With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.
In the treatment of dentofacial deformities, analysis of skeletal pattern, with evaluation of plaster dental cast, is essential procedure. This study was based on 20 patients with dentofacial deformity who were admitted to the department of oral and maxillofacial surgery Kngnam sacred heart Hospital during the period of Jan 1988 through Aug 1989. We studied serial cephalometric radiogarphs of patients (pre-op, postop immediately, postop 6 moth). The obtained results indicates the good resistance of rigid fixation against relapse in orthognathic surgery.
Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.28
no.3
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pp.216-225
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2002
Hyaluronic acid (HA) is an almost essential component of extracellular matrices. Early in embryogenesis mesenchymal cells migrate, proliferate and differentiate, in part, because of the influence of HA. Since the features of embryogenesis are revisited during wound repair, including bone fracture repair, this study was initiated to evaluate whether HA has an effect on calcification and bone formation in an in vitro system of osteogenesis. Mouse calvaria Pre-osteoblast (MC3T3-E1) cells were cultured in ${\alpha}-MEM$ medium with microorganism-derivative hyaluronic acid that was produced by Strep. zooepidemicus which of molecular weight was 3 million units. The dosages were categorized in each 0.5, 1.0 and 2.0 mg/ml concentration experimental groups. After 2 and 4 days cultures in expeirmental and control groups, the tendency of cell proliferation, MTT assay, protein synthesis ability, collagen synthesis and alkaline phosphatase activity were analysed and bone nodule formation capacity were measured with Alizarin Red S stain after 29 days cultures. The cell proliferation was increased in time, especially the group of 0.5 and 1.0 mg/ml concentration of HA were showed prominent cell proliferation. After 2 and 4 days culture, experimental groups in general were greater cell activity in MTT assay. The protein synthesis was increased in all experimental groups compared to control group, especially most prominent in 1.0 mg/ml concentration group. The collagen synthesis capacity were increased in HA experimental groups, especially prominent in 1.0 mg/ml group and the activity of alkaline phosphatase were increased, especially also prominent in 1.0 mg/ml group, compared to control group. Above these, the activity of mouse carvarial pre-osteoblast cells was showed greater bone osteogenesis activity in all applied HA experimental group, especially group of 1.0 mg/ml concentration of HA.
Background: The surgical treatment of pectus carinatum is usually a modified Ravitch operation that consists of complete costal cartilage resection and sternal wedge osteotomy. We tried a simple and easy technique that is resection of only deformed, protruded costal cartilage and pre-sternal compression with using a stainless steel bar and this is done without sternal osteotomy. Therefore, we performed partial cartilage resection and pre-sternal compression with a stainless steel bar and we observed the effects and the efficiency of treatment. Material and Method: From July, 2006 to June, 2008, 10 patients with pectus carinatum underwent our modified technique of pectus carinatum surgery. The effects of surgery and the complications were reviewed. Result: 5 patients with only pectus carinatum underwent our modified technique of pectus carinatum surgery. 5 patients with pectus carinatum and pectus excavatum underwent our modified technique of pectus carinatum surgery and Nuss surgery. The mean patient age was 13.4+3.3 years old. The mean operation time was 137.6+22.9 minutes for the pectus carinatum patients and 234.0+36.5 minutes for the pectus carinatum and pectus excavatum patients. The mean length of hospitalization was 11.8+1.0 days. The Haller pectus index of pectus carinatum was $2.10{\pm}0.21$ preoperatively and this was increased to $2.53{\pm}0.07$ postoperatively. The only complication was simple partial wound disruption in 1 patient. Conclusion: We performed partial cartilage resection and pre-sternal compression with a stainless steel bar in 10 patients with pectus carinatum and its effects were good. Our modified technique of pectus carinatum is easy and simple as compared with the Ravitch operation. But removal of the stainless steel bar has not yet been performed for these patients and long-term follow up is needed to accurately evaluate the. effects of this surgery in many surgical cases.
Purpose: The purpose of this study was to compare the improvement and maintenance effects of foot reflexology (FR) on sensations after breast cancer surgery with those of lavender foot bath (LFB). Methods: Using a single-blind design, both 18 women to receive 20-min FR by trained experts and 14 women to soak feet in $40^{\circ}C$ foot tub water with 5 drop lavender essential oil, 15-min were intervened every two days. Repeated measures were taken pre 1st-(baseline-4th op. day), pre 3rd-(2nd data), and pre 5th-intervention (3rd data) with following up at 1-week after 5th intervention (4th data). The reliable translated Korean version of Baron's Breast Sensation Assessment Scale was used to assess sensations after breast cancer surgery (SABCS) characterized by prevalence, frequency, severity, and distress. Results: A significant difference between baseline and the 3rd, and a decrease tendency from baseline to the 3rd were observed for the severity and distress in FR and for the prevalence and severity in LFB. A significant or important decrease tendency between the 3rd and the 4th were observed for the severity and distress in FR and for the severity in LFB. Conclusion: Iterative FR has the improvement and maintenance effects on the severity and distress while LFB has only those on the severity.
Kim, Geun-Hyo;Lee, Jae-Seok;Lee, Chang-Yoon;Lee, Yeon-Woo;Bae, In-Ho;Park, Hee-June;Lee, Byung-Joo;Kwon, Soon-Bok
Osong Public Health and Research Perspectives
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v.9
no.6
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pp.354-361
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2018
Objectives: The purpose of this study was to explore the effects of injection laryngoplasty (IL) with hyaluronic acid in patients with vocal fold paralysis (VFP). Methods: A total of 50 patients with VFP participated in this study. Pre- and post-IL assessments were performed, which included analyzing the sustained vowel /a/ phonation, and the patient reading 1 Korean sentence from the "Walk" passage that comprised 25 syllables in 10 words. To investigate the effect of IL on vocal fold function, acoustic analysis (acoustic voice quality index, cepstral peak prominence, maximum phonation time, speaking fundamental frequency) was conducted and auditory-perceptual (grade and overall severity), visual judgment (gap), and self-questionnaire (voice handicap index-10) assessments were performed. Results: The patients with VFP showed statistically significant differences between pre-and post-IL assessments for acoustic and auditory-perception, visual judgment, and self-questionnaire assessments. Conclusion: The patients with VFP showed positive change in vocal fold function between pre- and post-IL measurements. The findings showed that IL with hyaluronic acid is an effective method to improve vocal fold function in patients with VFP.
Background: The purpose of this study was to assess the relevance of preoperative magnetic resonance imaging (MRI) evaluation by occupation ratio (OR) at maximum diameter of supraspinatus muscle. Methods: Patients from the Inje University Sanggye Paik Hospital who received rotator cuff repair and underwent pre- and postoperative MRI were selected as subjects of this study. On T1-weighted MRIs, OR of fat and muscle at Y-shaped view, OR at a location on supraspinatus muscle where its diameter was maximum on coronal view, and pre- and postoperative Goutallier Classification and changes in the tangent sign were measured. Statistical significance of postoperative OR was assessed regarding time from symptom onset to surgery, size of rotator cuff tear, preoperative OR, and the difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view. Results: Preoperative OR at Y-shaped view was $52.28{\pm}8.57$ (32.5-65.3). Preoperative OR difference between maximum diameter and Y-shaped view was $13.76{\pm}10.51$ (2.38-42.04), and Pearson correlation coefficient was 0.604 (p=0.001). Postoperative OR at Y-shaped view was $63.77{\pm}9.35$ (37.3-76.1). Pearson correlation coefficient of pre- and postoperative Goutallier Classification was -0.579 (p=0.002) and Pearson correlation coefficient of the postoperative difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view was -0.386 (p=0.047). Conclusions: Fatty degeneration of supraspinatus muscle in rotator cuff tear patients should be evaluated not only in the conventional Y-shaped view, but also at location of maximum diameter of supraspinatus muscle to establish patients' therapeutic plan.
Predictional study for lateral change between pre- and post-orthognathic surgery has been emphasized mainly on anterior area of lateral profile; upper lip, lower lip and chin et al. So interest for lateral profile change has been less in posterior area of lateral profile and literature analyzing gonial angle change is rare. The purpose of this study is to make prediction for gonial angle change possible and to offer somewhat treatment guidance for gonial angle to be improved by investigating overall gonial angle change between pre- and post-orthognathic surgery and inquiring into factors influencing on pattern of genial angle change. For this study 35 patients were selected retrospectively. Lateral cephalometric radiographs were taken in just pre-op time, pod 1 day, pod 1 year. They were analyzed and genial angles were measured. The results were as follows : 1. Gonial angle at pod 1 day was decreased about $9.3^{\circ}$ than pre-op and gonial angle at pod 1 year was increased about $4.0^{\circ}$ than pod 1 day. So genial angle at pod 1 year was decreased about $5.3^{\circ}$ than pre-op genial angle(p<0.01). 2. Mean pre-op gonial angle was $129.4^{\circ}$, showing significantly high value than normal and mean gonial angle at pod 1 year was $124.1^{\circ}$, showing value near to normal. 3. Mean gonial angle change between pre-op and pod 1 year was decreased about $5.4^{\circ}$ in female and $5.3^{\circ}$ in male. There was no statistically significant difference between male and female(p>0.05). 4. Principal factor influencing on decreased gonial angle in gonial angle change between pre-op and pod 1 year was amount of mandibular setback. 5. Principal factor influencing on increased gonial angle in gonial angle change between pod 1 day and pod 1 year was % horizontal relapse, and it was thought that resorption and bone remodelling on posterior area in mandibular distal segment also were related to increased gonial angle. 6. It is thought that sagittal split ramus osteotomy in mandibular prognathic patients with high value of gonial angle is effective to improvement of gonial angle, and In patients who have normal range of gonial angle and are required with excessive mandibular setback, short lingual cut method, additional resection of posterior margin of distal segment, Obwegeser II method will be considerd. 7. More prudent operation and careful post-op management will be responsible for maintenance of postoperative stable gonial angle.
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