• Title/Summary/Keyword: Sacred Site

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Case Report of Transparotid Approach of Mandibular Subcondylar Fracture (하악골 과두하 골절의 이하선 경유 접근법을 통한 관혈적 정복술 증례보고)

  • Moon, Mincheol;Oh, Suk Joon;Koh, Seoung Hoon
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.33-36
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    • 2009
  • Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

Design of Pagoda Park, Seoul (탑골공원 설계)

  • 김성균
    • Journal of the Korean Institute of Landscape Architecture
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    • v.29 no.2
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    • pp.42-49
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    • 2001
  • This design proposal was presented to a design competition for renovation of the Pagoda Park, located in Chongro-2ga, Chongro-gu, Seoul, where the first ˝Manse˝ (hurrah) Movement fighting against Japanese colonization, broke out on March 1st, 1919. The park has been considered to be the first modern park in Korea also. The objectives for the design were to make a sacred place to commemorate the 3.1 ˝Manse˝ Movement, to preserve and symbolically memorialize historic remains of the old ˝Wongaksa˝ Temple, an to provide natural and rest areas for citizen. For the space composition, three axes symbolic of, ´freedom and independence´, ´mercy´, and ´nature´, were created. For the freedom and independence axis, exiting facilities, such as statures and monuments related to the 3.1 Movement, were relocated centering around the octagonal pavilion, which was the starting point for the movement, to give order of the site. For the ercy axis, symbols of traditional temple structures, such as, ´Iljugate´-´Pian bridge´-´Chongwang gate´-´Haetal gate´-Pagoda-Buddhist sanctum, were created to symbolize the temple remains and placeness. For the nature axis, tree groves, walking trails, and rest areas for citizen were provided around the site. As a whole the design provided structural orders from secular spaces outside to sacred spaces inside.

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Closed Reduction and Fixation of Metatarsal Head and Neck Fractures Using Antegrade Intramedullary K-wire (6 Cases Report) (전향성 골수내 K-강선을 이용한 중족골 두 및 경부 골절의 비관혈적 정복 및 고정술(6예 보고))

  • Kim, Hyong-Nyun;Lim, Hee-Joon;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.91-94
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    • 2009
  • Metatarsal head and neck fractures are injuries that often result from a direct blow of a heavy objects to the metatarsal head. The head is often impacted or displaced to the plantar aspect that if not treated may cause malunion which later induces painful plantar calluses. If the fracture fragment is large enough, closed reduction may be successfully performed, but when the fragment is small or closed reduction is unsuccessful, open reduction is needed. We present our reduction and fixation technique for the metatarsal head and neck fractures using antegrade intramedullary Kirschner wire (K-wire) without opening the fracture site or infringing the metatarsophalangeal (MTP) joint which allows immediate motion of the joint and partial weight bearing in a stiff soled shoe.

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One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique

  • Cho, Jae-Young;Jang, Young-Chul;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Lee, Jong-Wook;Choi, Jai-Koo
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.118-123
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    • 2012
  • Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.

Research for Current Status of Protected Area in Korea and World Protected Area Designation - Focused on sacred natural sites designated as scenic site & natural monument - (국내 보호지역의 현황 및 세계보호지역 설정을 위한 기초연구 - 명승·천연기념물로 지정된 보호지역을 중심으로-)

  • Kim, Jae-Ung;Kim, Seung-Min
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.3
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    • pp.191-200
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    • 2014
  • This study aims to analyze the current status of government-designated cultural heritage that are protected as sacred natural sites, focused on natural monuments and scenic sites, and provide basic research for these cultural heritage to be included in the protected area category. First, among natural cultural heritage that are designated and protected by Cultural heritage Protection Law, there are 40 scenic sites and 126 natural monuments that have been selected as sacred nature sites. Second, the study showed that sacred nature sites are sacred places that have been long associated with happiness and misfortune of the villagers, including Dangsan Forest, Seunghwanglim(Forest), and, as physical environment and combination of cultural value, rules, and attitude and belief system toward the land that protect the people. The unique folk beliefs of the region provide strong protection of the place. Third, although the natural monuments of old and large trees are not included in the protected area as they are recognized sparsely, but can be designated as world protected area as protected areas are set around sacred nature sites. Fourth, in order to be included in IUCN category, sacred natural sites of scenic sites will need to be managed by specific categories of each area according to the interior status of the designated areas and maintain the sustainability of the natural heritage by protecting both physical and spiritual elements.

Endoscopic Management of Ampullary Tumors (십이지장 팽대부 종양의 내시경적 치료)

  • Hwehoon Chung;Jae Keun Park
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.93-98
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    • 2023
  • Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

Correction of Syndactyly using Pentagonal Flap with Minimal Skin Graft (오각형피판과 최소한의 피부이식을 이용한 합지증의 교정)

  • Bae, Byoung Man;Eo, Su Rak;Kim, In Kyu;Koh, Sung Hoon;Jones, Neil F.
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.64-69
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    • 2007
  • Purpose: The key of treatment in syndactyly is to separate the fused digits safely, and to create a normal web space with enough cutaneous coverage. Despite many techniques have described the correction of syndactyly, skin graft still remains the annoying one. We designed the pentagonal flap from hand dorsum to reconstruct the web space reliably and try to minimize the need for skin graft. Methods: Between July 2003 and August 2005, six cases of syndactyly were corrected at UCLA Medical Center and Hallym University Sacred Heart Hospital using dorsal pentagonal flap for web space reconstruction and straight incisions for the sides of digits to minimize the need for skin graft. The proximal edge of the pentagonal flap was designed in V shape to allow for easy closure of the donor site after advancement. The pentagonal flap was advanced volarly with the underlying dermofat tissues to form a digital web. In some cases, skin defects were unavoidable and covered with full thickness skin graft from the inguinal area. Results: Syndactyly were seen in 4 cases of Apert syndrome, 1 postburn scar webbing with PIP joint contracture and 1 recurrence after the incomplete reconstruction. In all Apert syndrome, straight line incision was used along the sides of the fingers and skin graft was needed. But, in 2 cases of incomplete type, we could save the need for skin graft only for the correction of syndactyly. We could get a good looking web space without any complications such as flap or graft loss. Conclusion: As a modification of Sherif's V-Y dorsal metacarpal flap, we believe pentagonal flap could be one of the easiest and safest way to reconstruct the web space of syndactyly in functional and cosmetic standpoint.

Sensory Complications in Patients after Scalp Mass Excision and Its Anatomical Considerations

  • Yang, Jin Seo;Choi, Hyuk Jai;Cho, Yong Jun;Kang, Suk Hyung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.200-204
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    • 2014
  • Objective : To evaluate the incidence of postsurgical sensory complications in patients with scalp masses and classify the locations of them from a surgical standpoint according to anatomical considerations. Methods : A total of 121 patients who underwent surgery for scalp mass were included in this study. The authors reviewed medical records and preoperative radiologic images. We investigated the complications related to sensory changes after procedure. Enrolled patients have been divided into three groups. Group A included patients with tumors above the superior nuchal line (SNL), Group B with tumors within the trapezius muscle area and patients who had tumors on the lateral trapezius muscle area were assigned to Group C. We compared the incidence related to postoperative sensory complications and summarized their additional treatments for these with clinical outcome. Results : There were 12 patients (10%) with sensory complications related on the mass excision site (Group A : 1 patient, Group B : 2 patients, Group C : 9 patients). Six patients were affected with lesser occipital nerve (LON), 2 patients on greater occipital nerve (GON) and 4 patients on GON and LON. Over 6 months after surgery, two of the twelve patients with sensory complications did not have complete recovered pain in spite of proper medications and local chemical neurolysis with 1.0% lidocaine and dexamethasone. Conclusion : Occipital neuropathy should be considered as a complication related excision of scalp mass. The sensory complications are more frequent in Group C because of the anatomical characteristics of the occipital nerves and there were no statistical difference for other variables.

Effect of co-administration of atelocollagen and hyaluronic acid on rotator cuff healing

  • Jeong, Jeung Yeol;Khil, Eun Kyung;Kim, Tae Soung;Kim, Young Woo
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.147-155
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    • 2021
  • Background: This study aimed to evaluate the co-administration effect of atelocollagen combined with hyaluronic acid (HA) injections for treatment of full-thickness rotator cuff tear (RCT). Methods: Eighty patients who underwent arthroscopic rotator cuff repair for full-thickness RCT from March 2018 to November 2019 were enrolled. The patients were randomly allocated to the following groups: combined atelocollagen and HA injection (group I, n=28), only HA injection (group II, n=26), and no injection (group III, n=26). Clinical outcomes were assessed at 3, 6, and 12 months after surgery using the American Shoulder and Elbow Surgeons score, visual analog scale pain score, functional scores (pain visual analog scale, function visual analog score), and range of motion. Magnetic resonance imaging was performed 12 months after surgery to evaluate rotator cuff integrity. Results: Preoperative demographic data and postoperative clinical outcomes did not differ significantly among the three groups (p>0.05). However, in group I, the number of steroid injections after surgery was significantly lower than that in the other groups (p=0.011). The retear rate on follow-up magnetic resonance imaging was significantly higher in group II (9.5%, n=2) and group III (13.6%, n=3) than in group I (0%) (p=0.021). Conclusions: Co-administration of atelocollagen and HA improves healing of the rotator cuff and increases the integrity of the rotator cuff repair site. This study provides encouraging evidence for use of combined atelocollagen-HA injections to treat patients with full-thickness RCT.

Landscape Characteristics of the Dangsan Forests at Chungmak Village, Buan-gun and Perspectives on 'Protected Area' Designation (부안군 죽막마을 당산숲의 경관 특성 및 '보호지역' 설정)

  • Choi, Jai-Ung;Kim, Dong-Yeob;Rhee, Sang-Young
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.4
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    • pp.85-93
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    • 2014
  • Although the Chungmak village, Gyeokpo-ri, Buan-gun is a small seashore village, it's an important place that has the largest ancient maritime ritual sites in Korea. This 'Chungmak-dong Ritual Site'(5~6 century, Baekje of the Three-kingdom period) was located in the Dangsan forest of Black Pine (Pinus thunbergii) Colony, and that has a significant meaning concerned with Dangsan forest's origin. Chungmak village located in the Scenic Site # 13 named 'Chaeseokgang and Jeokbyeokgang coastal cliff in Buan', and have retained the Jeollabuk-do Tangible Cultural Property # 58 named 'Suseongdang', the Natural Monument # 123 named 'Machilus community in Gyeokpo-ri, Buan'. The 'Suseongdang Gaeyang Grandmother Dangsinje (Village Ritual)' which is Dangsan ritual has been held every year by village residents. The practical management of Suseongdang and Machilus community has been conducted by village residents. In this study, the landscape characteristics of the Dangsan forest were investigated including neighborhood elements such as Bibo forest, seashores, and farm fields. The conservation of cultural landscape was thought to be achieved by designating 'Protected Area of Sacred Natural Sites'. The Dangsan forest ought to be recognized for their valuable landscape characteristics. It should be managed as a protected area and a sacred natural sites in order to be registered as a World Cultural Heritage.