상악골의 수평적 및 수직적 발육이상이 동반되어 있는 대부분의 악안면 기형 환자에서 상하악골을 동시에 재위치시키는 "상하악골 동시 이동 수술"은 현재 악교정 수술에서 보편화되어 있는 술식으므로, 이 경우 수술중에 일차로 상악골의 정확한 위치를 얻는 것이 매우 중요하다. Le Fort I 수평골절단술을 이용한 상악골의 재위치시 위치 이동의 정확성을 기하기 위하여 고전적으로 사용되어온 계측방법인 내부계측법(Intrnal measuring technique)은 최근에 이르러 계측상의 삼차원적 오차에 따른 정확도에 많은 의문이 제기되어 왔으며, 따라서 이를 보완하기 위하여 1985년 Johnson 이 처음으로 외부계측법(External measuring technique)을 소개한 이후로, Van Sickels 등의 여러 학자들에 의하여 그 사용의 유용성 및 정확성이 입증되어 왔다. 이에 저자등은 최근 2년간 본 교실에서 경험상 상${\cdot}$하악골동시이동 악교정수술환자중, 외부계측법에만 의존하여 상악골 이동량을 술중 계측했던 17명의 환자에서 수술전 이동계측량과 수술후 이동된 결과를 Lateral cephalometics상에서 전치부와 구치부의 수직 및 수평적 이동 오차 관계로, P-A cephalogram 상에서 수평적 이동 및 상악치열의 중심선 변위에 대한 이동 오차 관계로 분석하여 외부계측법에 의한 수술적 이동의 정확도를 평가하므로써 향후 이 방법의 사용에 대한 신뢰성을 보고자 본 연구를 시행하였다. 연구 결과로써, 상악골의 수직 및 수평적 이동시 외부계측법 만을 이용한 경우, 수술전 이동량에 비해 비교적 신뢰성 있게 상악골을 원하는 위치로 이동시킬 수 있는 것으로 사료되나, 대체적으로 전하방 및 우측으로 위치되기 쉬운 경향을 보여주었으며, 정면상의 수평기울기(transverse plane)에 대한 편차는 수술자에 의해 크게 영향을 받지 않았으나 상악치열의 중심위는 수술자에 의해 영향을 받은것 같다.

• 한국임상수의학회지
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• 제31권6호
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• pp.477-482
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• 2014

본 연구에서는 복강경을 이용한 고양이의 난소절제술에서 지혈 장치로서 $LigaSure^{TM}$와 양극 전기 응고 장치(bipolar)의 효과를 수술시간, 부작용에 대하여 비교해 보고자 하였다. 10마리의 고양이를 각각 5 마리씩 A군과 B군으로 무작위로 나누었고, A군은 좌측 난소는 $LigaSure^{TM}$로, 우측 난소는 양극 전기 응고 장치(bipolar)로 절제하였다. 반대로 B군은 좌측 난소는 양극 전기 응고 장치(bipolar)로, 우측 난소는 $LigaSure^{TM}$로 절제하였다. 수술은 three midline portals로 하였으며, 수술시간, Body Condition Score, ovarian pedicle fat과 부작용 등을 체크하였다. 그 결과, 총 수술시간은 평균 $24:18{\pm}6:36$분 이었으며, $LigaSure^{TM}$ ($1:24{\pm}0:59$ 분)가 양극 전기 응고 장치(bipolar) ($2:16{\pm}1:14$ 분, p = 0.021)에 비하여 난소절제에 유의적으로 더 짧은 시간이 걸렸다. BCS와 ovarian pedicle fat은 수술시간에 유의적인 영향을 미치지 않았으며, 부작용으로는 미약한 출혈, 복벽 손상, smoke 발생 등이 있었는데 수술시간에 유의적인 영향을 미치지 않았다. 이러한 결과들은 $LigaSure^{TM}$가 비교적 고가의 수술장비라는 단점이 있음에도 불구하고 복강경을 이용한 고양이의 난소절제술에 유용한 수술적 활용 방법이 될 수 있을 것이라는 것을 보여준다.

• 대한소아치과학회지
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• 제49권1호
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• pp.45-56
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• 2022

이 연구의 목적은 심한 우식 또는 저광화에 이환된 제1대구치에 기성금속관을 수복한 후 교합 변화에 대해 평가하는 것이다. 제1대구치가 교합 평면까지 도달하여 교합되는 환자 중 기준에 부합하는 24명의 환자를 대상으로 연구를 진행하였다. 하나의 제1대 구치에 기성금속관으로 수복치료를 진행하였다. 치료 전, 치료 직후, 4주 후, 8주 후 검진마다 T-Scan III을 사용하여 최대교두감합위에서 교합력 분포를 측정하였고 디지털 버니어 캘리퍼로 수직피개를 측정하였으며 정중선의 변화를 조사하였다. 8주 후 검진에서는 설문 조사를 진행하였다. 대부분 치료 전과 비교해서 치료 직후 악궁에서 수복한 쪽과 수복하지 않은 쪽 사이의 교합력 분포가 역전되었으며 수직피개는 감소했다. 하지만 4주 후에 좌, 우측 교합력이 평형을 이루었고 수복한 제1대구치와 수복하지 않은 제1대구치의 교합력 분포는 비슷한 값을 가졌다. 또한 변화한 수직피개, 정중선은 치료 전 상태로 회복되었고 치료 후 유의할만한 턱관절 및 저작 불편감은 없었다. 이번 연구를 통해 기성금속관 수복 후 한 달 뒤에 자발적인 교합 평형이 이루어진 것을 확인할 수 있었다.