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Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.359-371
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    • 2010
  • Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

The Liability of Participants in Commercial Space Ventures and Space Insurance (상업우주사업(商業宇宙事業) 참가기업(參加企業)의 책임(責任)과 우주보험(宇宙保險))

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
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    • v.5
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    • pp.101-118
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    • 1993
  • Generally there is no law and liability system which applies particulary to commercial space ventures. There are several international treaties and national statutes which deal with space ventures, but their impact on the liability of commercial space ventures has not been significant. Every state law in the United States will impose both tort and contract liability on those responsible for injuries or losses caused by defective products or by services performed negligently. As with the providers of other products and services, those who participate in commercial space ventures have exposure to liability in both tort and contract which is limited to the extent of the resulting damage The manufacturer of a small and cheap component which caused a satellite to fail to reach orbit or to operate nominally has the same exposure to liability as the provider of launch vehicle or the manufacturer of satellite into which the component was incorporaded. Considering the enormity of losses which may result from launch failure or satellite failure, those participated in commercial space ventures will do their best to limit their exposure to liability by contract to the extent permitted by law. In most states of the United States, contracts which limit or disclaim the liability are enforceable with respect to claims for losses or damage to property if they are drafted in compliance with the requirements of the applicable law. In California an attempt to disclaim the liability for one's own negligence will be enforceable only if the contract states explicitly that the parties intend to have the disclaimer apply to negligence claims. Most state laws of the United States will refuse to enforce contracts which attempt to disclaim the liability for gross negligence on public policy grounds. However, the public policy which favoured disclaiming the liability as to gross negligence for providers of launch services was pronounced by the United States Congress in the 1988 Amendments to the 1984 Commercial Space Launch Act. To extend the disclaimer of liability to remote purchasers, the contract of resale should state expressly that the disclaimer applies for the benefit of all contractors and subcontractors who participated in producing the product. This situation may occur when the purchaser of a satellite which has failed to reach orbit has not contracted directly with the provider of launch services. Contracts for launch services usually contain cross-waiver of liability clauses by which each participant in the launch agrees to be responsible for it's own loss and to waive any claims which it may have against other participants. The crosswaiver of liability clause may apply to the participants in the launch who are parties to the launch services agreement, but not apply to their subcontractors. The role of insurance in responding to many risks has been critical in assisting commercial space ventures grow. Today traditional property and liability insurance, such as pre-launch, launch and in-orbit insurance and third party liability insurance, have become mandatory parts of most space projects. The manufacture and pre-launch insurance covers direct physical loss or damage to the satellite, its apogee kick moter and including its related launch equipment from commencement of loading operations at the manufacture's plant until lift off. The launch and early orbit insurance covers the satellite for physical loss or damage from attachment of risk through to commissioning and for some period of initial operation between 180 days and 12 months after launch. The in-orbit insurance covers physical loss of or damage to the satellite occuring during or caused by an event during the policy period. The third party liability insurance covers the satellite owner' s liability exposure at the launch site and liability arising out of the launch and operation in orbit. In conclusion, the liability in commercial space ventures extends to any organization which participates in providing products and services used in the venture. Accordingly, it is essential for any organization participating in commercial space ventures to contractually disclaim its liability to the extent permitted by law. To achieve the effective disclaimers, it is necessary to determine the applicable law and to understand the requirements of the law which will govern the terms of the contract. A great deal of funds have been used in R&D for commercial space ventures to increase reliability, safety and success. However, the historical reliability of launches and success for commercial space ventures have proved to be slightly lower than we would have wished for. Space insurance has played an important role in reducing the high risks present in commercial space ventures.

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Three-dimensional finite element analysis for the effect of retentive groove design on joint strength of casting connection (유지구 설계가 주조연결강도에 미치는 영향에 관한 삼차원 유한요소법적 연구)

  • Kim, Jung-Woo;Jeong, Chang-Mo;Jeon, Young-Chan;Yun, Mi-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.1
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    • pp.29-38
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    • 2009
  • Statement of problem: A casting connection technique is widely used for repair, correction and addition to base metal framework. However, a casting connection technique may increase the risk of failure in clinical situations when high stresses exist. Purpose: The purpose of this study was to investigate the mechanical retentive groove design comparatively to increase the joint strength by using the three-dimensional finite element analysis model of a 3-unit fixed partial denture. Material and methods: Ten finite element models were constructed. (Model A: One retentive groove, Model B: Two retentive grooves, Model C: Three retentive grooves, Model D: Four retentive grooves, Model E: One horizontal groove and two vertical grooves, Model F: Two horizontal grooves and one vertical groove, Model G: One groove with the enlarged dimension, Model H: Two grooves with the enlarged dimension, Model I: One groove with the increased height, Model J: One groove with the increased width of base). The vertical force was applied to the mesial and the distal fossa to the casting connection of mandibular first molar. Results: The main factors, affecting joint strength of casting connection were both the retention between the primary cast and the secondary cast and the thickness of the primary cast remaining after preparing retentive groove. The increase of retentive force, according to the numbers and the dimension of retentive groove had an effect on distributing stress. However, in some cases, the increase of retentive force resulted in the increase of stress by reducing thickness of the primary cast in the connection area. Conclusion: The design of retentive groove that limits number of retentive groove for metal thickness and increases the depth of retentive groove for retention is highly recommended.

pT1N3 Gastric Cancer (pT1N3 위암)

  • Ahn, Dae-Ho;Kwon, Sung-Joon;Yun, Hyo-Yung;Song, Young-Jin;Mok, Young-Jae;Han, Sang-Uk;Kim, Wook
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.109-113
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    • 2006
  • Purpose: Various minimally invasive surgical techniques, such as an endoscopic mucosal resection and a laparoscopic gastrectomy, are becoming common practice for some cases of early gastric cancer (EGC) defined in terms of the depth of invasion being limited to the mucosa or submucosa. However, there are rare cases of early gastric cancer with massive lymph-node metastasis. Materials and Methods: From 6 university hospitals of Korea, 2,772 EGC cases were resected during the various period of analysis (1,432 cases of mucosal cancer and 1,340 of submucosal cancer). Results: As control data, we used the data from a single institute, CHA University Hospital. There were nine cases of early gastric cancer (9/2,772, 0.32%) with N3 lymph node metastasis defined by more than 15 lymph nodes being metastasized according to the UICC-TNM classification (pT1N3, stage IV). Two cases were mucosal cancer (2/1,432, 0.1 4%), and seven cases were submucosal cancer (7/1,340, 0.52%). Metastasized lymph nodes varied in number from 18 to 52. There were three male and six female patients with a mean age of 57. This is a totally reversed sex ratio compared to the usual gastric cancer or EGC. Among the total of 9 EGC patients, there were 5 who had superficial spreading carcinomas with surface areas larger than $25\;cm^2$. This is a significantly higher proportion compared to the general EGC population. When we compared the tumor size according to the LN status, the N3 group was definitely larger than the other groups. 78% of the pT1N3 cases showed lymphatic invasion, which is very high compared to the 4.7% in general EGC cases. Among the 9 cases, 6 patients had too short a follow-up period to evaluate the correct prognosis, but there was one patient with a non-curative resection and two patients with early recurrence. Although the sample size is small and the follow-up period is short, we can expect a very poor prognosis when we consider the common prognosis of EGC that is widely known and accepted. Conclusion: From these results, we can a conclude that the risk factors for pT1N3 gastric cancer are female patients, submucosal invasion, larger tumor size, and lymphatic invasion. However rare, the existence of pT1N3 gastric cancer needs to be taken into consideration, especially during the diagnosis. Furthermore, minimally invasive treatment for EGC needs to be chosen with great precaution. Since the prognosis of pT1N3 gastric cancer is expected to be poor, aggressive adjuvant chemotherapy may be necessary. (J Korean Gastric Cancer Assoc 2006;6:109-113)

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Clinical Availability of Endoscopic Incision and Submucosal Dissection for the Treatment of Gastric Neoplasms (위종양성 병변에 대한 내시경 절개 점막하 박리법의 임상적 유용성)

  • Jung, Yoon-Ho;Eun, Soo-Hoon;Cho, Joo-Young;Jung, In-Seop;Ryu, Chang-Beom;Lee, Joon-Seong;Lee, Moon-Sung;Kim, Boo-Sung;Shim, Chan-Sup
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.76-83
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    • 2006
  • Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.

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Prospective Randomized Study of Six Months' Chemotherapy and Nine Months' Chemotherapy for Cervical Lymph Node Tuberculosis (결핵성 경부 임파선염의 6개월 대 9개월 요법에 대한 전향적 비교 연구)

  • Lee, Jae Hee;Cha, Seung Ik;Jang, Sang Su;Jung, Chi Young;Park, Jae Yong;Park, Jun Sik;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.274-282
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    • 2003
  • Background : Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. It was recently reported that the treatment for tuberculous lymphadenitis could be shortened to 6 months without increasing the risk of a relapse. However, there is no report of a prospective randomized study on the use of 6-month chemotherapy with HERZ for cervical lymphadenitis, which is regimen recommended in the areas concerned with the initial drug resistance. The aim of this study is to evaluate the efficacy of the 6-month regimen with HERZ for cervical lymphadenitis in areas where there is a high prevalence of drug resistance in Korea. Method : From January 1997 to February 2002, 92 patients with cervical tuberculous lymphadenitis were recruited from Kyungpook national university hospital. Forty-six patients were given the 6-month regimen(2HERZ/4HER) and the other forty-six patients were given the 9-month regimen(2HERZ/7HER). Result : Of the 46 patients given the 6-month regimen, 5 had residual lymph nodes greater than 5 mm after the completion of treatment and 3 had new lymph nodes or an increased lymph node size during the follow-up period. Of the 46 patients in the 9-month regimen, 9 had residual lymph nodes and 8 had new events during the follow-up period. There were no significant differences between the two groups. Conclusion : These results suggest that the 6-month HERZ regimen can be used safely as the initial treatment for tuberculous lymphadenitis in areas with a similar prevalence of drug resistance.

Influences of Tunnel Covering Materials and Seeding Dates on the Growth and Productivity of Water Spinach (Ipomoea aquatic F.) under Unheated Greenhouse (공심채 무가온 하우스 재배시 터널피복재와 파종시기에 따른 생육과 생산성 비교)

  • Uhm, Mi Jeong;Kwon, Sung Whan;Song, Young Ju
    • Journal of Bio-Environment Control
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    • v.23 no.4
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    • pp.349-355
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    • 2014
  • This study was performed to evaluate influences of tunnel covering materials and seeding dates on the growth and productivity of water spinach (Ipomoea aquatic F.) cultured early in unheated greenhouse. During tunnel installation period, from March 5 to April 30 and from October 11 to November 10, air and soil temperature in tunnel covered with polyethylene film (PEF) had risen $2.0-2.4^{\circ}C$ and $0.9-1.0^{\circ}C$, respectively, compared to those in non-tunnel (NT). Air and soil temperature in tunnel with illite non-fabric (INF) also had risen $1.6-1.8^{\circ}C$ and $0.6-0.8^{\circ}C$, respectively. Especially, it showed greater effects of the rise at low temperature time zones of the day. In plots of seeding on March 15 in tunnel covered with PEF or INF, temperature during emergence period, emergence days and rate were similar to plot seeding on April 5 in NT. There were two more harvesting in plots of seeding on March 5 or March 15 in tunnel, and increasing of total yield by 22.5-25.7% compared to plot of seeding on April 5 in NT. But there was observed no significant differences between PEF and INF. Whereas PEF was necessary to be removed at midday sometimes because it had risk of high temperature injury, INF was not necessary. All above suggest that it was suitable to sow seed on the middle of March in tunnel covered with INF, for early culture of water spinach in unheated greenhouse.

A Clinical Study of Child Abuse (아동학대로 진단된 환아의 임상적 고찰)

  • Choi, Yoon Jin;Kim, Shin Mi;Sim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.436-442
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    • 2007
  • Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

Effect of Immature Compost on Available Nutrient Capability and Heavy Metal Accumulation in Soil for Lettuce (Lactuca sativa L.) Cultivation (퇴비 내 영양소 및 중금속이 상추 재배에 미치는 영향)

  • Phonsuwan, Malinee;Lee, Min Ho;Moon, Byeong Eun;Kim, Young Bok;Kaewjampa, Naruemol;Yoon, Yong Cheol;Kim, Hyeon Tae
    • Journal of Bio-Environment Control
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    • v.25 no.4
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    • pp.343-350
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    • 2016
  • The aim of this study was to evaluate effects of immature compost on the amount of nutrient content, heavy metal concentration, and application rate that were used for lettuce cultivation. The characteristics of the two composts (Compost A (CA) was immature compost and Compost B (CB) was mature compost) were evaluated upon mixing with commercial soil at 0%, 25%, 50%, and 75% (w/w). The poor chemical characteristics were appeared by use of immature compost as soil amendment; the 50% and 75% rates were weakly acidic at pH 5.39 and 5.50, respectively. The total carbon content at using of 75% of the immature compost and mature compost increased the most to 14.5 and 6.5% and it significantly increased concentrations of the total nitrogen and phosphorus compared to control. As for 75% mature compost rate increased significantly the concentrations of Cu ($128mg\;kg^{-1}$), Zn ($260mg\;kg^{-1}$), Pb ($0.32mg\;kg^{-1}$) and, Cd ($0.48mg\;kg^{-1}$) compared to control, and the highest As concentration increased significantly at 75% and 50% (6.69 and $6.28mg\;kg^{-1}$) including in 25% immature compost as $6.48mg\;kg^{-1}$. However, all of the high compost rates significantly decreased the shoot biomass of lettuce. The immature compost was potentially amended at an application rate of 25% due to a slight salinity and low risk to heavy metal uptake on lettuce growth. This use may be available if the rate is lower than that used in this trial.

A Study on the Relationship Between Entrepreneur Characteristics and the Performance of Small Firms (창업자 특성과 소기업 사업성과 간 관계에 관한 연구)

  • Kim, Wan-Jae;Chung, Hwa-Young
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.2 no.3
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    • pp.33-60
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    • 2007
  • This study alms to analyze the entrepreneur characteristics of founder on enterprise performance from the strategic viewpoint as well as features of founder of small firms such as background feature of founder, psychological features and management skill. As considered by Background features of founder include educational background of founder, his experience in business creation, consultation or course related to business creation. This study verified the effects of factor which business performance (financial, non financial) on small firms. Also, this study considered psychological features of founder include achievement desire, risk-free propensity, level of patience on vagueness and control position. And it analyzed that between such factors and performance of small firms were examined in related. In the mean time, management ability of founder, entrepreneur ability, technical and function ability were considered for management skill of founder and alalyzed effect of the factors on performance of small firm were examined. Effects of strategic intention of founder of small firm were analyzed by the strategic viewpoint. At this time, strategy of small firm was divided into product-service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy. This study distributed questionnaire on CEO of small firms in Daejeon and Chungnam area for accomplish the study objective and it collected a total of 145 copies of questionnaires. As a result of analyzing collected questionnaire, this study deduced the following study results and suggestions. First, results different from those of existing studies were found Since sales, net income and profit rate of small firm were not high cause economic depression on the whole. Second, entrepreneur ability was found to be required for success of business creation. Entrepreneur ability of founder was the factor that affects both financial and non - financial performance of small firm. As such, entrepreneur ability can be regarded as the most important factor for success in business creation of small firm. Accordingly, entrepreneur ability is the most important source for success in business creation of small firm. Third, strategy of small firm was found to be the important factor that affects the non-financial performance even if it could not give significant effects on financial performance. Thus, product service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy have significant effects on non - financial performance of small firm. Accordingly, it is required to operate small firm with strategic mind - set for small firm to achieve success. This study analyzed the effects of feature of founder and strategy of small firm on business performance of small firm through practical analysis on small firms in Daejeon and Chungnam area, and deduced meaningful results. However, Since this study collected data on small firms in Daejeon and Chungnam only, there is a limit in generalizing the results of this study to all small firms in Korea. Companies answering to this questionnaire process were mainly wholesale and retail service companies. In addition, there is a limit in that it failed to analyze feature of representative type of industry due to limit in number of sample, it is required to divide representative type of industry and to compare and analyze types of industry in future studies.

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