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Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

  • Kim, Jin Hyung;Kim, Jeong Min;Park, Jang Wan;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.742-747
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    • 2013
  • Background The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. Methods This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. Results All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. Conclusions Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.

Clinical Effectiveness of Upper Extremity Performances on Mirror Therapy for Adult with Post Stroke Hemiplegia: A Systematic Review (뇌졸중으로 인한 편마비 환자의 상지기능 향상을 위한 거울치료의 임상적 효과에 대한 체계적 고찰)

  • Baek, Sun-Woong;Kim, Jong-Bae
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.71-80
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    • 2016
  • Objective: To illustrate effects and application potential of Mirror Therapy (MT) for patients with post-stroke hemiplegia. Method: With reference to 9 journals (published Jan.2005-Jan.2016) on Pubmed, selected based on in/exclusion standards. Result: Simple wrist/hand movements and task-based MT were used as intervention methods to examine the effects. Tools used to assess intervention effects included upper limb functioning, Activities of Daily Living (ADL), physical condition and quality of life. Upper limb functioning turned out to have significance for ADL with higher effectiveness at the distal than the proximal region. Yet the quality of life disparity between the experiment group and the control was not found to be significant. Conclusion: We believe that research can aid clinical therapists in applying MT accordingly to individual patient characteristics. Despite prolonged difficulty in confirming efficient application due to varied protocols, development of systemized treatment protocols for maximization of MT's effectiveness remains necessary.

Prognostic factors in Osteosarcoma (골육종의 예후인자)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Yang, Hyun-Seok;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.1-8
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    • 1997
  • Osteosarcoma is the most common primary bony malignancy and its survivorship has been progressed markedly through refined chemotherapy and surgery. But still there are many non-responders and analysis of prognostic factors may be helpful for them. Two hundred and sixty-six patients were enlisted between Mar, 1985 and Sep. 1994. Among them our inclusion criteria were: 1)primary, nonmetastatic classical osteosarcoma 2)extremity in location 3)no prior treatment at other institute and completed neoadjuvant chemotherapy and surgery according to our protocol. One hundred and eleven cases were eligible. Analyzed factors were:age, sex, location, tumor size, and pathologic response. Statistical methods were log-rank test for univariate and Cox's test for multivariate analysis. Male to female ratio was 69:42 with an average age of 17.2 years. Locations of tumor were distal femur 59, proximal tibia 29, and proximal humerus 8. Tumor size were measured by its maximal diameter and 48 cases were above 10cm and 47 cases were below 10cm. For pathologic response, 57 cases showed more than 90% and 54 cases were less than that. Limb salvage procedure was 101 cases and amputation was 10 cases and their local recurrence rate were 3.6%. Average follow-up period was 24(9-78.2) months and their final status was CDF 86, AWD 8, NED 5, and DOD 12 cases. In univariate study: type of operation(p=0.005), tumor size(p=0.005), and pathologic response(p=0.02) were significant variables. Pathologic response(p=0.03) and type of operation(p=0.01) were meaningful prognostic factors on multivariate analysis. But the latter result was interpreted as a bias, so pathologic response remained as a sole meaningful prognostic factor. More aggressive chemotherapy will be needed to improve the survival.

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Effect of cement space on the marginal and internal fit of zirconia restorations fabricated by CAD/CAM system (시멘트 공간이 캐드캠 시스템으로 제작한 지르코니아 수복물의 변연과 내부 적합도에 미치는 효과)

  • Lee, Jung-Hwan;Ahn, Jae-Seok
    • Journal of Technologic Dentistry
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    • v.39 no.4
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    • pp.235-242
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    • 2017
  • Purpose: The aim of this study was to evaluate the marginal and internal gap of zirconia copings fabricated by CAD/CAM system and to research the effect of cement space on the fit of zirconia prosthesis. Methods: Zirconia copings were designed using 3shape software and then milled from presintered zirconia blocks by Kavo dental milling machine. The cement space was set at $0{\mu}m$ around the margins for all groups, and additional cement space appling 1 mm above the finish lines of tooth. The samples were classified into 4 groups according to the cement space setting(Cs-0, Cs-40, Cs-80, Cs-120). Replica technique used to investigate marginal and internal gap. The silicone film thickness was recorded using a optical microscope with image software analysis system at 75${\times}$magnification. The assessment performed on the six points in bucco-lingual and mesio-distal sections(4 groups, 10 copings per group, 12 measuring points per coping). The data were statistically analyzed with one-way ANOVA followed by pair-wise Tukey's post hoc tests(${\alpha}$<0.05). Results: Better marginal and internal fit values were exhibited by $80{\mu}m$ cement space. The results showed that different cement space values had statistically significant effect on the marginal and internal gap of zirconia copings(p<0.001). The gap of margin and axial wall area was smaller than that the gap of occlusal area in all groups(p<0.001). Conclusion : Effect of different cement spaces on the marginal and internal gap of zirconia copings.

Comparative Study of Modeling of Hand Motion by Neural Network and Kernel Regression (손 동작을 모사하기 위한 신경회로망과 커널 회귀의 모델링 비교 연구)

  • Yang, Hac-Jin;Kim, Hyung-Tae;Kim, Seong-Kun
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.34 no.4
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    • pp.399-405
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    • 2010
  • The grasping motion of a person's hand for a simplified degree of freedom was modeled by using the photographic motion measured by a high-speed camera. The mathematical expression of distal interphalangeal (DIP) motion was developed by using relation models of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) motions to reduce the degree of freedom. The mathematical expression for humanoid-hand operation obtained using a learning algorithm with a neural network and using a kernel regression model were compared. A feasible model of hand operation was obtained on the basis of comparative data analysis by using the kernel regression model.

Measurement of Critical Structures around Paraclinoidal Area : A Cadaveric Morphometric Study

  • Lee, Hyun-Woo;Park, Hyun-Seok;Yoo, Ki-Soo;Kim, Ki-Uk;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.1
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    • pp.14-18
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    • 2013
  • Objective : Although removal of the anterior clinoid process (ACP) is essential surgical technique, studies about quantitative measurements of the space broadening by the anterior clinoidectomy are rare. The purposes of this study are to investigate the dimension of the ACP, to quantify the improved exposure of the parasellar space after extradural anterior clinoidectomy and to measure the correlation of each structure around the paraclinoidal area. Methods : Eleven formalin-fixed Korean adult cadaveric heads were used and frontotemporal craniotomies were done bilaterally. The length of C6 segment of the internal carotid artery on its lateral and medial side and optic nerve length were checked before and after anterior clinoidectomy. The basal width and height of the ACP were measured. The relationships among the paraclinoidal structures were assessed. The origin and projection of the ophthalmic artery (OA) were investigated. Results : The mean values of intradural basal width and height of the ACP were 10.82 mm and 7.61 mm respectively. The mean length of the C6 lateral and medial side increased 49%. The mean length of optic nerve increased 97%. At the parasellar area, the lengths from the optic strut to the falciform liament, distal dural ring, origin of OA were 6.69 mm, 9.36 mm and 5.99 mm, respectively. The distance between CN III and IV was 11.06 mm. Conclusion : With the removal of ACP, exposure of the C6 segments and optic nerve can expand 49% and 97%, respectively. This technique should be among a surgeon's essential skills for treating lesions around the parasellar area.

Changes in longitudinal craniofacial growth in subjects with normal occlusions using the Ricketts analysis

  • Bae, Eun-Ju;Kwon, Hye-Jin;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.44 no.2
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    • pp.77-87
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    • 2014
  • Objectives: This study was designed to define the Korean norm values for the Ricketts analysis. Methods: In this longitudinal study, lateral cephalograms of 31 subjects with normal occlusion were taken biennially from ages 9-19 years. Cephalometric measurements were performed. Parameters for which the 10-year change did not exceed one standard deviation were defined as unchanged. The means and standard deviations for the measured parameters were determined for each age group. Results: No significant changes in growth were observed in the molar relationship, incisor overjet, incisor overbite, mandibular incisor extrusion, interincisor angle, lower incisor tip (B1) to A point-Pogonion (A-PO) plane, upper incisor tip (A1) to A-PO plane, B1 inclination to A-PO, A1 inclination to A-PO, B1 inclination to Frankfurt plane (FH), convexity, lower facial height, facial axis, maxillary depth, maxillary height, palatal plane to FH, cranial deflection, ramus Xi position, or porion location. Continual changes over the 10 years of growth were observed in the maxillary first molar distal position to pterygoid true vertical plane, facial depth, mandibular plane to FH, anterior cranial length, mandibular arc, and corpus length. Conclusions: Clinicians can apply the Korean norms at age 9 as determined in this study when using the Ricketts analysis. The patient's age at the beginning of treatment and their sex should be taken into consideration when drawing visual treatment objectives.

RADIOGRAPHIC STUDY OF PERI-IMPLANT BONE LOSS AND ITS RELATIONSHIP TO THE MORPHOLOGY ON MAXILLARY ANTERIOR ALVEOLAR RIDGE (임플란트주위골 흡수 및 상악전치부 치조제 형태와의 관계에 대한 방사선학적 연구)

  • Lee, Jun-Hee;Hong, Jong-Rak;Kim, Chang-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.575-579
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    • 2006
  • Purpose : The purpose of this study was to evaluate peri-implant bone loss and implant success on anterior maxillary alveolar ridges and Compare Class III and Class IV ridges in the aspect of peri-implant bone loss. Material and Methods : 14 patients (aged 21 to 68, 6males and 8females), who lacked maxillary anterior teeth and were installed from January 2000 to April 2003 at Samsung Medical Center, were selected. The type of implant used included 30 $Br\ddot{a}nemark$ implant. They were taken with digital tomographic and conventional intraoral radiographic examinmation, and were treated with implant installaion without bone augmentation. The peri-implant bone resorption was measured at the mesial and distal aspect of implant on the conventional intraoral radiographs. Results : The study classified the anterior maxillary alveolar ridge and measured peri-implant bone resorption from the period of implant installation to the 2nd year after functional loading radiographically. The study revealed no statistically significant difference between two groups, which was classified by its morphology. The average bone resorption on healing period before loading was 0.18mm and 0.18mm, the 1st year of loading period, 0.77 mm and 0.84mm, and on the 2nd year of loading period, 0.07mm and 0.06mm, respectively on both Class III and class IV. Conclusion : In the knife edge form of anterior maxillary residual ridges(Class IV), implant placement without ridge augmentation does not have significant difference with that of Class III alveolar ridge in the concern of Implant success after 2 year functional loading period in the aspect of peri-implant bone resorption radiographically.

The Value of MRI in Diagnosis of Peripheral Nerve Disorders (말초신경질환에서 자기공명영상의 진단적 가치)

  • Lee, Han Young;Lee, Jang Chull;Kim, Il-Man;Lee, Chang-Young;Ikm, Eun;Kim, Dong Won;Yim, Man Bin
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1120-1126
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    • 2001
  • Objective : The development of magnetic resonance neurography(MRN) has made it possible to produce highresolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. Material and Method : MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery. Results : In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change. Conclusion : MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.

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Notes on Three Species of the Laboulbeniales (Ascomycotina) Newly Collected from Korea (한국산 충생자낭균류의 미기록종에 관하여)

  • Lee, Yong-Bo;Na, Young-Hee
    • The Korean Journal of Mycology
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    • v.27 no.3 s.90
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    • pp.208-210
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    • 1999
  • Three species belong to the genus Laboulbenia were collected on Carabidae (Coleoptera) and Harpalidae (Coleoptera) from several regions of Korea. Laboulbenia anoplogenii Thaxter was collected from Stenolophus quinquepustulatus Widemann. The characters of this species are the fourth layer of receptacle consisted of two or three cells and the distal end of its posterior cell projecting upward. The thalli were produced on posterior and anterior legs of the hosts. Laboulbenia habui Terada was collected from Chlaenius variicornis Bates. This species is characterized by the basal cells of the secondary appendage composed of short-cylindrical cells, arranged alternately on a double row. The thalli were produced from the elytra and anterior abdomen of the hosts. Laboulbenia pallida Thaxter was collected from Anisodactylus signatus Panzer. This species is distinguished from other related species by the rounded tip of perithecium and the outer appendage branched on the basal cell. The thalli were produced on the posterior elytra of the hosts.

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