• Title/Summary/Keyword: Overcorrection

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Effectiveness and Safety of Tolvaptan for the Management of Hyponatremia: Risk of Inadvertent Overcorrection

  • Park, Mi Seon;Park, Seung Yong;Park, Seoung Ju;Beom, Jin Seon;Ahn, Hyo Cho;Kim, Ju Sin;Lee, Heung Bum
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.430-440
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    • 2018
  • Background : Hyponatremia is the most common electrolyte disturbance in hospitalized patients and has been associated with increased morbidity and mortality. Tolvaptan, a vasopressin receptor antagonist, is increasingly used for the treatment of euvolemic and hypervolemic hyponatremia. The aim of this study was to evaluate the effectiveness and safety of tolvaptan for the management of hyponatremia. Methods : This study was a retrospective evaluation of 106 patients who received at least one dose of tolvaptan for hyponatremia at a single tertiary academic hospital between January 2014 and June 2015. The primary endpoint was the change in serum sodium concentration after tolvaptan administration within 24 hours, with secondary endpoints of overcorrection and adverse effects. Results : The mean initial dose of tolvaptan was $20.2{\pm}7.2mg$ and the median duration of treatment was 15 days (range, 1-261 days). The maximal changes in sodium levels at 24 and 48 hours were $8.2{\pm}4.7mmol/L$ and $10.5{\pm}15.3mmol/L$, respectively. Of 99 patients in whom sodium concentrations were followed up, sodium overcorrection was observed in 26 (26.3%) patients, which was associated with concomitant use of an enzyme inhibitor (odds ratio [OR] = 4.80, 95% Cl: 1.27-18.15). However, sex, body mass index (BMI), serum albumin, a daily dose of tolvaptan, and concomitant use of hypertonic saline did not show any significant difference in overcorrection. The most commonly reported adverse effects were mild and related to aquaresis, such as polyuria, thirst, and constipation. However, severe adverse effects such as hyperkalemia, hypotension, and one death related to osmotic demyelination were also reported. Conclusions : Tolvaptan is effective for treating hyponatremia. Nevertheless, the drug should be used cautiously due to serious adverse effects related to sodium overcorrection.

The Learning Curve for Biplane Medial Open Wedge High Tibial Osteotomy in 100 Consecutive Cases Assessed Using the Cumulative Summation Method

  • Lee, Do Kyung;Kim, Kwang Kyoun;Ham, Chang Uk;Yun, Seok Tae;Kim, Byung Kag;Oh, Kwang Jun
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.303-310
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    • 2018
  • Purpose: The purpose of this study was to investigate whether surgical experience could improve surgical competency in medial open wedge high tibial osteotomy (MOWHTO). Materials and Methods: One hundred consecutive cases of MOWHTO were performed with preoperative planning using the Miniaci method. Surgical errors were defined as under- or overcorrection, excessive posterior slope change, or the presence of a lateral hinge fracture. Each of these treatment failures was separately evaluated using the cumulative summation test for learning curve (LC-CUSUM). Results: The LC-CUSUM showed competency in prevention of undercorrection, excessive posterior slope change, and lateral hinge fracture after 27, 47, and 42 procedures, respectively. However, the LC-CUSUM did not signal achievement of competency in prevention of overcorrection after 100 procedures. Furthermore, the failure rate for overcorrection showed an increasing tendency as surgical experience increased. Conclusions: Surgical experience may improve the surgeon's competency in prevention of undercorrection, excessive posterior slope change, and lateral hinge fracture. However, it may not help reduce the incidence of overcorrection even after performance of 100 cases of MOWHTO over a period of 6 years.

Usefulness of Ultrasound-Guided Closed Reduction of Nasal Bone Fracture (비골골절의 비관혈적 정복술 중 사용한 초음파의 유용성)

  • Lee, Seong Pyo;Suhk, Jung Hoon;Choi, Won Suk;Kim, Tae Bum;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.9 no.1
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    • pp.12-16
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    • 2008
  • Purpose: Closed reduction is most common treatment method for nasal bone fracture but it requires secondary correction operation commonly. For preventing secondary revision, we applied ultrasonography during closed reduction of nasal bone fracture and examined the result of operation. Methods: 80 patients were sorted into 2 groups, ultrasound-guided closed reduction group(n=40) and manual closed reduction group(n=40). We classified the unilateral fracture involving lower 1/2 of nasal bone into type I, the bilateral fracture involving lower 1/2 of nasal bone into type III and the fracture of upper 1/2 of nasal bone into type III. The occurrence rate of overcorrection and undercorrection were evaluated by comparing preoperative and postoperative MDCT(Multi Direction Computed Tomography). Results: In manual closed reduction group, overcorrection were found in 4 patients and undercorrection were found in 3 patients. In ultrasound-guided closed reduction group, overcorrection was not observed and undercorrection was observed in 2 patients. Conclusion: Intraoperative ultrasound evaluation of nasal bone fracture resulted in reduced occurrence rate of secondary nasal deformities, showed easier detection of the fractured site and have superiority upon simple physical examination or simple x-ray.

Alleviation of Overcorrection Problem in Neural Korean Spelling Correction (뉴럴 한국어 맞춤법 교정기에서 과교정(Overcorrection) 문제 완화)

  • Park, Chanjun;Lee, Yeonsu;Yang, Kisu;Lim, Heuiseok
    • Annual Conference on Human and Language Technology
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    • 2020.10a
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    • pp.582-587
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    • 2020
  • 현재까지 한국어 맞춤법 교정 Task는 대부분 규칙기반 및 통계기반 방식의 연구가 진행되었으며 최근 딥러닝 기반의 한국어 맞춤법 교정에 대한 연구가 진행되고 있다. 맞춤법 교정에서 문법적 또는 철자적으로 틀린 부분을 교정하는 것도 중요하지만 올바른 문장이 입력으로 들어왔을 때 교정을 진행하지 않고 올바른 문장을 출력으로 내보내는 것 또한 중요하다. 규칙기반 맞춤법 교정기 같은 경우 문장의 구조를 흐트러트리지 않고 규칙에 부합하는 오류 부분만 고쳐낸다는 장점이 있으나 신경망 기반의 한국어 맞춤법 교정 같은 경우 Neural Machine Translation(NMT)의 고질적인 문제점인 반복 번역, 생략, UNK(Unknown) 때문에 문장의 구조를 흐트러트리거나 overcorrection(과교정) 하는 경우가 존재한다. 본 논문은 이러한 한계점을 극복하기 위하여 Correct to Correct Mechanism을 제안하며 이를 통해 올바른 문장이 입력으로 들어왔을 시 올바른 문장을 출력하는 성능을 높인다.

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Effect of Overcorrection (-)Lens on Stereo-acuity and Angle of Deviation in Intermittent Exotropia (간헐외사시에서 과교정 (-)렌즈가 입체시 및 사시각에 미치는 영향)

  • Kim, Young Cheong;Park, Sang Woo
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.3
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    • pp.305-311
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    • 2013
  • Purpose: This study was conducted to evaluate the effect of prescription of overcorrection (-) lens, which is the one of the non-surgical treatments, on stereo-acuity and angle of deviation in intermittent exotropia. Methods: Twenty four children with intermittent exotropia were enrolled from October 2011 to December 2011. The angle of deviation(${\Delta}$), stereo-acuity (arcsec), monocular and binocular visual acuity (BVA, LogMAR), control of exodeviation and fusional ability using Worth 4 dot test were evaluated at near (33 cm) and far (6 m), under the overcorrecting (-)lens of -1.00, -.00, and -.00 D. Results: As a baseline finding, the angle of exodeviation was $20.9{\pm}9.7$ at near and $23.0{\pm}7.5$ at far. The angle of exodeviation at near decreased to $18.5{\pm}10.0$ (p<0.01), $15.8{\pm}9.0$ (p<0.01), $14.0{\pm}9.1$ (p<0.01) compared with baseline angle of exodeviation at near, as increasing diopters of (-) lens from -.00 D, -2.00 D and -.00 D, respectively. The angle of exodeviation at far also decreased to $21.4{\pm}5.2$ (p=0.01), $19.6{\pm}6.3$ (p<0.01) compared with baseline, as increasing minus lens from -2.00 D and -3.00 D, respectively. However, BVA, control of exodeviation, fusional ability and stereo-acuity showed no significant decrease despite of increasing diopters of (-)lens. Conclusions: The prescription of overcorrection (-)lens is an effective therapeutic method in intermittent exotropia which can reduce the near and far angle of exodeviation, and binocular visual acuity and stereo-acuity maintained without significant decrease despite of application of overcorrection (-)lens.

Considerations for nasal bone fractures: Preoperative, perioperative, and postoperative

  • Han, Dong Gil
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.3-6
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    • 2020
  • Nowadays, the incidence of nasal bone fracture is increasing because of social complexity with frequent social activity, and reduction of fractures is relatively simple and can be corrected in short operation time. However, the postoperative results are known to be less satisfied with higher complication rates relatively. These problems could have resulted from inaccurate recognition and interpretation of fracture aspect, inaccurate planning of operation resulting in under or overcorrection, ignoring septal management, complication related nasal packings with removal, postoperative management, and patient satisfaction with complication.

Prevention of Complication and Management of Unfavorable Results in Reduction Malarplasty (광대뼈 축소성형술 시 합병증의 예방과 불만족스러운 결과에 대한 해결방안)

  • Yang, Jung Hak;Lee, Ji Hyuck;Yang, Doo Byung;Chung, Jae Young
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.465-470
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    • 2008
  • Purpose: Reduction malarplasty is a popular aesthetic surgery for contouring wide and prominent zygoma. However a few patients complain postoperative results and want to revise the midfacial contour. We analyzed the etiology of unfavorable results and treated unsatisfied midfacial contours after reduction malarplasty. Methods: Total 53 patients were performed secondary operation for correction of unfavorable results after primary reduction malarplasty from elsewhere. Midfacial contour was evaluated with plain films and three-dimensional computed tomography. Unfavorable midfacial contours were corrected by secondary malarplasty. Flaring of zygomatic arch was reduced with infracturing technique and prominent zygomatic body was reduced with shaving. Drooped or displaced zygoma complex has been suspended to higher position and fixed with interosseous wiring. As adjuvant procedure, autologous fat injection has been performed in the region of depressed zygomatic body region. Results: The etiology of unfavorable midfacial contour after reduction malarplasty was classified into 7 categories: undercorrection of zygomatic arch(n=8), undercorrection of zygomatic arch and undercorrection of zygomatic body(n=6), undercorrection of zygomatic arch and overcorrection of zygomatic body(n=28), overcorrection of zygomatic body(n=3), simple asymmetry(n=4), malunion(n=2) or nonunion(n=2). Slim and balanced malar contour was achieved with treatment. And most of the patients were satisfied with the results of the surgery. Conclusion: To prevent the unfavorable results after reduction malarplasty, complete analysis of facial contour, choice of appropriate operation technique, precise osteotomy under direct vision, and security of zygoma position are important.

Analysis of Postoperative Complications in Blepharoptosis (안검하수 교정술 후 생긴 합병증 분석)

  • Oh, Chang Hyun;Park, Dae Hwan;Kim, Peter Chan Woo;Shim, Jeong Su;Lee, Yong Jig
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.743-749
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    • 2009
  • Purpose: Many researches about various surgical method for blepharoptosis have already been introduced. But researches for complications after blepharoptosis correction is relatively insufficient. So, this study was performed to recognize common complications that arised depending on the severity of blepharoptosis, levator function and surgical method. Methods: 250 patients who have underwent surgical treatment for blepharoptosis from 1987 to 2006 were employed in this study. Patients were categorized by severity of blepharoptosis, levator function and surgical method that has been used. Complications after blepharoptosis correction were analyzed. Result: Total of 64 patients had occurred complications, the specifics are as following; undercorrection 22, asymmetry 13, overcorrection 12, lagophthalmos 4, abnormal eyelid contour 4, exposure keratitis 3, ectropion 2, inclusion cyst 2, infection 1 and conjunctival prolapse 1. Among above patients, 3 patients had two kinds of complications. 21 patients was underwent secondary surgery due to complication. Conclusion: Evaluating the outcomes of the secondary surgery, the early correction was better than the late correction. The most of the complications were recovered through conservative and surgical treatments. The most of the complications (47 patients) were undercorrection, asymmetry, overcorrection and took 73.4% of the total complications. The more severe the blepharoptosis and the more poor the levator function, the rate of complications were higher. According to the operation methods, most complications were occurred in levator operation, frontalis transfer and OOM flap.

THE TREATMENT OF SEVERELY ROTATED MAXILLARY INCISORS BY MESIODENS (정중과잉치로 인해 회전된 상악 중절치의 치험례)

  • Lee, Bum-Eui;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.630-635
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    • 2004
  • The etiology of mesiodens is unknown but the most widely accepted theory is the hyperactivity of the dental lamina. Complications of mesiodens are delayed or prevented eruption of maxillary central incisors, displacement or rotation of permanent teeth, crowding of affected region, abnormal diastema or permanent space closure, dilaceration or abnormal root development of permanent teeth, primordial or follicular cyst formation, root resorption of adjacent teeth, eruption into nasal cavity. If mesiodens rotate the maxillary central incisors, space deficiency is not common and relapse is very common. So overcorrection is needed. To prevent the rotational relapse, early treatment, overcorrection, long retention period, properly formed proximal surface, use of coupled force, and surgical techniques have been suggested. The authors present two cases, whose chief complain were severely rotated maxillary incisors by mesiodens, treated by orthodontic and surgical technique and showed good results.

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Surgical correction for Tessier number 7 craniofacial cleft using a medially overcorrected design

  • Ryu, Jeong Yeop;Eo, Pil Seon;Tian, Lulu;Lee, Joon Seok;Lee, Jeong Woo;Choi, Kang Young;Yang, Jung Dug;Chung, Ho Yun;Cho, Byung Chae
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.16-22
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    • 2019
  • Background Various surgical techniques have been used to correct Tessier number 7 craniofacial cleft, which involves macrostomia, ear deformity, and hemifacial microsomia. To achieve symmetrical and satisfactory results in patients with macrostomia, the authors performed a 1-mm medial overcorrection on the cleft side and evaluated the results of this procedure. Methods A retrospective medical record review of patients diagnosed with Tessier number 7 craniofacial cleft from March 1999 to February 2017 was performed. Using clinical photographs, outpatient clinic records, and operative records, information was recorded regarding concurrent congenital anomalies, postoperative complications, and follow-up. Using Photoshop CS2, the length of both sides of the lip was compared. The ratio of these lengths was calculated to evaluate lip symmetry. Results Of the patients treated at the Department of Plastic and Reconstructive Surgery at Kyungpook National University Chilgok Hospital, 11 (male-to-female sex ratio, 7:4) were diagnosed with Tessier number 7 craniofacial cleft. Concurrent congenital anomalies included skin tag, hemifacial microsomia, and cleft palate. The mean duration of follow-up was $78.273{\pm}72.219$ months and the mean ratio of the lengths of both sides of the lip was $1.048{\pm}0.071$. Scar widening occurred as a postoperative complication in some patients. No cases of wound infection, bleeding, or wound dehiscence occurred. Conclusions For the successful correction of macrostomia, plastic surgeons should consider both functional and aesthetic problems of the lip. Adequate repair of the orbicularis oris muscle, skin closure with Z-plasty, and medial overcorrection of the neo-oral commissure led to good results in our patients.