• Journal of Chest Surgery
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• v.32 no.7
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• pp.628-636
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• 1999

Background: Recent advances in understanding the anatomy of the complete atrioventricular septal defect(including right-dominant unbalanced atrioventricular septal defect) have led to alternative methods of repairing these defects. Material and Method: From May 1997 to July 1998, 8 consecutive infants(age range, 2 to 28 months, mean body weight 6.0$\pm$2.2 kg) received a single-stage intracardiac repair of the complete atrioventricular septal defect with modified surgical methods. Depending on the specific anatomic structure, the procedure was simplified in 3 patients by a direct closure of the ventricular element of the defect(Group I). Two patients judged unsuitable for direct closure due to a potential left ventricular outflow tract obstruction had received a standard two-patch repair(Group II). The remaining 3 patients with right-dominant unbalanced complete atrioventricular septal defect underwent biventricular repair; to enlarge the orifice of the left atrioventricular valve, the ventricular septal patch was placed slightly more to the right of the ventricular crest, a left sided bridging leaflet was augmented with an autologous pericardial patch, and the leaflet was repaired with a double- orifice(Group III . Result: In all 8 patients, the postoperative echocardiography demonstrated good hemodynamics. Seven patients were weaned from the ventilators after a mean 3$\pm$1 days, and 1 patient was weaned after 24 days due to a reoperation and emphysematous lung problem. A reoperation was performed in 1 patient for progressive left atrioventricular valve regurgitation due to leaflet tearing. There were no early and late mortalities. At the time of the latest review, judging from the echocardiographic criteria, left atrioventricular valve stenosis was mild in 1 patient(mean pressure gradient 6.5 mmHg, 13.5%), left atrioventricular valve regurgitation was absent or grade I in 7 patients(87.5%). The right atrioventricular valve regurgitation was absent or grade I in all 8 patients(100%). Conclusion: Infants with complete atrioventricular septal defect were treated with either a simplified approach with direct closure of the ventricular element of the defect or a modified surgical technique for a right-dominant unbalanced atrioventricular septal defect, depending on the anatomic structure. The results were no operative mortalities and low morbidity.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.115-121
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• 2012

Purpose: The process of the proton treatment is done by comparing the DRR and DIPS anatomic structure to find the correction factor and use the PPS to use this factor in the treatment. For the accuracy of the patient set up, the PPS uses a 6 axis system to move. Therefore, there needs to be an evaluation for the accuracy between the PPS moving materialization and DIPS correction factor. In order to do this, we will use a self made PPS QA Phantom to measure the accuracy of the PPS. Materials and Methods: We set up a PPS QA Phantom at the center to which a lead marker is attached, which will act instead of the patient anatomic structure. We will use random values to create the 6 axis motions and move the PPS QA Phantom. Then we attain a DIPS image and compare with the DRR image in order to evaluate the accuracy of the correction factor. Results: The average correction factor, after moving the PPS QA Phantom's X, Y, Z axis coordinates together from 1~5 cm, 1 cm at a time, and coming back to the center, are 0.04 cm, 0.026 cm, 0.022 cm, $0.22^{\circ}$, $0.24^{\circ}$, $0^{\circ}$ on the PPS 6 axis. The average correction rate when moving the 6way movement coordinates all from 1 to 2 were 0.06 cm, 0.01 cm, 0.02 cm, $0.1^{\circ}$, $0.3^{\circ}$, $0^{\circ}$ when moved 1 and 0.02 cm, 0.04 cm, 0.01 cm, $0.3^{\circ}$, $0.5^{\circ}$, $0^{\circ}$ when moved 2. Conclusion: After evaluating the correction rates when they come back to the center, we could tell that the Lateral, Longitudinal, Vertical were all in the acceptable scope of 0.5 cm and Rotation, Pitch, Roll were all in the acceptable scope of $1^{\circ}$. Still, for a more accurate proton therapy treatment, we must try to further enhance the image of the DIPS matching system, and exercise regular QA on the equipment to reduce the current rate of mechanical errors.

• Journal of Korean Medical classics
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• v.24 no.4
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• pp.43-53
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• 2011

According to the result about 'San Jiao(三焦)'recorded on "Yellow Empero's Canon Internal Medicine Ling Shu(黃帝內經 靈樞)", we achieved following results. 1. As we consider the concept of 'San Jiao' recorded on "Ling Shu", in early time, it was related to bladder(膀胱) and there was no divided concept into 'Shang Jiao(上焦)', 'Zhong Jiao(中焦)' and 'Xia Jiao(下焦)'. Later, there was appearance of body metabolism concept in anatomic way and started to emphasize that stomach(胃) is the very beginning of digestion. This point then adjusted into the concept which the core theory of digestion and water metabolism begins with 'Zhong Jiao' and processes to 'Shang Jiao' and 'Xia Jiao' then it established the 'San Jiao' theory adjusted to the functional change than property change. Later as there is set theoretical structure of 'three Yin and three Yang(三陰三陽)', it included the concept of 'San Jiao' onto meridian system theory to complete as a theory. Finally, it completed the theoretical structure that 'San Jiao' runs water metabolism of circulation, body fluid and urine for body to produce blood and Qi to protect and provide nutrition to the human body. 2. From the point of each part, 'San Jiao' means all body composition factor related to the relation to the digestion and water metabolism to produce Qi and blood. Also, the details of entire function of 'San Jiao' tells that 'Zhong Jiao' intakes food and divides the clarity and turbidity of digested substances. The origin of this digestion and water metabolism lies at Xia Jiao. The clean substance including the mood and taste climbs via Shang Jiao. The vapor like substance climbed to Shang Jiao becomes 'defensive Qi(衛氣)' and controls body temperature and sweat by supporting and spreading the Qi by Shang Jiao. The liquid substance climbed to Shang Jiao becomes blood. The blood has stronger character as substance than defensive Qi so Zhong Jiao becomes the base and the way for the blood. The turbid Qi separated at Zhong Jiao passes large intestine and the solid substance is excreted and the liquid is absorbed into bladder. The Xia Jiao that controls this process controls the liquid state of water matabolism so control the urine with bladder. Therefore, 'San Jiao' can be understood as a general concept that controls entire water metabolism as a way of food, Qi and blood.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.6
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• pp.552-558
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• 2005

Orthognathic surgery changes patient's mandibular position and environment of related anatomic structures. Many clinicians were interested in these changes and studied about this problem. However, most of them were based on two dimensional cephalogram. According to the development of image and computer system, it would be possible that the airway change is analyzed with three dimensional CT. So we tried to measure the volumetric change of airway and analyzed the relationship between the airway structure and volumetric change. Nineteen patients who experienced orthognathic surgery due to mandibular prognathism were analyzed with 3D CT data (preoperative and postoperative 6 months) and 2D lateral cephalometry. Volumetric change was measured and 3 dimensional change of related structure was assessed with simulation program ($V-works^{(R)}$, 4.0 Cybermed, Korea). Ten patients showed the decrease of airway volume change and nine showed the increase of airway volume change. Volumetric change was determined by dimensional change of mandible and hyoid bone. The dimensional positions of mandible and hyoid bone were the key factor for determining the airway change after surgery. Airway change is also predictable with the dimensional change of mandible and hyoid bone.

• The korean journal of orthodontics
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• v.28 no.4 s.69
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• pp.547-561
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• 1998

Obstructive sleep apnea (OSA) is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effcts on the occurrence of apnea and that the genioglossus muscle also plays an important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital, Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the placement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. We also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyogram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft Palate and SPAS, MAS, VAL, H-H1, MP-H showed statistically significant differences between the normal and OSA groups, but the IAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the IAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.123-136
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• 1989

The purpose of this study was to decide the diagnostic value of transmaxillary and transcranial projection in the evaluation of mandibular condyles. Five dry skulls with intact anatomic structure were selected for this study and the artificial osteophytes were attached to 9 different are as of the mandibular condyle. Ninety transcranial and forty-five transmaxillary radiographs were taken and then the radiographs were evaluated three times. The results were as follows; In transcranial radiographs, superocentral osteophyte was easily observed in closing state than in opening state (p<0.05). But there were no significant differences in other locations (p>0.05). The osteophytes on the medial and central portion easily observed at the transmaxillary projection than transcranial projection (p<0.05), but there was no significant difference on the lateral portion (p>0.05). The osteophytes on the superior (p<0.01) and posterior (p<0.01.) portion were easily observed at the transmaxillary projection than transcranial projection, but there was no significant difference on the anterior portion (p >0.05). The more laterally located osteophytes (p<0.01) at the transcranial projections were easily observed. The more posteriorly located osteophytes (p<0.05) at the transmaxillary projections were easily observed.

• Journal of the Korean Society of Radiology
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• v.5 no.6
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• pp.369-375
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• 2011

In dental radiography, panoramic views cause distortion and thus may bring about inaccurate results in the process of quantitative analysis. In this connection, there has recently been an increasing use of cone beam computed tomography (CBCT) that is known to provide high-resolution images and positional information. In this study, a dental computed tomography unit, 'DCT-90-P IMPLAGRAPHY (Vatech, Korea)', was applied to 20 patients for 24 seconds respectively, with a tube voltage of 85kVp and a tube current of 7mA. The data of CBCT were three-dimensionally reconstructed by use of a computer program, and were histomorphometrically analyzed. The results showed that the diameter of mandibular canal is less distorted at a certain inclination of the mandibular body. The image tends to seem more distended in proportion to the distance between the subject and film. Also, the image tends to be affected according as it is out of focus. In conclusion, it requires that the image should be reconstructed in light of anatomic position and structure.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.783-787
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• 2005

Eight patients underwvnt reoperation after valve replacement surgery with a mechanical valve from January, 1992 to December, 2003. Among the various indications for reoperation, there were 4 patients with paravalvular leakage; 3 patients underwent resuturing of the area of leakage and one patient underwent redo valve replacement. Among the three patients with stenosis due to thrombosis of the valve, 2 patients underwent redo valve replacement and one patient underwent thrombectomy. In one patient, the valve functioned normally, but stenosis was caused by overgrowth of the patient and redo valve replacement was done 123 months later. There was no postoperative mortality or morbidity. After an average of 51 months ($2\~134$ months) of postoperative follow up, the patients were in good condition and were able to maintain a NYHA functional class of I or II. The operative method used, whether it be a redo valve replacement or valve sparing method, depends upon the type of lesion and the anatomic structure.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.88-94
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• 2011

Ranula is a mucosal cyst that occurs in the mouth floor. This is a pseudo cyst caused by mucous retention within the tissue due to the rupture of catheter in the salivary gland. Ranula occurs mainly in a unilateral form and is characterized by painless bluish transparent swelling, with a increasing mass size. If the size is large, it can cause discomfort during swallowing, pronounciation, and mastication, but external swelling and infection is rare. Treatments include observation for spontaneous resolution, simple incision and drainage, marsupialization and excision. Marsupialization done by removing parts of the cyst wall and connecting it to the oral mucosa. It is a conservative procedure and recommended for children. It has advantages such as maintaining outline of oral tissue and less risk of damaging anatomic structure. Recurrence is common, mostly occurring within 4 months after surgery. This case is about a eight-year-old girl with ranula on the right mouth floor. This patient was treated with marsupialization that is one of treatment for ranula, and recurrence was not observed.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.1
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• pp.61-71
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• 2009

Anchorage control is important in orthodontic treatment. Recently miniscrew is widly used as maximum anchorage in orthodontic treatment, and then it is important to install miniscrew safely without damaging adjacent anatomic structure. In a view of Miniscrew's stability, maxilla is unfavorable than mandible, and moreover maxillary soft buccal bone has disadvantage on stability. so palatal area comes into notice for installation area. We measured distance between palatal roots and bone thickness at midpalatal area using 3D computed tomography, and have found following results. 1. On the comparison of distance between palatal roots, the distance between 2nd premolar and 1st molar was significantly longest and the distance between premolars was significantly shortest. 2. Going toward lateral area from midpalatal suture and posterior area from zero point, bone thickness significantly became shorter and shorter. And 5.0mm palatal sagittal plane has more significance decrease of bone thickness than 2.5mm palatal sagittal plane. According to these results, we can conclude that the palatal installation of miniscrew between 2nd premolar and 1st molar is safest. And it is more safe that comes closer to midpalatal suture and to anterior area in regard to incisive canal.