• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.216-222
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• 2016

Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.407-413
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• 2000

To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

• 구강회복응용과학지
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• 제18권2호
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• pp.127-144
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• 2002

There is an increasing appreciation of the vital role that biomechanics play in the performance of oral implant. The aim of this article is to provide some basic principles that will allow a clinician to formulate a biomechanically valid treatment plan. However, at this point in the history of oral implantology, the clinician should realize that we do not know enough to provide absolute biomechanical rules that will guarantee success of all implants in all situations. To examine the biomechanical questions, one must begin with an analysis of the distribution of biting forcess to implants. Related topics, such as stress transfer to surrounding tissues and interrelationships between bone biology and mechanical loading are major subjects, deserving a separate discussion. Once rigid fixation, angulation, crestal bone level, contour, and gingival health are achieved, stress beyond physiologic limits is the primary cause of initial bone loss around implants. The restoring dentist has specific responsibilities to reduce overload to the bone-implant interface. These include proper diagnosis, leading to a treatment plan designed with adequate retention and form, and progressive loading to improve the amount and density of bone and further reduce the risk of stress beyond physiologic limits. The major remaining factor is the development of occlusal concept in harmony with the rest of the stomagnetic system.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.691-694
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• 2014

Background: Tumor length in patients with esophageal cancer (EC) has recently received great attention. However, its prognostic role for EC is controversial. The purpose of our study was to characterize the prognostic value of tumor length in EC patients and offer the optimum cut-off point of tumor length by reliable statistical methods. Materials and Methods: A retrospective analysis was conducted on 71 consecutive patients with EC who underwent surgery. ROC curve analysis was used to determine the optimal cut-off point for tumor length, measured with a handheld ruler after formalin fixation. Correlations between tumor length and other factors were surveyed, and overall survival (OS) rates were compared between the two groups. Potential prognostic factors were evaluated by univariate Kaplan-Meier survival analysis. A P value less than 0.05 was considered significant. Results: There were a total of 71 patients, with a male/female divide of 43/28 and a median age of 59. Characteristics were as follows: squamous/adenocarcinoma, 65/6; median tumor length, 4 (0.9-10); cut-off point for tumor length, 4cm. Univariate analysis prognostic factors were tumor length and modality of therapy. One, three and five year OS rates were 84, 43 and 43% for tumors with ${\leq}4cm$ length, whereas the rates were 75, 9 and 0% for tumors >4 cm. There was a significant association between tumor length and age, sex, weight loss, tumor site, histology, T and N scores, differentiation, stage, modality of therapy and longitudinal margin involvement. Conclusions: Future studies for modification of the EC staging system might consider tumor length too as it is an important prognostic factor. Further assessment with larger prospective datasets and practical methods (such as endoscopy) is needed to establish an optimal cut-off point for tumor length.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.422-431
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• 2019

Objective : In an aging society, the number of patients with symptomatic degenerative spondylolisthesis (DS) is increasing and there is an emerging need for fusion surgery. However, few studies have compared transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) for the treatment of patients with DS. The purpose of this study was to investigate the clinical and radiological outcomes between TLIF and LLIF in DS. Methods : We enrolled patients with symptomatic DS at L4-5 who underwent TLIF with open pedicle screw fixation (TLIF group, n=41) or minimally invasive LLIF with percutaneous pedicle screw fixation (LLIF group, n=39) and were followed-up for more than one year. Clinical (visual analog scale and Oswestry disability index) and radiological outcomes (spondylolisthesis rate, segmental sagittal angle [SSA], mean disc height [MDH], intervertebral foramen height [FH], cage subsidence, and fusion rate) were assessed. And we assessed the changes in radiological parameters between the postoperative and the last follow-up periods. Results : Preoperative radiological parameters were not significantly different between the two groups. LLIF was significantly superior to TLIF in immediate postoperative radiological results, including reduction of spondylolisthesis rate (3.8% and 7.2%), increase in MDH (13.9 mm and 10.3 mm) and FH (21.9 mm and 19.4 mm), and correction of SSA ($18.9^{\circ}$ and $15.6^{\circ}$) (p<0.01), and the changes were more stable from the postoperative period to the last follow-up (p<0.01). Cage subsidence was observed significantly less in LLIF (n=6) than TLIF (n=21). Fusion rate was not different between the two groups. The clinical outcomes did not differ significantly at any time point between the two groups. Complications were not statistically significant. However, TLIF showed chronic mechanical problems with screw loosening in four patients and LLIF showed temporary symptoms associated with the surgical approach, such as psoas and ileus muscle symptoms in three and two cases, respectively. Conclusion : LLIF was more effective than TLIF for spondylolisthesis reduction, likely due to the higher profile cage and ligamentotactic effect. In addition, LLIF showed mechanical stability of the reduction level by using a cage with a larger footprint. Therefore, LLIF should be considered a surgical option before TLIF for patients with unstable DS.

• 안보군사학연구
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• 통권13호
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• pp.1-41
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• 2016

US 8th Army in the attack on the Western Front was a situation that was frustrated by the 13th Corps Communist army. To this time support this, goals that have been granted to the US 1st Marine Division that initiated the attack in Mupyonri direction, lack the potential to achieve was not decisive. It was a operation specific erroneous judgment that occurred because there was no one accurately grasp the battlefield of the situation the wrong UN Forces Command. Tactical victory can be to maximize the operation outcomes. However, there is no possible failure of the operation is to expand the tactical success. This is because the failure of the operation, because directly linked to the success or failure of the war. Tactical victory can be to maximize the operation outcomes. However, operation specific failure is not it possible to expand the tactical victory. Therefore tactical success of the US 1st Marine Division, can not compensate for operation specific failure of the United Nations Forces Command. However, Chinese Communist Army 9th Corps is obsessed only victory of tactics to annihilate the US 1st Marine Division, by being fixation to the Chosin whole area, it was not possible to run a operational operation. Therefore tactical success df the US 1st Marine Division, Chinese Communist Army 9th Corps is to extinguish the ability to increase the number of the 13th Corps of the Western Front, 8th Army US have contributed to have escaped the crisis. In addition, the US 10th Corps while maintaining the combat force, by an important role to withdraw through the sea, was able to complement the misjudgment of the operation.

• 한국실내디자인학회논문집
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• 제23권6호
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• pp.115-124
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• 2014

This study has carried out scanning tests in order to figure out the features of scanning search by sex of space users, with the result of which the validity of data has been estimated. In this research, the scanning patterns were set up for verifying the typology of scanning paths and then the reason for determining scanning paths and the validity of estimation method were reviewed. Since the observation features depends on sex, the analysis of visual activities for acquiring any information in a space will reveal the intention and purpose of space users. The findings by analyzing the features of scanning pattern by sex which were found at the determination of scanning patterns can be defined as the followings. First, for estimating the process of space-information search, the movement distance at each point of continuative-observation data from the angle of eye-movement has been extracted, on the ground of which the fixation and movement of eye have been defined for the establishment of scanning-cut characteristics. Second, the scanning times were estimated for the extraction of effective observation data that would be used for comparative analysis, which showed that men had more data (3,398.2/64.4%) than women (2,998.2/55.6%). This enables the acknowledgment that the scanning cut of men was relatively less, which indicates that men will acquire more information on space than women in the process of observing any space. Third, men's scanning times (58.0 times/2.02 seconds) were less than those of women (71.9 times/1.39 seconds) while the scanning time of the former was longer than that of the latter, which shows the feature that it takes longer for men than women in scanning while the scanning times of the former is less than those of the latter. Fourth, the observation features can be determined that the combination of this result with the predominance character by sex for a general viewpoint to be employed indicates that while men employ mixed-scanning for observation activities to acquire space-information spending for longer time, women, by concentrated-scanning, focus on a single point for shorter time or stay at one location for a considerably long time for space-information acquirement.

• 유통과학연구
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• 제13권12호
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• pp.85-94
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• 2015

Purpose - The purpose of this paper is to provide a political registration point for analyzing the economic impacts on the national economy from the REITs distribution industry in our country. The REITs distribution industry was introduced in 2001 to accelerate the corporate restructuring process and advance the real estate market. During its establishment, the REITs distribution industry faced difficulties; however, the industry grew rapidly through interest from institutional investors, thus mitigating the establishment problems by 2006. In Korea, more than 108 REITs were operating as of the end of June 2015. REITs contribute significantly to the national economy. The economic impacts on the national economy of the REITs distribution industry was analyzed using input-output (I-O) analysis with respect to production, imports, value-added, and employment. Research design, data, and methodology - The research used an I-O analysis of the activities of the REITs distribution industry in the national economy. The I-O analysis methodology analyzes the economic effects that influence other industries with respect to one unit of external investment. The data for this analysis were the I-O table of 2013 as published by the Bank of Korea in 2014. Results - The findings of this study are as follows. First, if an external input to the REITs distribution industry is 1 won, the overall impact of the product is 1.3869 won, the import induction is 0.0002 won, and the value-added induction is 0.7656 won. A new investment of 659.9 billion won into the REITs industry was estimated to produce a gross effect of 915.2 billion won. Second, if an external input to the REITs distribution industry is 1 billion won, the employment-inducing effects are estimated at 19.6394 individuals. The employment-inducing coefficient of 19.6394 for the REITs distribution industry indicates that the industry created significant employment-more than other industries-because the coefficient was 2.2 times the 2013 industry average employment-inducing coefficient of 8.8. Third, the investment effects of the REITs distribution industry on production induction, value-added induction, and employment induction are assumed to be large in business support services, financing, communications and broadcasting, and professional, scientific, and technical services. Conclusions - The REITs distribution industry was analyzed as having a strong employment inducing, high value added effect. The REITs distribution industry is an excellent alternative for the government authority to create multilateral jobs. Because the REITs distribution industry has a significant positive impact on the national economy, it should be developed. However, the I-O methodology has restrictions with respect to the fixation and timing of the input coefficient. Follow-up research is expected to supplement the analysis method at a specific point in time.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.161-165
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• 2011

Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.225-232
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• 2011

Purpose: This study was designed to retrospectively evaluate the postsurgical initial stability of the Le Fort I osteotomy with posterior impaction and rigid internal fixation for the correction of mandibular prognathism with midface deficiency. Particular attention was paid to the magnitude and direction of the initial postsurgical change. Methods: 20 healthy patients with mandibular prognathism and midface deficiency participated in this study. All patients underwent Le Fort I osteotomy with posterior impaction and mandibular setback BSSO by one surgeon. Preoperative (T0), immediate postoperative (T1) and follow-up period (T2) cephalograms were taken and analyzed. Change between T0~T1 and T1~T2 was measured and analyzed. Results: Between T0~T1, significant differences were observed in all measurements except the ANS point and mandibular plane angle. Between T1~T2, only the occlusal plane angle was significantly changed. No significant changes were found in all other measurements. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions.