• Archives of Plastic Surgery
• /
• v.43 no.2
• /
• pp.172-180
• /
• 2016

Background Conventional frontalis transfer may cause a range of complications. In order to overcome complications, we made modifications to the surgical technique, and compared the outcomes of patients who underwent conventional frontalis transfer with those of patients who underwent modified frontalis transfer. Methods We conducted a retrospective study of 48 patients (78 eyes) who underwent conventional frontalis transfer between 1991 and 2003 (group A) and 67 patients (107 eyes) who underwent modified frontalis transfer between 2004 and 2014 (group B). The frontalis transfer procedures were modified conform to the following principles. The tip of the frontalis muscle flap included soft tissue that was as thick as possible and the soft tissue on the tarsal plate was removed to the greatest extent possible. A double fold was created in cases of unilateral ptosis. In order to evaluate the objective effects of modification, preoperative and postoperative values of the marginal distance reflex 1 (MRD1), the corneal exposure area, and the decrease in eyebrow height were compared between the two groups. Results In group A, patients showed an improvement of 1.19 mm in the MRD1, a 6.31% improvement in the corneal exposure area, and a 7.82 mm decrease in eyebrow height. In group B, patients showed an improvement of 2.17 mm in the MRD1, an 8.39% improvement in the corneal exposure area, and an 11.54 mm decrease in eyebrow height. The improvements in group B were significantly greater than those in group A. Conclusions Modified frontalis transfer showed better results than the conventional procedure and provided satisfactory outcomes.

• Journal of Oral Medicine and Pain
• /
• v.22 no.2
• /
• pp.309-325
• /
• 1997

In order to set the lasing variables and evaluate, clinically, the therapeutic effects of a pulsed Nd:YAG laser on oral lesion, the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (wavelength 1064nm, Pulse duration 120$\mu$sec, fiber diameter 200$\mu$m/320$\mu$m) to 22 cases of oral soft tissue lesions and 6 cases of oral hard tissue lesions. The obtained results were as follows : 1. The effective excision with contact mode and the effective hemostasis of accompanied bleeding with noncontact mode were occurred by lasing on oral soft tissue lesions with fiber diameter of 320$\mu$m under the variables of 2.0~4.0W and 20~50Hz which were controlled into high power/low pulses for excision, low power/high pulses for hemostasis, low power in granulation tissue and high power in fibrous tissue according to therapeutic goals and tissue conditions. 2. About 50% of decreasing effect on hypersensitivity was occurred by lasing with non-contact and contact mode on cervical abrasion which caused dentinal hypersensitivity with fiber diameter of 320$\mu$m under the variables of 0.7 - 1.0W and 10Hz which were applied 2~3 times with 1 week interval. 3. The effective sterilization of infected root canal and lesion of periapical abscess was occurred by lasing with contact and spiral modes on wall of root canal and periapical abscess with fiber diameter of 200$\mu$m of which the tip was placed about 1mm shorter than root canal length under the variables of 1.OW and 10Hz.

• Geotechnical Engineering
• /
• v.1 no.1
• /
• pp.73-84
• /
• 1985

This Paper aims at investigating the distribution of stresses and the displacement of soft foundation layer subject to embankment load by the finite elements method (FEM). The stresses include the volumetric stress, the Pore water Pressure, the vertical stress. The horizontal stress and the shear stress. The Christian-Boehmer's method was selected as technique for FEM and the general elasticity model and modified Cam-clay model as the governing equations under Plain-strain condition depending on drained and undrained conditions. The results obtained are as follows: 1. The volumetric stress is almost consistent with the pore water pressure. This means that the total stress is the same value with the pore water pressure under the undrined condition 2. The vertical stress appears in the same value regardless of the drained or undrained condition and the model of the constitutive equations. 3. The horizontal stress has almost same value with the drain condition model. 4. depending on the constitutive model. The shear stress is affected by both the drain condition and the constitute model. The resulted value by the modified Cam-clay model has the largest. 5. The direction of the displacement vector turns outward near the tip of load during the increasing load. 6. The magnitude of displacement due to the modified Cam.clay model is as twice large as that due to elastic model.

• Archives of Plastic Surgery
• /
• v.38 no.1
• /
• pp.127-129
• /
• 2011

Purpose: Nasotracheal or oral intubation procedure is widely used for facial bone fractures. However, during the operation intubated tube can interfere or obstruct the view of the operator. We authors used a modified submental intubation method in panfacial bone fracture patients for intact airway and the operation view. Methods: After intravenous induction of anaesthesia, traditional orotracheal tubation was done. A horizontal incision was made 2 cm from the midline, 2 cm medial to and parallel with the mandible in the submental region. 1 In order to approach to the floor of the oral cavity, a haemostat was pushed through the soft tissues. A chest tube front cover was applied to the intubation tube and the tube was inserted through the submental tunnel. Orotracheal tube was disconnected and pulled back through the soft tissue and secured with a suture. Results: The procedure took about 30 minutes and there were no problems during the intubation. Intraoral manipulation and occlusal checks were free without any interference. Extubation was also easily done without any complications such as lung aspiration, infection, hematoma, or fistula. Conclusion: Submental endotracheal intubation is fast, safe, easy to use and free from the concern about the tube being pull back again. Conventional submental intubations are being held without any coverage of the tip. We authors applied the modified method to the trauma patients and obtained satisfactory results. From the above advantages, modified submental intubation can be widely available not only in fractured patients, but also in aesthetic or orthognathic surgeries.

• Archives of Plastic Surgery
• /
• v.35 no.2
• /
• pp.208-213
• /
• 2008

Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5 cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site. Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

• Archives of Reconstructive Microsurgery
• /
• v.18 no.1
• /
• pp.35-39
• /
• 2009

Purpose: Various techniques have been attempted for design of the flaps. However, there are some disadvantages. They have thin, pliable, and two dimensional methods. The aim of this study is to report usefulness of polyurethane foam dressing materials for three dimensional design of the digital island flap. Methods: From June of 2007 to september of 2008, 10 patients received digital island flap surgery for soft tissue defect of the finger. After minimal debridement of the wound, size and shape of the defect were measured using polyurethane foam. We used Medifoam-$5^{(R)}$ And then, designed this inset the wound. The flap was designed on the donor site with a arterial pedicle as the central axis according to size and shape. A full thickness skin graft from the groin is applied on the flap donor defect and secured with a tieover bolster dressing. Results: Reviewing sizes of the flaps, the length and width of flaps ranged from 1.5 to 3.3 cm and 1.0 to 2.5 cm. The PACS(Picture Archiving Communication System) program allows identification of the donor depth of finger. The distance for the soft tissue ranged from 4.3 mm to 6.7 mm. Mean depth of donor site was 5.3${\pm}$0.6 mm. Also, the thickness of Medifoam-$5^{(R)}$ ranged nearly 5 mm. On flap insetting, full-thickness skin graft was necessary. We did not experience any problems in the recipient site size either, regardless of the extended flaps. Conclusion: Polyurethane foam has many advantages over the more conventional templates. Refinements in flap design and surgical technique resulted in favorable functional and cosmetic results. Especially, for beginner, Polyurethane foam dressing material is a simple and safe tool and therefore is an excellent choice for design of the island flap.

• The korean journal of orthodontics
• /
• v.45 no.6
• /
• pp.308-321
• /
• 2015

Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

• Journal of the Korean Geotechnical Society
• /
• v.27 no.1
• /
• pp.77-86
• /
• 2011

The advanced geotechnical information has been required to determine the accurate design parameters for complex construction. However, the Standard Penetration Test (SPT), which has low reliability, has been used to estimate the subsurface condition in the field. The objective of this paper is development and application of the Static-Dynamic penetrometer, which detects the resistances in soft clay, sand and rock. The energy losses according to the rod connection methods (perfect or non-perfect connection, and number rods) are experimentally evaluated. The reflection and transmission ratios are used to investigate the energy loss by a simulation. The static-dynamic cone penetrometer, in which the accelerometers and strain gauges are installed on the cone tip and the rod head, is used to estimate the energy loss during penetration by impacts. The experimental and simulation studies show that the transferred energy through rods with non-perfect connection dramatically decreases. Furthermore, the transferred energy on the rod head is not the same as that on the cone tip. This study demonstrates that the energy loss should be evaluated on the cone tip.

• Journal of the Korean Geotechnical Society
• /
• v.26 no.8
• /
• pp.15-25
• /
• 2010

The thin-layered sand seam in clay affects the soil behavior. Although the standard cone penetrometer (A: $10cm^2$) have been used to evaluate the thin-layered soil, the smaller diameter cone penetrometer have been commonly recommended because of the high resolution. The purpose of this study is the development and application of the Cone Resistivity Penetrometer (CRP), which detects qc, fs, and electrical resistivity at cone tip for the evaluation of thin layered soils. Two sizes of the CRP are developed for the laboratory and field test. The projected areas of CRP for the laboratory and field tests are $0.78cm^2$ (d: 1.0 cm) and $1.76cm^2$ (d: 1.5 cm), repectively. The length of friction sleeve is designed in consideration of ratio of the projected area to the friction sleeve area. The application tests are carried out by using the artificially prepared thin-layered soils in the laboratory. In addition, the field tests are conducted at the depth of 6 to 15 m in Kwangyang. In the laboratory test, the measured electrical resistivity and cone tip resistance detect the soil layers. Moreover, in the field test the CRP investigates the three thin-layered soils. This study suggests that the CRP may be a useful tool for detecting thin-layered in soft soils.

• Journal of Chest Surgery
• /
• v.14 no.1
• /
• pp.67-70
• /
• 1981

Aneurysms of the extracranial carotid artery are rare. This is a case report of the rapidly expanding false carotid aneurysm at left common carotid artery, which was repaired surgically with internal shunt This 20 year old male patient had a large pulsatile mass on left lateral aspect of neck at the time of admission. About 1 month before admission, he had received a trauma on left neck by glass piece and noted massive blood loss. And its skin of lesion was sutured simply at local clinic and well healed. 10 days before the admission, he had the sudden onset of the adult thumb sized and pulsatile mass and the mass had been enlarged more and more to the adult first-sized one. The cervical film showed a egg-sized and soft tissue mass. There was systolic bruit on the mass. The diagnosis was confirmed with the angiogram of left carotid artery and this showed the man`s thumb tip-sized extravasation at the point 2 Cm below the bifurcation of Internal and external carotid arteries. The emergency operation was performed by the internal shunt with carotid artery. The aneurysm was enclosed with the adventitia and carotid sheath, and the intima and media were Intact and had the opening of 0.5 cm in diameter. The opening was sutured by the one-hand mattress suture method and firmed with the Aron Alpha-A "Sankyo." The postoperative course was uneventful and the patient was discharged with good general condition.