• Title/Summary/Keyword: distal extension

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Arterial or venous free flaps for volar tissue defects of the proximal interphalangeal joint: A comparison of surgical outcomes

  • Choi, Min Suk;Roh, Si Young;Koh, Sung Hoon;Kim, Jin Soo;Lee, Dong Chul;Lee, Kyung Jin;Hong, Min Ki
    • Archives of Plastic Surgery
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    • v.47 no.5
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    • pp.451-459
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    • 2020
  • Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint. Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients' age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups. Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P =0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant. Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

Radiographic Comparison of Cranial Tibial Wedge Osteotomy versus Tibial Plateau Leveling Osteotomy: A Cadaveric Study

  • Lee, Jiyoon;Kim, Dongwook;Oh, Hyejong;Lee, Sungin;Choi, Seok Hwa;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.93-99
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    • 2022
  • The present study was performed to compare cranial tibial wedge osteotomy (CTWO) and tibial plateau leveling osteotomy (TPLO) through radiographic evaluation. The experiment was conducted with five cadaver dogs [mean (± SD) weight, 32.9 ± 4.1 kg; mean (± SD) age, 6 ± 2 years; three males and two females] euthanized for reasons unrelated to this study. The cadaver dogs consisted of German Shepherd (n = 3), Belgian Malinois (n = 1), and mixed breed (n = 1). CTWO and TPLO were carried out by the standard surgical method. Radiographic evaluation was performed by comparing several factors, including the flexion and extension angles, the anatomical mechanical axis angle (AMA-angle), tibial length, patellar height measurement using the Labelle-Laurin method, mechanical medial proximal tibial angle (mMPTA), mechanical medial distal tibial angle (mMDTA), and frontal plane alignment (FPA). Both the CTWO and the TPLO groups showed significantly increased flexion angles after surgery. Only the CTWO group had significantly increased extension angle. Although both groups showed significant decreases in the AMA-angle, the mechanical axis moved cranially against the anatomical axis only in the CTWO group. The patellar height was significantly lowered in the CTWO group. No significant differences were found in mMPTA, mMDTA, or FPA. In conclusion, radiographic comparison revealed more changes in CTWO group than in TPLO group.

Clinical Study of Neck Base Injury (경저부 혈관손상의 임상적 고찰)

  • 우종수
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.378-384
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    • 1978
  • Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

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Design of Biomimetic Hand Prosthesis with Tendon-driven Five Fingers (생체모방형 건구동식 의수의 설계)

  • Jung, Sung-Yoon;Kang, Sung-Kyun;Bae, Ju-Hwan;Moon, In-Hyuk
    • Journal of Biomedical Engineering Research
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    • v.30 no.3
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    • pp.205-212
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    • 2009
  • This paper proposes a biomimetic hand prosthesis with tendon-driven five fingers. Each finger is composed of a distal-middle phalange, a proximal phalange and a metacarpal bone, which are connected to a link mechanism. The finger flexion is a resultant motion by pulling a wire to serve as a tendon, but the finger extension is performed by an elastic mechanism composed of a restoration spring. The designed hand prosthesis with tendon-driven five fingers has totally six degrees of freedom. But its weight is merely 400.73g. The hand can perform various hand functions such as the grasping and the hand postures. From experimental results, we show that the proposed hand prosthesis is useful to amputees as a prosthetic hand.

Image Based Quality Assurance of Range Compensator for Proton Beam Therapy (양성자치료용 보상체의 영상기반 정도 관리 기반 프로그램 개발)

  • Kim, Jin-Sung;Yoon, Myong-Geun;Kim, Dong-Wook;Lim, Young-Kyung;Kwak, Jung-Won;Park, So-Ah;Shin, Dong-Ho;Shin, Jung-Wook;Lee, Se-Byeong;Park, Sung-Yong;Cho, Kwan-Ho
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.35-41
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    • 2008
  • The main benefit of proton therapy over photon beam radiotherapy is the absence of exit dose, which offers the opportunity for highly conformal dose distributions to target volume while simultaneously irradiating less normal tissue. For proton beam therapy two patient specific beam modifying devices are used. The aperture is used to shape the transverse extension of the proton beam to the shape of the tumor target and a patient-specific compensator attached to the block aperture when required and used to modify the beam range as required by the treatment plan for the patient. A block of range shifting material, shaped on one face in such a way that the distal end of the proton field in the patient takes the shape of the distal end of the target volume. The mechanical quality assurance of range compensator is an essential procedure to confirm the 3 dimensional patient-specific dose distributions. We proposed a new quality assurance method for range compensator based on image processing using X-ray tube of proton therapy treatment room. The depth information, boundaries of each depth of plan compensatorfile and x-ray image of compensator were analyzed and presented over 80% matching results with proposed QA program.

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A PHOTOELASTIC STRESS ANALYSIS IN MANDIBULAR DISTAL EXTENSION REMOVABLE PARTIAL DENTURE DESIGNED UNILATERALLY WITH DIFFERENT DIRECT RETAINERS (편측성으로 설계된 하악 유리단 국소의치에서 직접유지장치의 설계 변화에 따른 광탄성 응력 분석에 관한 연구)

  • Son Hong-Suk;Kay Kee-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.30 no.1
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    • pp.25-42
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    • 1992
  • The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from a unilateral distal extention removable partial dentures with five kinds of the direct retainers, that is, the bilaterally designed bar clasp of the cross-arch lingual bar and the unilaterally designed bar clasp, circumferential clasp, mini-Dalbo attachment, and telescope retainer. A photoelastic model for mandible was made of the epoxy resin(PL-1) and hardner (PLH-1) with the acrylic resin teeth used and was coated with plastic cement-1 at the lingual surface of the model, and then five kinds of removable partial dentures were set, A unilateral vertical load of about 16Kg was applied on the first molar and the stress pattern of the photoelastic model under each condition was analyzed by the reflective circular polariscope. The following results were obtained: 1. The conventional removable partial denture with the bilaterally cross arch lingual bar produced the most favorable stress distribution on the residual ridge and supporting structure of abutment teeth than the unilaterally designed removable partial dentures. 2. The unilaterally designed removable partial denture with the bar clasp produced the stress distribution on the residual ridge, except sligtly higher stress concentration on the supporting structure of the abutment teeth, similar to the conventional removable partial denture with the bilaterally designed cross arch lingual bar. 3. On the unilaterally designed removable partial dentures, the bar clasp produced greater stress distribution on the residual ridge and supporting structure of the abutment teeth than the circumferential clasp. 4. On the unilaterally designed removable partial dentures, the mimi-Dalbo attachment produced relatively higher stress concentration on the residual ridge, but produced lesser stress concentration on the supporting structure of the abutment teeth than the other direct retainers. 5. On the unilaterally designed removable partial dentures, the telescope retainer produced uniform stress distribution on the residual ridge, but produced higher stress concentration at the root apex of the terminal abutment tooth than the other direct retainers. 6. On the unilaterally designed removable partial dentures the circumferential clasp and telescope retainer produced slightly higher stress concentration on the residual ridge and supporting structure of the abutment teeth than the bar clasp and mini- Dalbo attachment.

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Comparison of Stress of the Abutment Teeth and Denture Base in Distal Extension Removable Partial Dentures Retained Konus Crown, Precision Attachment and RPI Clasp with the Occlusal Load Application (유리단 국소의치의 교합하중 적용시 이중금관, 어태치먼트 및 RPI clasp 유지장치에 따라 지대치와 의치상에 미치는 응력 비교)

  • Jun, In-Sik;Kim, Bu-Sub;Chung, In-Sung
    • Journal of Technologic Dentistry
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    • v.28 no.2
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    • pp.331-346
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    • 2006
  • Free-end partial dentures, which are supported by teeth surrounded by dental root membranes and elastic mucous membrane tissues, may cause stress to the abutment teeth due to external force imposed on the denture base, increase the mobility of the abutment teeth, and bring about a change in the periodontal tissue. General retainers used in partial dentures are categorized into clasp, attachment, and Konus crown. Stress imposed on the abutment teeth and mobility of the denture base have relations with the lifetime of a crown and abutment teeth, and have direct relations with the chewing ability. Thus, a need arises to make a comparative analysis of stress of the three direct retainers on the abutment teeth and interpret the mobility of the denture base. This study designed three kinds of removable partial dentures (one kind of attachment partial denture, one kind of Konus crown partial denture, and one kind of clasp partial denture), and fabricated Dentiforms of bilateral partial dentures (Kennedy Class I) with lower left 1st premolar and lower right 1st and 2nd premolars being as the abutment teeth. A strain gauge was installed in the mesial and distal surface of the lowerr left 1st premolar (No. 34) of the fabricated dentiform and in the lower part of the denture base, and installed were a clasp partial denture, an attachment partial denture, and a Konus crown partial denture. Then, the vertical static load of 5kgf and 7.5kgf at the occlusion surface of the lower left No. 6 molar was generated for a total of 20 frequencies of load each using a push-full gauge, and thus a change in the output of the strain gauge was measured. With the respective application of Konus crown, attachment and RPI clasp in the free-end partial denture, surveyed was the distribution of stress imposed on the abutment teeth and the denture base according to the location of occlusion force load so as to come up with the following results. 1. Konus crown and attachment partial dentures generated much stress, and more stress on the abutment teeth than RPI clasp dentures did. Attachment dentures tended to further intensify stress on the abutment teeth than Konus crown dentures did. 2. Attachment dentures and Konus dentures imposed less stress on the denture base than RPI clasp dentures did. There was no stress difference between Attachment and Konus crown dentures. 3. Dentures that were designed with the application of retainers using sturdy linkage methods tended to be less mobile.

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Rhizoctonia Blight of Azolla japonica Caused by Rhizoctonia solani (Rhizoctonia solani에 의한 큰물개구리밥(Azolla japonica) 마름병)

  • Lee, Jung-Han;Cha, Jea-Yul;Noh, Gil-Han;Han, Ki-Soo;Bae, Dong-Won;Kwon, Young-Sang;Lim, Chae-Shin;Jeong, Sung-Woo;Kwon, Jin-Hyeuk;Park, Chung-Gyoo;Kwak, Youn-Sig
    • Research in Plant Disease
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    • v.17 no.3
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    • pp.405-409
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    • 2011
  • Azolla Lam. is a small aquatic fern with deeply bilobed leaves, which are consisted of a thick greenish, with chlorophyll, upper (dorsal) lobe and a thinner, translucent lower (ventral) lobe, without chlorophyll, submerged in the water. Azolla blight was observed at a lotus pond. Mycological characteristics of the fungus associated with Azolla blight was immediately determined as Rhizoctonia sp. by the thickness and branching of hypha at right angles at the point toward the distal end of septa, with branching hypha is constricted. The fungus produced brown mycelia and dark brown sclerotia on PDA. The optimum temperature for mycelial growth and sclerotia formation were $25^{\circ}C$ and $30^{\circ}C$, respectively. The optimum temperature for fungal infection was $30^{\circ}C$, when spray inoculated. Phylogenetic analysis of rDNA-ITS revealed that the fungus was identified as Rhizoctonia solani (AG-1 IA) closest to one causing rice sheath blight disease. This is the first report on the blight disease of Azolla caused by R. solani in Korea.

A RADIOGRAPHIC STUDY ON THE MORPHOLOGY OF THE MAXILLARY SINUS (상악동의 형태에 관한 방사선학적 연구)

  • Kim Bong-Young;Kim Jae Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.2
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    • pp.297-306
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    • 1991
  • The purpose of this study is to improve the availabilities of radiographic technics as diagnostic methods to evaluate maxillary sinus in dental clinic. For the morphologic study of maxillary sinus, 20 dry maxillas were used and intraoral standard views, orthopantomograms, and skull P-A views were taken. For measuring the vertical image magnification rates, 5 sites in maxillary molar regions of 5 dry mandibles were selected radndomly and 25 wires of the determined sizes for selected portions were attached to the sites, after then, intraoral radiograms with bisecting technic and orthopantomograms were taken. The acquired results were as follows: 1. The anterior extension of the maxillary sinus on orthopantomogram was the distal side of the canine in 45.45% of subjects, the mesial side of the canine in 27.27%, the lateral incisor in 9.09%, the mesial side of the 1st premolar in 9.09%, and the mesial side of the 2nd pre-molar in 9.09%. 2. The positional relationship between the floor of maxillary sinus and the apex of alveolar socket revealed superimposed type in 58.3% of subjects, approached type in 33.3%, and separated type in 8.4%. 3. The morphology of inferior border of maxillary sinus was simple V or U shape in edentulous stage and V or wide U shape in alveolar socket stage. 4. The vertical image length on intraoral film taken by bisecting technic was magnified by 27.23% on the average and the length on orthopantomogram by 12.35%. 5. The inferior borders of maxillary sinus coinciding with each of the areas bearing the anterior and the posterior teeth on skull P-A view were determined.

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Surgical Treatment of Left Subclavian Aneurysm -A case report- (Subclavian artery 의 동맥류 -1예 수술 경험-)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Khil Rho;Kim, Song Myung
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.245-250
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    • 1976
  • A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

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