• Title/Summary/Keyword: Prospective approach

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Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study

  • Khandeparker, Purva Vijay Sinai;Dhupar, Vikas;Khandeparker, Rakshit Vijay Sinai;Jain, Hunny;Savant, Kiran;Berwal, Vikas
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.144-150
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    • 2016
  • Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

Cognition and Memory Impairment after Operation in Ruptured Cerebral Aneurysm Patients (뇌동맥류 파열 환자의 수술후 인지기능과 기억력장애에 관한 연구)

  • Kim, Byung Joo;Choi, Chang Hwa;Kim, Dae Jin
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.842-848
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    • 2001
  • Objectives : The mortality rate of subarachnoid hemorrhage(SAH) has been reduced recently due to refinement of microsurgical technique and improved perioperative management. Also, many survivors of SAH show excellent neurological recoveries. However, we found that a high proportion of the survivors do not fully regain their premorbid status in cognitive and memory function. Object of this study is to evaluate which factors might influence on cognitive and memory impairment in ruptured aneurysmal SAH patients. Methods : In this prospective study, a series of 66 patients with aneurysmal subarachnoid hemorrhage(SAH) from 1996 to 1998, most of whom had a "good" or "fair" neurological outcome, were assessed with various tests of cognition and memory function. All patients underwent clipping operation by pterional approach. Right side approach was performed in 16 case and left 21 cases. K-WAIS(Korean-Wechsler Adult Intelligence Scale) was used as method of cognition and memory function test. The time interval between SAH and assessment varied between 4 months and 8 months, averaging 6.2 months. Statistical analyses were carried out for each test score to see whether aneurysm site(A-com : non A-com), route of approach, age and sex, vasospasm, Hunt-Hess grade and Fisher CT group at admission, Glasgow Outcome Scale(GOS) at discharge affect cognitive and memory function. Results : Aneurysm site was not shown to be associated with performance on any test, and the initial grade (Hunt-Hess grade, Fisher CT group) of SAH and vasospasm had only minimal predictive values. The grade at discharge( GOS) was proved to be the best predictor of impairment of cognition and memory function within 1 year after operation. Conclusion : The authors conclude that the diffuse effects of SAH are more important than focal neuropathology in relation to cognitive impairment in this group of patients.

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The prospective preliminary clinical study of open reduction and internal fixation of mandibular angle fractures using 2 miniplates (하악 우각부 골절 시 2개의 miniplate를 이용한 관혈적 정복술에 대한 전향적 예비 임상연구)

  • Yang, Seung-Bin;Jang, Chang-Su;Kim, Ju-Won;Yim, Jin-Hyuk;Kim, Jwa-Young;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.320-324
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    • 2010
  • Introduction: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures. Materials and Methods: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery. Results: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery. Conclusion: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients’discomfort and simplify the surgical procedure.

Paraspinal Muscle Sparing versus Percutaneous Screw Fixation: A Prospective and Comparative Study for the Treatment of L5-S1 Spondylolisthesis

  • Jang, Kun-Soo;Kim, Heyun-Sung;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.163-166
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    • 2011
  • Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.

Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity

  • Baek, Jongyoon;Kim, Bum Soo;Yu, Hwarim;Kim, Hyuckgoo;Lim, Chaeseok;Song, Sun Ok
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.199-204
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    • 2018
  • Background: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. Methods: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. Results: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures ($0.50{\pm}0.38^{\circ}C$ and $1.41{\pm}0.68^{\circ}C$ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference > $1^{\circ}C$) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). Conclusion: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

No Adverse Outcomes of Video-Assisted Thoracoscopic Surgery Resection of cT2 Non-Small Cell Lung Cancer during the Learning Curve Period

  • Bilgi, Zeynep;Batirel, Hasan Fevzi;Yildizeli, Bedrettin;Bostanci, Korkut;Lacin, Tunc;Yuksel, Mustafa
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.275-280
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    • 2017
  • Background: Video-assisted thoracoscopic surgery (VATS) anatomic lung resections are gradually becoming the standard surgical approach in early-stage non-small cell lung cancer (NSCLC). The technique is being applied in cases of larger tumors depending on the experience of the surgical team. The objective of this study was to compare early surgical and survival outcomes in patients undergoing anatomic pulmonary resections using VATS and thoracotomy techniques for clinical T2 NSCLC during the adaptation period of the surgical team to the VATS approach. Methods: The data of all patients who underwent anatomic pulmonary resection for NSCLC using VATS and open techniques since April 2012 were recorded to create a prospective lung cancer database. Clinical T2 NSCLC patients who underwent VATS anatomic lung resection were identified and compared with cT2 patients who underwent open resection. Results: Between April 2012 and August 2014, 269 anatomical resections for NSCLC were performed (80 VATS and 189 thoracotomy). Thirty-four VATS patients who had clinical T2 disease were identified and stage-matched to thoracotomy patients. The average tumor diameter was comparable ($34.2{\pm}11.1{\times}29.8{\pm}10.1mm$ vs. $32.3{\pm}9.8{\times}32.5{\pm}12.2mm$, p=0.4). Major complications were higher in the thoracotomy group (n=0 vs. n=5, p=0.053). There was no 30-day mortality, and the 2-year survival rate was 91% for VATS and 82% for thoracotomy patients (p=0.4). Conclusion: VATS anatomic resections in clinical T2 NSCLC tumors are safe and have perioperative and pathologic outcomes similar to those of thoracotomy, while remaining within the learning curve.

Weed Management Using a Potential Allelopathic Crop (제초제(除草劑) 신기능(新機能) 작물품종(作物品種) 이용(利用) 잡초방제(雜草防除) 기술(技術))

  • Kim, Kil-Ung;Park, Kwang-Ho
    • Korean Journal of Weed Science
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    • v.17 no.1
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    • pp.80-93
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    • 1997
  • Allelopathic compounds as naturally occurring herbicide have originally reported from local vegetation since B.C. 300. These compounds are known as secondary plant metabolites which released from plants into the environment often attract or repel, nourish or poison other organisms. In recent, many natural plant allelochemicals be used to attempt to biologically or ecologically control weed among worldwide weed scientists. Some allelochemicals have also used as fungicides, insecticides, and nematodicides, and were less than man-made agrochemicals to damage the global ecosystem. It makes efficient use of resources internal to the farm, relies on a minimum of purchased inputs. Some scientists selected for allelopathic activity when breeding weed-controlling cultivars of rice, sorghum, cucumber, surflower etc. Thus, this paper is focused on allelopathic compounds isolated from cultivated crop with the high potential of prospective herbicides. The most environmentally acceptable and sustainable approach to utilization of allelopathy for weed control is to develop plant cultivars with proven allelopathic characteristics. In rice accessions, there are 60 cultivars/lines which have known as allelopathic activity and some of these cultivars control weed more less 90% within certain radius of activity. These accessions are originated from 15 countries including Korea, Japan, USA, India, Philippines, Indonesia, Laos, Taiwan, Afghanistan, Mali, Pakistan, Colombia, Egypt, China, and Dom. Rep. From these cultivars, the most common allelopathic compounds identified in rice are p-Hydroxybenzoic, Vanillic, p-Coumaric, and Ferulic acids. In addition, allelopathic lines of the following crop have shown inhibition of weed growth : beet (Beta vulgaris), lupin(Lupinus spp.), com(Zea mays), Wheat(Triticum aestivum), oats(Avena spp.) peas(Pisum sativum), barley(Hordeum vulgare), rye(Secale cereale), and cucumber(Cucumis sativus). Thus, future allelopathy research must be designed its potentially phytotoxic propertices and the ecotoxic features of the allelochemicals from release to degradation ; its ecological sustainability, its allelopathic effect in early growth. stages, and selectivity properties in combination with chemical stages, and selectivity properties in combination with chemical concentrations. Also, research approach in allelopathy might be screened for highly allelopathic germplasm collection of crops, the idea being to ultimately transfer this agronomic character into improved cultivars by either conventional breeding or other genetic transfer techniques.

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A radiographic evaluation of graft height changes after maxillary sinus augmentation

  • Kim, Do-Hyung;Ko, Min-Jeong;Lee, Jae-Hong;Jeong, Seoung-Nyum
    • Journal of Periodontal and Implant Science
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    • v.48 no.3
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    • pp.174-181
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    • 2018
  • Purpose: The aims of the present study were to quantitatively assess graft height changes after sinus lift procedures and to analyze the factors that influenced graft height changes, including the residual bone height before surgery, surgical approach, and tooth type. Methods: A total of 39 maxillary posterior implants placed during a simultaneous sinus lift procedure were evaluated. Panoramic radiographs of all patients were taken immediately after implant installation and at 3 months, 6 months, 1 year, 2 years, and 3 years. To analyze graft height changes over time, we measured the distance between the implant platform and the base of the grafted sinus floor at 3 locations. The radiographs were analyzed by a single examiner. Results: Graft height tended to decrease over time, and a statistically significant difference was observed at 2 years compared to baseline (P<0.05). There was no statistically significant difference in graft height change according to the surgical approach or tooth type. For residual bone height, a statistically significant difference in graft height change was found between those with 4-7 mm of residual bone height and those with ${\geq}7mm$ (P<0.05). Conclusions: Graft height after sinus lift procedures significantly decreased at 2 years compared to baseline after sinus augmentation. Further studies should be done with controlled variables, and prospective studies with 3-dimensional images are needed to clarify the factors that influence graft height changes.

Fractal Approaches to Ecological and Limnological Phenomena (생태학적 ${\cdot}$ 육수학적 현상들에 대한 프랙탈의 적용)

  • Chang, Hyun-Jeong;Kang, Sin-Kyu;Lee, Do-Won
    • Korean Journal of Ecology and Environment
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    • v.33 no.2 s.90
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    • pp.69-79
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    • 2000
  • Fractal geometry has become one of prospective research approaches as the complex structure of natural entities is not easily characterized by traditional Euclidean geometry. With the fractal geometry, we can better decipher the complex structure and identify natural and anthropogenic agents of landscape patterns occurring at different spatial scales. The usefulness of fractal, however, has not been fully appreciated among Korean academic societies, especially in ecological and limnological fields. We attempt to address three points in this study. First, we introduce the concept and dimension of fractal and review relevant research approaches, especially with respect to ecological and limnological phenomena. Second, we explore possible applications of fractal to some aspects of geography and land use characteristics in South Korea. For the analyses of fractal dimensions, we used data published in other studies previously and collected for this study. Data were analyzed by a perimeter/area method of fractal dimension for the spatial distribution of global solar radiation and leaf area index, and the movement of wild boars in forested landscapes of mid-eastern Korea. The same approach was also applied to the water channel of a hypothetical river and the shape of reservoirs in Yongin, Kyunggi Province. Finally, we discuss the results and key issues to consider when a fractal approach is employed in ecology and limnology.

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Active Facial Tracking for Fatigue Detection (피로 검출을 위한 능동적 얼굴 추적)

  • Kim, Tae-Woo;Kang, Yong-Seok
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.2 no.3
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    • pp.53-60
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    • 2009
  • The vision-based driver fatigue detection is one of the most prospective commercial applications of facial expression recognition technology. The facial feature tracking is the primary technique issue in it. Current facial tracking technology faces three challenges: (1) detection failure of some or all of features due to a variety of lighting conditions and head motions; (2) multiple and non-rigid object tracking; and (3) features occlusion when the head is in oblique angles. In this paper, we propose a new active approach. First, the active IR sensor is used to robustly detect pupils under variable lighting conditions. The detected pupils are then used to predict the head motion. Furthermore, face movement is assumed to be locally smooth so that a facial feature can be tracked with a Kalman filter. The simultaneous use of the pupil constraint and the Kalman filtering greatly increases the prediction accuracy for each feature position. Feature detection is accomplished in the Gabor space with respect to the vicinity of predicted location. Local graphs consisting of identified features are extracted and used to capture the spatial relationship among detected features. Finally, a graph-based reliability propagation is proposed to tackle the occlusion problem and verify the tracking results. The experimental results show validity of our active approach to real-life facial tracking under variable lighting conditions, head orientations, and facial expressions.

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