• Archives of Plastic Surgery
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• 제48권4호
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• pp.384-388
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• 2021

Adequate positioning of the hand is a critical step in hand fracture operative repair that can impact both the clinical outcome and the efficiency of the operation. In this paper, we introduce the use of a thermoplastic splint with an added thumb stabilizing component as a means to increase the surgeon's autonomy and to streamline the patient care pathway. The thermoplastic splint is custom fabricated preoperatively by the specialist hand therapist. The splint is used prior, during, and post operation with minimal modification. The thumb component assists maintaining the forearm in a stable pronated position whilst drilling and affixing metal work. This is demonstrated in the video of removal of metal work and open reduction and internal fixation of a metacarpal fracture.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.86-89
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• 2019

Buried bumper syndrome is a rare but potentially severe complication of percutaneous endoscopic gastrostomy tube insertion. Though this complication is uncommon, it may lead to pressure necrosis, bleeding, perforation, peritonitis, sepsis, or death. Each case of buried bumper syndrome is unique in terms of patient comorbidities and anatomic positioning of the buried bumper. For this reason, many approaches have been described in the management of buried bumper syndrome. In this case report, we describe the case of an adolescent Caucasian female who developed buried bumper syndrome three years after undergoing percutaneous endoscopic gastrostomy insertion. We review diagnosis and management of buried bumper syndrome and describe a novel technique for bumper removal in which we use a guide wire in combination with external traction to maintain a patent gastrostomy lumen while removing the internal percutaneous endoscopic gastrostomy bumper.

• 대한치과의사협회지
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• 제57권5호
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• pp.279-287
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• 2019

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.

• 대한치과보철학회지
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• 제46권6호
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• pp.591-601
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• 2008

STATEMENT OF PROBLEM: The improvement in oral function and comfort from the dental implant appears to depend on the particular type of implant support used with the denture. The number and positioning of implants have an influence on the force transfer and subsequent stress distribution around implants. Nevertheless, a quantitative comparison has not been made between the types of implant prosthesis used with different materials compared to conventional complete denture. PURPOSE: The objective of this study is to assess the masticatory performance, bite force and impact of two different type of implant supported prostheses on oral health-related quality of life compared to conventional complete denture with GOHAI, validated oral-specific health status measures, the sieving method, and the Prescale Dental System. MATERIAL AND METHODS: From the years 1999 to 2006, a total of 30 completely edentulous patients in a single arch were selected from the Yonsei University Dental Hospital, Department of Prosthodontics and Implant Clinic in Seoul, S. Korea. Patients were divided into 3 groups of 10 each. Group HR was restored with fixed-detachable hybrid prostheses with resin teeth. Group FP had fixed dentures with porcelain teeth while Group CD had a complete denture. The masticatory performance was compared between 3 groups. RESULTS: The results showed a significant improvement in oral health-related quality of life with dental implants compared to a conventional denture in GOHAI comparison. Overall, implant prostheses showed a higher masticatory performance ($S_{50}$) and maximum bite force compared with conventional dentures (P < .05) but no differences between different implant supported prostheses (P > .05). CONCLUSION: Within the limitation of this study, the numbers of implant and material of implant prostheses does not appear to impact patient satisfaction, masticatory performance or bite force.

• 대한물리의학회지
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• 제2권2호
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• pp.243-250
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• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

• The Korean Journal of Pain
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• 제29권2호
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• pp.123-128
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• 2016

Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.

• 대한치과보철학회지
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• 제34권3호
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• pp.457-463
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• 1996

An esthetically pleasing result in denture service is dependent upon several consideration. Esthetic considerations for the edentulous patient include tooth size, shape, arrangement, positioning, gingival contour, age, sex, personality differences, and ethnic type. Especially, the form of anterior artificial teeth is an important factor on the esthetics. The selection of artificaial teeth requires understanding and knowledge on physical and biologic factors and has to meet the indivisul esthetics and functional needs of each patient. However, the selection of artificial teeth is based on the large degree of subjective judgement of the dentist, Therefore, this is one of the most unscientific processes. Many attempts have been made to find a guideline for the selection of artificial teeth. Temperamental theory by White and Hall utillized with the physical characteristics such as body size, body form, color of eyes and hair, and disposition. SPA theory by Frush and Fisher utilized with the basis of sex, personalities, and age of the indivisual. There has not been provided for a guideline and study on the selection of artificial teeth for Koreans yet. This study was aimed to evaluate the William's typal matching theory in Koreans. 1. The facial forms of korean adult were ovoid(46.3%), square(36.7%) and tapered(17.0%) form. 2. The anatomic forms of natural maxillary incisors were ovoid(45.3%), tapered(31.3%), square(23.3%) form. 3. The forms of face and natural maxillary incisors were ovoid(21.9%), squared(11%), tapered(6.3%). 4. The natural maxillary incisors were similar in form to the facial form only in 39%. There was no correlation between the form of the face and the form of natural maxillary central inisors in Koreans. 5. Artificaial teeth which was selected according to the typal matching theory did not represent the form of the natural teeth in 61 per cents of the fatal, but it felt that they harmonized with the form of the patient's face and produced good results.

• 한국정보통신학회논문지
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• 제20권11호
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• pp.2073-2078
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• 2016

최근 센서 데이터 통합최근 센서를 통한 상황인지는 많은 연구가 진행되고 있다. 그러나 센서 데이터의 수집과 분석은 아직 통합이 부족하다. 이는 센서에서 발생하는 데이터에 대하여 메타데이터, 규격, 단위, 검출된 값에서 일치시키기 어렵기 때문이다. 따라서 다양한 센서에서 발생하는 데이터를 효율적으로 이용하기 위한 방법론이 필요하다. 본 논문에서는 이동하는 iBeacon에서 발생하는 정보를 통하여 위치를 인식하는 시스템을 제안하고자 한다. 본 시스템은 iBeacon을 착용한 환자가 실내에서 이동할 때 정확한 위치를 인식할 수 있는 데이터를 표본으로 온톨로지를 구축한다. 이는 기본 항목과 센서의 항목을 매핑하고, 검출된 값으로 필터링을 수행한 결과를 지식으로 저장한다. 이에 제안 시스템은 온톨로지를 통하여 iBeacon을 휴대한 환자가 실내에서 이동하여 발생하는 값을 인식함으로써 효율적인 위치정보를 추출할 수 있다. 이는 비콘 뿐만 아니라 다른 센서에 적용이 가능하고, 온톨로지 구성방법에 따라 다양한 적용이 가능하다.

• Imaging Science in Dentistry
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• 제50권1호
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• pp.37-43
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• 2020

Purpose: The purpose of this study was to evaluate the accuracy of linear measurements in the horizontal and vertical dimensions based on object position and slice inclination in cone-beam computed tomography (CBCT) images. Materials and Methods: Ten dry sheep hemi-mandibles, each with 4 sites (incisor, canine, premolar, and molar), were evaluated when either centrally or peripherally positioned within the field of view (FOV) with the image slices subjected to either oblique or orthogonal inclinations. Four types of images were created of each region: central/cross-sectional, central/coronal, peripheral/cross-sectional, and peripheral/coronal. The horizontal and vertical dimensions were measured for each region of each image type. Direct measurements of each region were obtained using a digital caliper in both horizontal and vertical dimensions. CBCT and direct measurements were compared using the Bland-Altman plot method. P values <0.05 were considered to indicate statistical significance. Results: The buccolingual dimension of the incisor and premolar areas and the height of the incisor, canine, and molar areas showed statistically significant differences on the peripheral/coronal images compared to the direct measurements (P<0.05). Molar area height in the central/coronal slices also differed significantly from the direct measurements (P<0.05). Cross-sectional images of either the central or peripheral position had no marked difference from the gold-standard values, indicating sufficient accuracy. Conclusion: Peripheral object positioning within the FOV in combination with applying an orthogonal inclination to the slices resulted in significant inaccuracies in the horizontal and vertical measurements. The most undesirable effect was observed in the molar area and the vertical dimension.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.164-164
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• 2008

The beach-chair traction position is designed to allow the use of traction while allowing the surgeon to orient the shoulder in an upright position and convert to an open procedure, if necessary. The patient is placed in the beach-chair position under general anesthesia. A three-point shoulder holder (Arthrex, Naples, Florida) is attached to the rail of the operating table on the same side as the surgeon, whereas it is placed on the side opposite the surgeon in the lateral decubitus position. A shoulder traction and rotation sleeve (Arthrex) are affixed to the arm following the manufacturer's instructions. Positioning the thumb toward the closed side of the sleeve ensures a field for the anterior portion of the rotator cuff and prevents the tendency of the suspension apparatus to place the arm in internal rotation. The arm is maintained in 30 to 40 degree abduction and 30 to 40 degree flexion by controlling the length and height of the bar and the location of the universal clamp. The universal clamp allows multiple planes of adjustment to control abduction and forward movement of the arm. The sleeve is attached to the longitudinal traction cable using a sterile hook, and a lateral strap is secured around the proximal portion of the sleeve to the overhead traction cable to ensure a field for glenohumeral reconstruction. The use of a lateral strap permits ideal shoulder positioning for improved access to the anterior and inferior glenohumeral joint. The lateral strap can be released or removed to widen the subacromial space during subacromial decompression or rotator cuff repair. A 10-lb weight is attached to the longitudinal traction cable for an average-sized person.