• 대한구순구개열학회지
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• 제12권2호
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• pp.65-72
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• 2009

Quadrilateral flap technique for primary cheiloplasty in patients with cleft lip was initially developed by Hagedorn in 1884. After Le Mesurier presented this procedure in 1940's, many surgeons adopted this technique for clinical advantage of reconstruction of Cupid's bow and lesser amount of tissue discarding than straight line technique. However, owing to its drawbacks such as sacrifice of Cupid's bow and prominent scar on philtral ridge, other techniques like Tennison's triangular flap and Millard's rotation-advancement flap have gradually taken its place. Nevertheless, some clinicians like Dr. Wang has modified this quadrilateral flap technique for better clinical outcomes. In this report we present 3 cases of unilateral complete cleft lip patients who underwent primary cheiloplasty with favorable outcomes based on Dr. Wang's modified quadrilateral flap technique.

• International Journal of Knowledge Content Development & Technology
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• 제8권3호
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• pp.29-40
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• 2018

This paper discussed motivation, some theories of motivation and motivation of library personnel. The most important aspect of any organization is its workforce. Motivation arouses, energizes, influences and sustains behaviour and performance of employees. Motivating factors include extrinsic factors which pertain to the conditions under which a job is performed and intrinsic motivators which contribute to job satisfaction and subsequently increase productivity. Two levels of motivation were identified in the library: the need-factor motivation and the profession-related motivation. Need-factor motivation is well-pronounced in the lower cadre of library staff such as library assistants, clerical staff, and porters who set their priority on economic needs. The profession-related motivation occurs among professionally trained librarians whose motivation hinges self-fulfillment derived from professional growth and development. Other motivating factor in the library is job design which includes job rotation, job enlargement, and job enrichment. Job design specifies the contents or methods of any job in such a way that various requirements of a job can be effectively satisfied. Adequate motivation of library employees lies with the managers because they generally control work distribution, freedom and autonomy, work challenge Remove, staff development and training, and advancement opportunities. The managers are urged to create enabling environment to ensure improved commitment, satisfaction, and productivity of employees in the library.

• Geomechanics and Engineering
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• 제14권1호
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• pp.1-8
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• 2018

This paper presents an investigation of the liquefaction characteristics and particle crushing of isotropically consolidated silica sand specimens at a wide range of confining pressures varying from 0.1 MPa to 5 MPa during undrained cyclic shearing. Different failure patterns of silica sand specimens subjected to undrained cyclic loading were seen at low and high pressures. The sudden change points with regard to the increasing double amplitude of axial strain with cycle number were identified, regardless of confining pressure. A higher cyclic stress ratio caused the specimen to liquefy at a relatively smaller cycle number, conversely producing a larger relative breakage $B_r$. The rise in confining pressure also resulted in the increasing relative breakage. At a specific cyclic stress ratio, the relative breakage and plastic work increased with the rise in the cyclic loading. Less particle crushing and plastic work consumption was observed for tests terminated after one cyclic loading. Majority of the particle crushing was produced and majority of the plastic work was consumed after the specimen passed through the phase transformation point and until reaching the failure state. The large amount of particle crushing resulted from the high-level strain induced by particle transformation and rotation.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.263-266
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• 2020

Infantile hemangiomas have a growth phase and an involution phase. For this reason, serial observation has generally been recommended as the treatment for uncomplicated infantile hemangiomas. Recently, however, individualized approaches have been emphasized. Although cleft lip and infantile hemangioma are common congenital diseases, infantile hemangiomas on the cleft side (i.e., in the operative field of the cleft lip) are extremely rare, and no clear guidelines have been established for their treatment. We experienced a case in which a patient with a cleft lip had an infantile hemangioma on the cleft side. In accordance with general treatment guidelines, cleft repair was performed 3 months after birth. The Millard rotation-advancement technique, which involves the use of a lower small triangular flap, was used for the repair. No intraoperative complications, such as massive bleeding, or postoperative complications were noted. The patient has received regular follow-up for the past 18 years, and other than a reddish scar on the lower lip, he currently has no related issues. Therefore, this case demonstrates that cleft lip repair performed according to cleft lip treatment guidelines produces good outcomes, even in cases involving a hemangioma on the cleft side.

• 대한구순구개열학회지
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• 제12권1호
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• pp.41-46
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• 2009

Historically, various techniques to correct the deformity of lip and nose in functional and esthetic ways were developed and applied in dealing the patients with cleft lip. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation-advancement method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, triangular flap technique has its advantage in designing the flap using the patient's anatomic landmarks. It enables less skillful operator to perform this technique relatively easily and produce reasonable results. In this report we present 8 cases of unilateral complete cleft lip and 3 casesof unilateral incomplete cleft lip. They all underwent primary cheiloplasty based on triangular flap technique, and functional, esthetic outcomes were favorable.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.480-483
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• 2019

Repairing surgical defects of the nose is still challenging due to its tridimensional shape and its aesthetic concern. Difficulty in reconstructing nasal subunits lies in their contour, skin texture and limited availability of adjacent skin. For lower nasal dorsum and supra-tip regions, we design a new combined local flap as existing local flaps may give disappointing results. This combination flap was performed on two patients for reconstruction of the lower nasal dorsum area after basal cell carcinoma excision. Size of the excision ranged from 20 to 25 mm diameter and safe margins were obtained. The defects were reconstructed with a local flap that combined a rotation nasal flank flap and a V-Y advancement nasolabial flap. Excision and reconstruction were performed in a one-stage surgery under intravenous sedation and local anesthesia. There were no postoperative complications and no flap loss occurred. Aesthetic and functional results after 6 months postoperatively were satisfying without modification of nasal shape. This flap is reliable and offers interesting functional and aesthetic outcomes. It can be considered as a new reconstruction alternative for supra-tip and lower nasal dorsum skin defects performed in a one-stage procedure under local anesthesia.

• 대한치과교정학회지
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• 제30권5호
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• pp.657-668
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• 2000

본 연구는 골격성 III급 부정교합 환자에서 상악골 전방이동 수술 후 야기되는 코의 형태변화에 대해 연구하고 이를 예측할 수 있는 요소를 찾아 교정-악교정 수술 복합 치료계획의 수립과 결과의 예측에 이용하고자 시행되었다. 부산대학교병원 치과진료처 교정과에 내원하여 골격성 III급 부정교합으로 진단되어 술전 교정치료를 받고 Le Fort I 골절단술로 상악골의 전방 이동시키는 동시에 하악골을 후방 이동시킨 남녀 성인 환자 25명을 대상으로 하였다. 이들의 수술전, 후 측모두부규격방사선사진과 정모 및 측모 안면사진을 계측, 분석하여 다음과 같은 결과를 얻었다. 1. 상악골 전방이동에 따른 비첨의 수직적 위치 변화는 상관성이 높았으며 ANt, SNt에서 A point의 전방이동에 의해 ${\beta}_0$는 각각 0.228, 0.257로 나타났다. 2. 상악골 전방이동에 따른 비첨의 수평적 위치변화는 상관성이 높았으며 ANt, SNt, Sn point에서 A point의 전방이류에 의해 ${\beta}_0$는 각각 0.484, 0.431, 0.806으로 나타났다. 3. 상악골의 전방이동에 따른 비익부의 확장정도는A point의 전방이동에 의해 0.002의 ${\beta}_0$를 나타내었으나, 임상적으로 유의한 변화는 없었다. 4. 수술 후 비첨의 수직적 및 전후방적 위치변화를 예측하는 지표로 사용된 ADV, DRI, Prominence of nose, Pre-Op CA 중 ADV 만이 설명변수로서 유의성이 있었다.

• 대한수학교육학회지:수학교육학연구
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• 제25권4호
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• pp.571-598
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• 2015

본 연구에서는 공간 과제에서 학생들이 사용하는 공간 인지 전략의 유형과 역할을 살펴보고자 Shepard & Metzler(1971)의 심적 회전 검사(mental rotation test)를 토대로 시각적 변별과 기억 능력을 측정하는 두가지 공간 과제를 개발하여, 초등학교 6학년 학생 63명을 대상으로 연구를 수행하였다. 연구 결과, 학생들은 접근 방법 측면에서 전체적 접근 전략과 부분적 접근 전략을, 처리 방법 측면에서 심상적 처리 전략과 분석적 처리 전략을, 준거 기준 측면에서 대상 변환 전략과 관점 변환 전략을 사용하였다. 사용 전략에 따른 검사 점수를 비교한 결과 접근 방법 측면에서는 부분적 접근 전략을 사용한 집단이, 처리 방법 측면에서는 분석적 처리 전략을 사용한 집단이, 준거 기준 측면에서는 관점 변환 전략을 사용한 집단의 검사점수가 더 높게 나타났다. 또한 이러한 전략은 변별 과제보다 재인 과제에서, 복잡도가 낮은 문항보다는 복잡도가 높은 문항에서 더 빈번하게 사용되었다. 따라서 부분적 접근전략, 분석적 처리 전략, 관점 변환 전략은 인지적 노력이 많이 요구되는 문제 상황에서 체계적으로 문제를 해결하도록 돕는 유용한 전략임을 확인할 수 있었다.

• 대한방사선기술학회지:방사선기술과학
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• 제38권4호
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• pp.389-394
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• 2015

의료영상 검사는 정보기술 및 의료장비의 발달로 인체의 해부학적 구조를 묘사하는 능력이 날로 발전하고 있다. 그러나 상지회전이 필요한 어깨관절 의료영상 검사에서는 인체구조의 복잡성으로 정확한 자세유지가 의료영상의 진단적 가치에 매우 중요하다. 자기공명검사의 경우 긴 검사시간과 고정된 자세가 필요해 검사자의 노력과 환자의 의지만으로 재현성 있는 검사가 불가능하다. 이에 상지회전과 정량적 각도가 가능한 보조기구를 개발하여 진단적 가치가있는 의료영상 검사를 하고자하였다. 본 연구는 선행 연구의 결과를 바탕으로 보조기구를 제작하였으며, 공학용 프로그램인 CATIA 프로그램으로 3차원 모델링을 설계하여, 3D프린터로 최종 완성된 보조기구를 제작하였다. 사용된 3D 프린터는 Stratasys Objet350 Connex 모델이며, 재질은 광경화성 수지를 사용하였다. 완성된 보조기구의 크기는 $120{\times}150{\times}190mm$이며, 손잡이부의 내경은 125.9 mm 로 디자인되었다. 보조기구는 총 4개의 부품으로 바디부(외부), 손잡이부(내부), 고정단자, 연결부로 구성되었으며 바디부와 손잡이부는 원활한 회전이 가능하도록 2.1 mm의 유격이 유지되도록 하였다. 손잡이부에는 360o 눈금선을 표시하여 환자마다 관찰에 필요한 회전각도를 기록할 수 있도록 하여 추적검사나 양쪽검사에 적용할 수 있도록 하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권1호
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• pp.51-62
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• 1994

The sagittal split osteotomy of the mandibular ramus is a common procedure which has been used in the correction of mandibular deformities for a few decades. Although the technical improvements have increased the reliability and stability of SSRO procedure, the postoperative relapse is imperative and clinically more significant than any other complication. One of the major causes of the relapse is due to the displacement of the proximal segment during SSRO procedure, which is well documented in the literature. Therefore it is important to preserve the original position of the proximal segment during SSRO proced and maxillofacial fixation period. In the case of mandibular asymmetry, if one side of mandible is advanced and the other side of mandible is setback during SSRO procedure, the proximal segment in the advancement site will rotate laterally and the proximal segment in the setback site will rotate medially. For the prevention of the lateral rotation or flaring of the proximal segment in the advancment site. we deliberately fracture the posterior protion of the distal segment in green-stick fashion during SSRO procedure, and there is no need to fix the fractured lingual segment. We fix the two osteotomized bony segments in the buccal cortex area rigidly with adjustable monocortical plates and screws. During SSRO procedure the lingual fracture technique was applied to nine patients with severe mandibular asymmetry who underwent orthognathic surgery in our hospital since march, 1992. These clinical experiencies enable us to find the lingual fracture technique has the following advantages. 1. The proximal segment is displaced minimally. 2. The osteotomized bony segments are contacted intimately. 3. The postoperative relapse and the healing period are decreased.