• Title/Summary/Keyword: Plastic Surgery

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Evaluation of strategic uprighting of the mandibular molars using an orthodontic miniplate and a nickel-titanium reverse curve arch wire: Preliminary cephalometric study

  • Park, Jae-Hyun;Choo, HyeRan;Choi, Jin-Young;Chung, Kyu-Rhim;Kim, Seong-Hun
    • The korean journal of orthodontics
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    • v.51 no.3
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    • pp.179-188
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    • 2021
  • Objective: To evaluate the overall treatment effects in terms of the amount of uprighting with changes in the sagittal and vertical positions of mandibular molars after applying an orthodontic miniplate with a nickel-titanium (NiTi) reverse curve arch wire (biocreative reverse curve [BRC] system). Methods: A total of 30 female patients (mean age, 25.99 ± 8.96 years) were treated with the BRC system (mean BRC time, 10.3 ± 4.07 months). An I-shaped C-tube miniplate (Jin Biomed) was placed at the labial aspect for the alveolar bone of the mandibular incisors. A 0.017 × 0.025-inch NiTi reverse curve arch wire was engaged at the C-tube mini-plate anteriorly and the first and second premolars and molars posteriorly in the mandibular arch. Pre- and post-BRC lateral cephalograms were analyzed. A paired t-test was used to analyze the treatment effects of BRC. Results: The mandibular second molars were intrusively uprighted successfully by the BRC system. Distal uprighting with a controlled vertical dimension was noted on the first molars when they remained engaged in the BRC and the distal ends of the arch wire were laid on the second molars. The mandibular first and second premolars showed a slight extrusion. The changes in the mandibular incisors were unremarkable, while the mandibular molar angulation improved significantly. The lower occlusal plane rotated counterclockwise (MP-LOP: 1.13° ± 2.60°). Conclusions: The BRC system can provide very effective molar uprighting without compromising the position of the mandibular anterior teeth.

Soft-tissue coverage for wound complications following total elbow arthroplasty

  • Macken, Arno A.;Lans, Jonathan;Miyamura, Satoshi;Eberlin, Kyle R.;Chen, Neal C.
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.245-252
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    • 2021
  • Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA. Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA. Demographic data and disease characteristics were collected through medical chart reviews. Additionally, we contacted all four patients that were alive at the time of the study by phone to assess any current elbow complications. Local tissue rearrangement was used for soft-tissue reconstruction in six patients, and a pedicle flap was used in three patients. The median follow-up period was 1.3 years (range, 6 months-14.7 years). Results: Seven patients (78%) underwent reoperation. Four patients (44%) had a reoperation for soft-tissue complications, including dehiscence or nonhealing of infected wounds. Five patients (56%) had a reoperation for implant-related complications, including three infections and two peri-prosthetic fractures. At the final follow-ups, six patients (67%) achieved successful wound healing and two patients had continued wound healing issues, while two patients had an antibiotic spacer in situ and one patient underwent an above-the-elbow amputation. Conclusions: This study reports a complication rate of 78% for soft-tissue reconstructions after TEA. Successful soft-tissue healing was achieved in 67% of patients, but at the cost of multiple surgeries. Early definitive soft-tissue reconstruction could prove to be preferable to minor interventions such as irrigation, debridement, and local tissue advancement, or smaller soft-tissue reconstructions using local tissue rearrangement or a pedicled flap at a later stage.

Case study of social accountability implementation of medical schools: case of 8 medical school in Korea (의과대학의 사회적 책무성 실천 사례: 8개 의과대학을 중심으로)

  • Jung–Sik Huh;Mi Kyung Kim;Yoo Sang Yoon;Keun-Mi Lee;Jong Hun Lee;Seung-Jae Hong;Hyo Hyun Yoo
    • Journal of Medicine and Life Science
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    • v.20 no.1
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    • pp.15-20
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    • 2023
  • Medical schools realize their social accountability in cultivating future doctors as decision-makers of medical care in the future society as an axis of society and carrying out communication, research, and medical service (medical care). This study summarized the social accountability status of eight medical schools in Korea, including the characteristics, activities, and programs in the sociocultural context. The data from the self-evaluation research reports of eight medical schools were classified and organized according to education, research, and medical care services. The medical schools offer related subjects, community service activities, and clinical practice, allowing active participation in local health promotion and disease prevention. Community health information research was conducted considering the difference between the local natural environment in which the medical school is located and the frequency of diseases. Medical schools and hospitals collaborated to conduct domestic and foreign health education volunteer activities. Social accountability must be prioritized, considering the importance of medical schools' functions and roles in a high knowledge-information society. Both doctors' medical capacity and competence to actively participate in developing medical care and health policies for the community should be strengthened.

Development of wound segmentation deep learning algorithm (딥러닝을 이용한 창상 분할 알고리즘 )

  • Hyunyoung Kang;Yeon-Woo Heo;Jae Joon Jeon;Seung-Won Jung;Jiye Kim;Sung Bin Park
    • Journal of Biomedical Engineering Research
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    • v.45 no.2
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    • pp.90-94
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    • 2024
  • Diagnosing wounds presents a significant challenge in clinical settings due to its complexity and the subjective assessments by clinicians. Wound deep learning algorithms quantitatively assess wounds, overcoming these challenges. However, a limitation in existing research is reliance on specific datasets. To address this limitation, we created a comprehensive dataset by combining open dataset with self-produced dataset to enhance clinical applicability. In the annotation process, machine learning based on Gradient Vector Flow (GVF) was utilized to improve objectivity and efficiency over time. Furthermore, the deep learning model was equipped U-net with residual blocks. Significant improvements were observed using the input dataset with images cropped to contain only the wound region of interest (ROI), as opposed to original sized dataset. As a result, the Dice score remarkably increased from 0.80 using the original dataset to 0.89 using the wound ROI crop dataset. This study highlights the need for diverse research using comprehensive datasets. In future study, we aim to further enhance and diversify our dataset to encompass different environments and ethnicities.

THE CHANGE OF SALIVARY FLOW RATE, AND CONCENTRATION OF TOTAL PROTEIN AND IGA AFTER RADIATION THERAPY OF ORAL CANCER (구강암 환자에서 방사선 조사에 따른 타액량, 총 단백 및 IgA 농도의 변화)

  • Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.3
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    • pp.249-256
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    • 1999
  • This study was performed to investigate the changes in flow and composition of saliva in oral cancer patients after radiation therapy. Stimulated whole saliva was collected from 7 patients who were scheduled for over 6,000cGy irradiation (180 - 225cGy fraction $Co^{60}$ therapy, 5 times a week). The flow rate of saliva, and concentration of total protein and IgA were measured before irradiation and 1, 2, 3, 4, 5 days and 1, 2, 3, 4, 6 weeks and 3, 6, 12 months after. The followings are results we obtained: 1. The salivary flow rate before irradiation was $0.8671{\pm}0.4057ml/min$. Significant decrease started 3 days after irradiation and reached a minimum at 4 weeks ($0.2621{\pm}0.2858ml/min$). Afterwards, flow rate started to increase and was on the way to recover at 1 year. 2. The concentration of total protein and IgA before irradiation were $137.2000{\pm}16.9912mg%$ and $3.4200{\pm}1.4114mg%$, respectively. After irradiation, these figures increased significantly and reached a maximum of $366.4000{\pm}174.0583mg%$ and $43.4800{\pm}29.1207mg/ml$, respectively at 6 weeks. Recovery towards normal values started following the end of irradiation and figures at 12 months had lowered to $165.400{\pm}21.1495mg%$ and $4.6200{\pm}2.1580mg/ml$ each. 3. The ratio of IgA to the amount of total protein was 2.5% before irradiation. This began to increase from 1 week following irradiation as the total dose of radiation received was increased (11.9% at 6 weeks). After 1 year from the start of radiation therapy, the ratio was reduced to such level that was before irradiation.

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EFFECTS OF HYDROQUINONE ON NEOPLASTIC TRANSFORMATION OF HUMAN EPITHELIAL CELLS IN CULTURE (Hydroquinone이 인체 상피세포의 발암화에 미치는 영향)

  • Sohn, Jung-Hee;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.218-228
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    • 2010
  • Components of dental resin-based restorative materials are reported to leach from the filling materials even after polymerization. Hydroquinone (HQ) is one of the major monomers used in the dental resin and is known as a carcinogen. Thus, carcinogenic risk of HQ leaching from the dental resin becomes a public health concern. The present study attempted to examine the carcinogenic potentials of HQ on the human epithelial cell, which is the target cell origin of the most of oral cancers. Cytotoxicity of HQ was observed above 50${\mu}M$ as measured by LDH assay, indicating a relatively low toxicity of this substance in human epithelial cells. The parameters of neoplastic cellular transformation such as cell saturation density, soft agar colony formation and cell aggregation were analyzed to examine the carcinogenic potential of HQ. The study showed that 2-week exposure of HQ showed the tendency of increase in the saturation density and the significant enhancement of soft agar colony formation at the highest dose, 50 ${\mu}M$ only. It is suggested that HQ has a weak potential of carcinogenicity. When cells were treated with HQ and TPA, a well-known tumor promoter, the parameters of neoplastic cellular transformation was significantly increased. This result indicates that the potential risk of carcinogenicity from HQ is largely dependent upon the presence of promoter. Exposure of 50 ${\mu}M$ HQ increased the time-dependent apoptosis as measured by the ELISA kit. This concentration coincides with a dose of neoplastic transformation, indicating a possible link between apoptosis and HQ-induced cellular transformation. Hydroquinone generated Reactive Oxygen Species (ROS) which was evidenced by the treatment of antioxidants such as trolox and N-acetyl cysteine and the GSH depleting agent, BSO. Antioxidants blocked the generation of ROS and the GSH depleting agent, BSO dramatically increased the ROS production. Since HQ is known to increase ROS production thru activation of transcriptional factor such as c-Myb and Pim-1, it is speculated that ROS generation by HQ plays a role in the activation of oncogene, which may lead to neoplastic transformation. In addition, ROS is involved in the alteration of signal transduction, which regulates the apoptosis in many cellular systems. Thus, ROS-mediated apoptosis may be involved in the HQ-induced carcinogenic processes. Protein kinase C (PKC) is known to play pivotal roles in neoplastic transformation of cells and its high expression is often found in a variety of types of tumors including oral cancer. PKC translocation of PKC-${\alpha}$ was observed following HQ exposure. Altered signaling system may also play a role in the transformation process. Taken together, HQ leached from the dental resin does not pose a significant threat as a cancer causing agent, but its carcinogenic potential can be significantly elevated in the presence of promoter. The mechanism of HQ-induced carcinogenesis involved ROS generation, apoptosis and altered signaling pathway. The present study will provide a valuable data to estimate the potential risk of HQ as a carcinogen and understand mechanism of HQ-induced carcinogenesis in human epithelial cells.

Staged Fontan Operation Via Bidirectional Glenn Operation (양방향성 GLENN 수술을 통한 단계적 FONTAN 수술의 임상분석)

  • 한재진;김웅한
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1062-1068
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    • 1997
  • From August 1989 to January 1996, a total of 105 cases of bidirectional Glean operations have been done as the interim stage for the patien s with some risk of univentricular correction at Sejong General Hospital. From December 1992, we started the conversion to Fontal operations for them, and 42 cases underwent Fontal-stage operation till February 1996. Their diagnoses were univentricular heart in 19(right ventricular type : 14), tricuspid atresia 11, double outlet of right ventricle 9, and others in 3 cases. The median age of bidirectional Glerln-stage operation was 12.5 months(range 2 months to 8 years) and Fontan-stage operation was at 59.6 months of median age(range 1 year 5 months to ,9 year 7 months). The mean waiting interval between the two operations was 33.88 $\pm$ 17.85 months with a range of 10 months to 6 years 3 months. During the waiting periods, 18 patients developed significant systemic-pulmonary collaterals andfor systemic verso-veno collateral channels. There were 5 hospital deaths after operations due to low cardiac output in 4 and sepsis in one. Most of the Fontal-stage operations were done by the late al tunneling with Core-Tex tube graft patch and fenestrated with the size of 2.5 ~6 mm. All the patients were followed-up(7 months to 4 years 2 months, mean 21.97$\pm$10.82 months) and there were 5 late deaths(postoperatively 6 months to 2 years) due to thromboembolism in 1, after heart transplantation 1, plastic bronchitis 1, protein loosing enteropathy 1, and pneumonia in 1. Dividing the patients by the waiting interval of 2 years, the early correction to Fontal group (N=16) showed the better results(hospital mortality 1116, late mortality 1116, significant collateral development 2/16) compared to the other group(N=26) (4/26, 4/26, 16/26). In conclusion, after the bidirectional Glean-stage operation successfully got rid of the previous risk factors, we recommand to do the Fontan-stage operation no later than 2 years of interval.

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Concurrence of Obstetric Brachial Plexus Injury, Congenital Muscular Torticollis and Cleft Palate (분만성 상완 신경총 손상, 선천성근성사경 및 구개열의 병발)

  • Lee, Han-Byul;Park, Myong-Chul;Kim, Chee-Sun;Han, Jae-Deok;Lee, Seung-Jae;Kim, Se-Yon;Yim, Shin-Young
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.71-75
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    • 2011
  • A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

Development and Application of a Novel Mammalian Cell Culture System for the Biocompatibility and Toxicity of Polymer Films and Metal Plate Biomaterials (고분자필름과 금속막 의료소재에 대한 생체적합성 및 독성 평가를 위한 새로운 세포배양시스템의 개발 및 적용)

  • Kwak, Moon Hwa;Yun, Woo Bin;Kim, Ji Eun;Sung, Ji Eun;Lee, Hyun Ah;Seo, Eun Ji;Nam, Gug Il;Jung, Young Jin;Hwang, Dae Youn
    • Journal of Life Science
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    • v.26 no.6
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    • pp.633-639
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    • 2016
  • Biomaterials including polymer, metal, ceramic, and composite have been widely applied for medical uses as medical fibers, artificial blood vessels, artificial joints, implants, soft tissue, and plastic surgery materials owing to their physicochemical properties. However, the biocompatibility and toxicity for film- and plate-form biomaterials is difficult to measure in mammalian cells because there is no appropriate incubation system. To solve these problems, we developed a novel mammalian cell culture system consisting of a silicone ring, top panel, and bottom panel and we applied two polymer films (PF) and one metal plate (MP). This system was based on the principal of sandwiching a test sample between the top panel and the bottom panel. Following the assembly of the culture system, SK-MEL-2 cells were seeded onto Styela Clava Tunic (SCT)-PF, NaHCO3-added SCT (SCTN)-PF, and magnesium MP (MMP) and incubated at 37℃ for 24 hr and 48 hr. An MTT assay revealed that cell viability was maintained at a normal level in the SCT-PF culture group at 24 or 48 hr, although it rapidly decreased in the SCTN-PF culture group at 48 hr. Furthermore, the cell viability in the MMP culture group was very similar to that of the control group after incubation for 24 hr and 48 hr. Together, these results suggest the sandwich-type mammalian culture system developed here has the potential for the evaluation of the biocompatibility and toxicity of cells against PF- and MP-form biomaterials.

Effects of Recombinant Human Epidermal Growth Factor (rhEGF) on Experimental Radiation-Induced Oral Mucositis in Rats (Rat의 방사선 조사성 구내염에 대한 Recombinant Human Epidermal Growth Factor (rhEGF)의 효과)

  • Jung Kwon-Il;Kim Sun-Hee;Moon Soo-Young;Kim Yeon-Wha;Hong Joon-Pio;Kim Hyun-Sook;Lee Sang-Wook
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.67-76
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    • 2006
  • Purpose: Oral mucositis is a common toxicity of radiation or chemotherapy, which is used a treatment for head and neck cancer. We investigated effects of recombinant human epidermal growth factor (rhEGF) on radiation-induced oral mucositis in rat model. Materials and Methods: Spraque-Dawley rats (7 per group) exposed to a single dose of 25 Gy (day 0) on their head, except for one group, were randomly divided into un-treated, vehicle-treated, and two rhEGF-treated groups. Rats were topically applied with rhEGF (15 or $30{\mu}g/oral$ cavity/day) or vehicle to their oral mucosa. Survival rate of rats, weight changes, and food intakes were examined from day 0 to 18 after radiation. Histology study was performed from oral mucosa of rats at day 7 and 18 after radiation. Results: rhEGF-treated groups (15 or $30{\mu}g/oral$) showed all survival rate 33%, whereas un-treated and vehicle-treated groups showed all survival rate 0% at the end of experiment. rhEGF-treated groups statistically had less weight loss compared to vehicle-treated group from day 2 to 7 after radiation. Food intake of rats with rhEGF treatment turned to increase at day 14 after radiation. At 7 day after radiation, un-treated and vehicle-treated groups showed severe pseudomembraneous or ulcerative oral mucositis. On the other hand, rhEGF-treated groups had no more than cellular swelling and degeneration of epidermal cells in oral mucosa of rats. Conclusion: These results suggest that rhEGF has significantly positive effects on radiation-induced oral mucositis in rats. rhEGF display a therapeutic potential on a clinical level.