• Title/Summary/Keyword: anterior zone

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The Anatomic Features and Role of Superficial Inferior Epigastric Vein in Abdominal Flap

  • Park, Seong Oh;Imanishi, Nobuaki;Chang, Hak
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.482-487
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    • 2022
  • In lower abdominal flap representing transverse rectus abdominis musculocutaneous (TRAM) flap or deep inferior epigastric perforator (DIEP) flap, superficial inferior epigastric vein (SIEV) exists as superficial and independent venous system from deep system. The superficial venous drainage is dominant despite a dominant deep arterial supply in anterior abdominal wall. As TRAM or DIEP flaps began to be widely used for breast reconstruction, venous congestion issue has been arisen. Many clinical series in regard to venous congestion despite patent microvascular anastomosis site were reported. Venous congestion could be divided in two conditions by the area of venous congestion and each condition is from different anatomical causes. First, if venous congestion was shown in whole flap, it is due to the connection between SIEV and vena comitantes of DIEP. Second, if venous congestion is limited in above midline (Hartrampf zone II), it is due to problem in venous midline crossover. In this article, the authors reviewed the role of SIEV in lower abdominal flap based on the various anatomic and clinical studies. The contents are mainly categorized into four main issues; basic anatomy of SIEV, the two cause of venous congestion, connection between SIEV and vena comitantes of DIEP, and midline crossover of SIEV.

Simultaneous Hard Tissue and Soft Tissue Graft with Dental Implant Placement and Provisionalization: A Case Report

  • Hyunjae Kim;Young-Dan Cho;Sungtae Kim
    • Journal of Korean Dental Science
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    • v.17 no.2
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    • pp.84-91
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    • 2024
  • Achieving both esthetic and functional implant rehabilitation is crucial for the successful treatment of the anterior maxilla. Adequate peri-implant alveolar bone and soft tissue are essential for optimal rehabilitation of the esthetic area, and there is a direct association between the implant position and prosthetic outcomes. Immediate provisionalization may also be advantageous when combined with augmentation. This case report described the implant placement in a 25-year-old female patient who had lost her right maxillary lateral incisor (#12) due to trauma-induced avulsion. The treatment involved simultaneous grafting and collagenated, deproteinized bovine bone mineral, along with subepithelial connective tissue taken from the right maxillary tuberosity. A polyetheretherketone abutment and non-functional immediate provisionalization were performed by removing both the proximal and occlusal contacts on the composite resin crown. Clinical and radiographic evaluations revealed maintenance of stable ridge contour aspects for six months following surgical treatment. In summary, implant rehabilitation in the esthetic zone can be successful using simultaneous soft and hard tissue grafts. Moreover, soft tissue stabilization post-subepithelial connective tissue grafting can be achieved through early or immediate visualization, along with immediate implant placement.

Structural and functional characteristics of rock-boring clam Barnea manilensis (암석을 천공하는 돌맛조개(Barnea manilensis)의 구조 및 기능)

  • Ji Yeong Kim;Yun Jeon Ahn;Tae Jin Kim;Seung Min Won;Seung Won Lee;Jongwon Song;Jeongeun Bak
    • Korean Journal of Environmental Biology
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    • v.40 no.4
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    • pp.413-422
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    • 2022
  • Barnea manilensis is a bivalve which bores soft rocks, such as, limestone or mudstone in the low intertidal zone. They make burrows which have narrow entrances and wide interiors and live in these burrows for a lifetime. In this study, the morphology and the microstructure of the valve of rock-boring clam B. manilensis were observed using a stereoscopic microscope and FE-SEM, respectively. The chemical composition of specific part of the valve was assessed by energy dispersive X-ray spectroscopy (EDS) analysis. 3D modeling and structural dynamic analysis were used to simulate the boring behavior of B. manilensis. Microscopy results showed that the valve was asymmetric with plow-like spikes which were located on the anterior surface of the valve and were distributed in a specific direction. The anterior parts of the valve were thicker than the posterior parts. EDS results indicated that the valve mainly consisted of calcium carbonate, while metal elements, such as, Al, Si, Mn, Fe, and Mg were detected on the outer surface of the anterior spikes. It was assumed that the metal elements increased the strength of the valve, thus helping the B. manilensis to bore sediment. The simulation showed that spikes located on the anterior part of the valve received a load at all angles. It was suggested that the anterior part of the shell received the load while drilling rocks. The boring mechanism using the amorphous valve of B. manilensis is expected to be used as basic data to devise an efficient drilling mechanism.

Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table (일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교)

  • Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.244-253
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    • 2019
  • Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

Histopathological Study of Cartilage in the Bone Bruise of the Lateral Femoral Condyle Associated with Anterior Cruciate Ligament Rupture (전방 십자 인대 파열시 손상된 대퇴골 외과 연골의 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Kim, Hee-Seon
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.154-161
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    • 2005
  • Purpose: to describe the histologic appearance of the type III bone bruise in knees which had sustained an acute anterior cruciate ligament (ACL) rupture. Materials and Method: Twenty-five patients who sustained acute ACL rupture were prospectively enrolled in this study. On MRI, 14 patients demonstrated type III bone bruise on lateral femoral condyle, and 11 patients didn't demonstrated bone bruise. Arthroscopic evaluation and biopsy of the articular cartilage and subchondral bone wert performed before ACL reconstruction. Histologic and immunohistochemical evaluations were done. Results: There was no difference between the bone bruise and control group in the hematoxylin-eosin staining for cell distribution, Masson's trichrome staining for collagen and immunohistochemical staining for type I and type II collagen (p>0.05). But in the safranin-O staining for glycosaminoglycan distribution, the bone bruise group had an evidence of decreased staining at the superficial and middle layers, compared with the control group (p<0.05). We also found fatty change of bone marrow in calcified zone of the bone bruise group with safranin-O staining. Conclusion: We suggest that the type III bone bruise found on MRI indicates a substantial damage to normal articular cartilage homeostasis, and may induce further damage of the articular cartilage.

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Immediate implant placement into extraction sites with periapical lesions in the esthetic zone: a case report (치근단 병소를 가진 치아의 발치 후 즉시 임플란트 식립 및 보철을 통한 심미성 회복)

  • Yi, Jae-Young;Kim, Jee-Hwan;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.191-197
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    • 2012
  • Esthetics is important in restoring maxillary anterior area. Alveolar bone resorption and loss of interdental papilla may be minimized by immediate implantation. Previous studies showed successful results with the immediate implantation in healthy extraction socket, while many of these studies objected the immediate implantation into extraction sites with periapical lesions. Recent studies, however, reported successful results of the immediate implantation into extraction sites with periapical lesions with careful debridement of extraction sockets and general medication of antibiotics prior to implantation. A 73-year-old female visited the department of Prosthodontics in ${\bigcirc}{\bigcirc}$ University Dental Hospital with the chief complaint of fallen post-core and crown on left maxillary incisor. Although the incisor was with vertical root fracture and periapical lesion, the immediate implantation following the extraction of tooth was planned. Thorough socket debridement, irrigation with chlorhexidine, and tetracycline soaking were followed by immediate implantation. The general medication of antibiotics (Moxicle Tab.$^{(R)}$, 375 mg) was prescribed before and after the surgery. Immediate provisional restoration was delivered two days after the surgery, and the definitive metal-ceramic restoration was placed about six months later after reproducing the emergence profile from the provisional restoration. This case presents satisfying result esthetically and functionally upto two years after the placement of prosthesis with the harmonious gingival line and no loss of marginal bone.

The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation (보철학적 교합 재구성을 위한 교합진단과 치료계획)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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Meniscus Repair using Meniscus Arrow with Anterior Cruciate Ligament Reconstruction (전방 십자 인대 재건술시 동반된 반월상 연골 파열에 대한 meniscus arrow를 이용한 봉합)

  • Cho Sung-Do;Park Tae-Woo;Hwang Su-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.156-160
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    • 2002
  • Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.

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The Effects of Plantar foot Pressure and EMG Activation of Neck, Lumbar and Low Limbs by Using Carrier during Walking (처네(앞.뒤) 사용 방법이 보행 시 목, 허리 및 다리 근육 활성도와 족저압에 미치는 영향)

  • Lee, Sang-Yeol;Chang, Jong-Sung;Lee, Myoung-Hee
    • Korean Journal of Applied Biomechanics
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    • v.19 no.2
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    • pp.237-244
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    • 2009
  • The purpose of this study was to investigate the changing plantar foot pressure and muscle activation of neck, lumbar and low limb by different way of the using carrier during walking. Twenty healthy and young females who brought up infants and had no musculoskeletal disorders of neck, lumbar and low limb were instructed to perform plantar foot pressure and muscle activation of neck, lumbar and low limb during different ways of the using the carrier and walking. Plantar foot pressures were recorded by RS-scan system(RS scan Ltd, German), muscle activation were recorded by ProComp infinitiTM(Thought Technology Ltd, Canada). The data collected by each way of the using carrier and One-way ANOVA was used to analyze. The results indicated that there was a significant increase on erector spinae muscle activation and pressure of great toe zone by using anterior carrier and there was a increase on activation of paraspinal muscle and metatarsal zone by using posterior carrier. Therefore, the way of using carrier could be influenced upon structure and function of the foot and muscle activation.

Mesodermal Formation and Patterning during Ascidian Embryogenesis (멍게 배발생 과정에서 중배엽 형성과 패턴화)

  • 김길중;니시다히로키
    • Development and Reproduction
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    • v.6 no.2
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    • pp.77-82
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    • 2002
  • In ascidians, a primitive chordate, maternal cytoplasmic factors and inductive interactions are involved in the specification of cell fates in early embryos. The larval structure of ascidians is relatively simple, and the major mesodermal tissues of the tadpole larva are notochord, muscle, and mesenchyme. Formation of muscle cells is a cell-autonomous process, and localized maternal macho-l mRNA specify muscle fate in the posterior marginal zone of the early embryo. In contrast, inductive influence from endoderm precursors plays important roles in the specification of notochord and mesenchyme fates. FGF-Ras-MAPK signaling is involved In the induction of both tissues. The difference in responsiveness of the posterior mesenchyme and anterior notochord precursors to FGF signaling is caused by the presence or absence of intrinsic factors that inherited from the posterior-vegetal egg cytoplasm, respectively. In these inductions, directed signal polarizes the induced cells and promotes asymmetric cell divisions to produce two daughter cells with distinct fates.

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