• Archives of Plastic Surgery
• /
• 제36권2호
• /
• pp.211-220
• /
• 2009

Purpose: Even in a small levator resection for blepharoptosis, 10 ~ 13 mm of $M{\ddot{u}}ller^{\prime}s$ muscle and levator aponeurosis is resected. To solve the problem, $M{\ddot{u}}ller^{\prime}s$ muscle was detached from the superior tarsal border and conjunctiva, and the muscle with overlying levator aponeurosis was advanced on the upper tarsus as a composite flap. The purpose of this study was to evaluate the effectiveness of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique for the correction of blepharoptosis. Methods: Between 2003 and 2008, 107 patients(183 eyes) underwent the advancement procedure of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis composite flap for blepharoptosis. The advanced composite flap was fixed 3 mm below the superior tarsal border and 2 ~ 3 mm of distal flap stump was left after trimming up to 5 mm. The results of the operations were evaluated. Results: The mean age of the patients was 35.2 years and 83 patients(145 eyes) were followed up for a mean of 16.7 months. 128 eyes (88.3%) showed a normal level of upper eyelid margin (MRD1 4.1 ~ 5.0 mm) or less than 1 mm ptosis (MRD1 3.1 ~ 4.0 mm). 10 eyes(6.9%) showed 1 ~ 2 mm ptosis (MRD1 2.1 ~ 3.0 mm). 7 eyes(4.8%) showed more than 2 mm ptosis which required secondary correction. About 80% of the 183 eyes needed no trimming of the flap stump with 5 ~ 6 mm of composite flap advancement and 20% had about 3 mm of the flap stump trimmed with 8 ~ 9 mm of composite flap advancement(shortening of the levator complex). Conclusion: $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique offers several advantages: There is no, or minimal, sacrifice of the normally functioning $M{\ddot{u}}ller^{\prime}s$ muscle; it is more physiological; it is reproducible and it is predictable - with gratifying results for blepharoptosis.

• Advances in pediatric surgery
• /
• 제8권2호
• /
• pp.119-125
• /
• 2002

The aim of this study was to evaluate the posterior sagittal anorectoplasty (PSARP) as a re-do operation in patients who failed initial repair of anorectal malformation. Nine patients (4 boys and 5 girls) who had previous failed surgery for anorectal malformation underwent secondary operations through posterior sagittal approach. The main reasons of surgery were constipation (n=3) and persistent anatomical derangement in spite of previous correction surgery (n=6). In addition to constipation, the former group (n=3) had various anatomical defects, and the latter group (n=6), of course, had constipation in some degrees. Patients ranged in age from 2 to 19 years (median 3 years) with only one over the age of 6 years. The primary procedures included PSARP (n=8) and anoplasty (n=1). The rectum was mobilized from surrounding structures through posterior sagittal approach and anatomical defects were corrected. The rectum underwent reconstruction, which involved relocation of the rectum and anus within the limits of the intact muscle complex. Patients underwent follow-up for periods ranging from 6 to 77 months (mean 37 months) after surgery. Anatomical corrections of all the defects were successfully fulfilled in 9 patients. All the patients were satisfied with the functional results after redo-PSARP compared with the preoperative defecatory function. This study suggests that (1) some of the patients with troublesome constipation may have anatomical defects, prominent or hidden, (2) surgeons should suspect the possibility of anatomical defect as the cause of incontinence and (3) preoperative thorough investigation to reveal the anatomical defects should be included in estimating patients with severe incontinence after previous surgery and planning the correction for failed previous surgery as well.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제30권4호
• /
• pp.380-385
• /
• 2008

양측성 구순구개열을 가진 16세 여자 환자가 소구증과 구순열비변형으로 인하여 개구 제한과 심미적 문제를 주소로 내원하였다. 병력에서 구순성형술, 구개성형술 그리고 이차구순비성형술을 받았으며, 임상 소견에서 상순과 하순이 매우 작고 입술의 폭은 40 mm 정도로 짧았으며 최대 개구량은 20 mm였다. Converse의 협점막 외전 피판을 이용한 양측성 구각성형술을 시행하였으며 수술 후 입술의 폭은 60 mm로 증가하였다. 수술 1년 경과 후 입술의 폭은 54mm로 약 6 mm 정도 회귀되었고, 그 외에 별다른 문제점 없이 심미적, 기능적으로 양호한 결과를 보였다. 협점막 외전 피판을 이용한 양측성 구각성형술은 입술의 폭과 크기를 증가시켜주고 입술의 외관을 개선하여 소구증의 외과적 교정에 적절한 술식임을 알 수 있었다.

• Tuberculosis and Respiratory Diseases
• /
• 제84권1호
• /
• pp.46-54
• /
• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• Journal of Astronomy and Space Sciences
• /
• 제27권2호
• /
• pp.153-160
• /
• 2010

We modified the optical system of 500 mm wide-field telescope of which point spread function showed an irregularity. The telescope has been operated for Near Earth Space Survey (NESS) located at Siding Spring Observatory (SSO) in Australia, and the optical system was brought back to Korea in January 2008. After performing a numerical simulation with the tested value of surface figure error of the primary mirror using optical design program, we found that the surface figure error of the mirror should be fabricated less than root mean square (RMS) $\lambda$/10 in order to obtain a stellar full width at half maximum (FWHM) below $28\;{\mu}m$. However, we started to figure the mirror for the target value of RMS $\lambda$/20, because system surface figure error would be increased by the error induced by the optical axis adjustment, mirror cell installation, and others. The radius of curvature of the primary mirror was 1,946 mm after the correction. Its measured surface figure error was less than RMS $\lambda$/20 on the table of polishing machine, and RMS $\lambda$/15 after installation in the primary mirror cell. A test observation performed at Daeduk Observatory at Korea Astronomy and Space Science Institute by utilizing the exiting mount, and resulted in $39.8\;{\mu}m$ of stellar FWHM. It was larger than the value from numerical simulation, and showed wing-shaped stellar image. It turned out that the measured-curvature of the secondary mirror, 1,820 mm, was not the same as the designed one, 1,795.977 mm. We fabricated the secondary mirror to the designed value, and finally obtained a stellar FWHM of $27\;{\mu}m$ after re-installation of the optical system into SSO NESS Observatory in Australia.

• 한국항해항만학회지
• /
• 제36권6호
• /
• pp.475-480
• /
• 2012

eLoran (enhanced Long Range Navigation)의 구축을 위해서는 로란시스템 설비업그레이드, 시스템 정보데이터 채널추가, dLoran (differential Loran) 사이트, ASF(Additional Secondary Factor) 데이터베이스 등이 필요하다. 특히 eLoran 송신국들의 정확한 UTC (세계협 정시, Coordinated Universal Time) 동기는 eLoran 시스템의 항법성능 향상을 위해 필수적이다. 따라서 송신국들의 정확한 UTC 동기를 위해서는 송신국의 절대 지연시간 측정 및 모니터링이 필요하며, 측정된 송신국 지연시간의 변화량을 보정정보로 이용자에게 제공하여야 한다. 본 연구에서는 포항 LORAN-C 송신국(9930M)을 대상으로 수신지점에서의 TOA(Time of Arrival) 산출을 위한 송신신호의 기준시점을 측정하는 방법을 제시하였고 지연측정 시스템 및 송출신호 위상 모니터링 시스템을 개발하여 포항 송신국의 기준시점을 평가하였다. 측정결과 포항 송신국의 기준점 오프셋은 $-2.23{\mu}s$로 측정되었으며 송신 로란펄스의 위상을 관측한 결과 1 개월간에 약 $0.3{\mu}s$ 정도 흐르는 것이 관측되어 로란의 PNT(Positioning, Navigation and Timing) 활용을 위해 위상 모니터링과 보상이 필수적임을 알 수 있었다.

• Archives of Plastic Surgery
• /
• 제43권6호
• /
• pp.559-563
• /
• 2016

Background Syndactyly of the foot is the second most common congenital foot anomaly. In East Asia, however, no large case study has been reported regarding the clinical features of isolated foot syndactyly. In this study, we report a review of 118 patients during the last 25 years. Methods We conducted a chart review of patients who underwent surgical correction for foot syndactyly between January 1990 and December 2014. Operations were performed with a dorsal triangular flap and a full-thickness skin graft. The demographics of included patients and their clinical features were evaluated. Surgical outcomes and complications were analyzed. Results Among 118 patients with 194 webs (155 feet), 111 patients showed nonsyndromic cases and 7 patients showed syndromic cases. In 80 unilateral cases (72.1%), the second web was the most frequently involved (37.5%), followed by the fourth (30%), the first (15%), the third (15%), the first and second in combination (1.3%), and the second and third in combination (1.3%). Among 31 bilateral cases, 2 cases were asymmetric. Among the remaining 29 symmetric bilateral cases, the second web was the most frequently involved (45.2%), followed by the first (22.6%), and the fourth (6.5%). No specific postoperative complications were observed, except in the case of 1 patient (0.51%) who required a secondary operation to correct web creep. Conclusions This retrospective clinical study of 118 patients with both unilateral and bilateral foot syndactyly revealed that the second web was the most frequently involved. In addition, complete division and tension-free wound closure with a full-thickness skin graft of sufficient size showed good postoperative results.

• Journal of Chest Surgery
• /
• 제53권6호
• /
• pp.381-386
• /
• 2020

Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

• 한국임상수의학회지
• /
• 제25권4호
• /
• pp.292-294
• /
• 2008

The purpose of this study was to evaluate the cause of lens luxation and to determine the frequency of vision loss, glaucoma, cataract, and corneal edema before and after intracapsular lens extraction (ICLE). The medical records of 8 dogs underwent ICLE for the correction of anterior lens luxation at the Veterinary Medical Teaching Hospital of Seoul National University from August 2005 to September 2007 were reviewed. The most frequently affected breed was Miniature Poodle (n = 3). The mean age was $10.8{\pm}2.1$ years. Preoperatively, 5 eyes (67.5%) with anterior luxation had secondary glaucoma, 7 eyes (87.5%) had vision loss, and all eyes (100.0%) had corneal edema. Four weeks after ICLE, 6 eyes (75.0%) had normal intraocular pressure (IOP), and 4 eyes (50.0%) regained vision. Corneal edema was reduced after ICLE in all eyes, but still remained in 4 eyes. It was considered that ICLE was beneficial in the management of anterior lens luxation, but the eyes without glaucoma before ICLE had more favorable prognosis than eyes with.

• 천문학회지
• /
• 제42권6호
• /
• pp.161-174
• /
• 2009

Observation of standard stars is of crucial importance in stellar photometry. We have studied the standard transformation relations of the UBV RI CCD photometric system at the Maidanak Astronomical Observatory in Uzbekistan. All observations were made with the AZT-22 1.5m telescope, SITe 2k CCD or Fairchild 486 CCD, and standard Bessell UBV RI filters from 2003 August to 2007 September. We observed many standard stars around the celestial equator observed by SAAO astronomers. The atmospheric extinction coefficients, photometric zero points, and time variation of photometric zero points of each night were determined. Secondary extinction coefficients and photometric zero points were very stable, while primary extinction coefficients showed a distinct seasonal variation. We also determined the transformation coefficients for each filter. For B, V, R, and I filters, the transformation to the SAAO standard system could be achieved with a straight line or a combination of two straight lines. However, in the case of the U filter and Fairchild 486 CCD combination, a significant non-linear correction term - related to the size of Balmer jump or the strength of the Balmer lines - of up to 0:08 mags was required. We found that our data matched well the SAAO photometry in V, B - V, V - I, and R - I. But in U - B, the difference in zero point was about 3.6 mmag and the scatter was about 0.02 mag. We attribute the relatively large scatter in U -B to the larger error in U of the SAAO photometry. We confirm the mostly small differences between the SAAO standard UBV RI system and the Landolt standard system. We also attempted to interpret the seasonal variation of the atmospheric extinction coefficients in the context of scattering sources in the earth's atmosphere.