Cleft palate is one of the most devastating congenital facial deformities frequently accompanied by cleft lip. In many cases, it causes phonetic and swallowing difficulties although surgical interventionwas applied. Among the surgical methods, Veau-Wardill-Kilner pushback palatoplasty (V-Y reposition) is widely used in the most cleft palate cases. It is designed to lengthen the palate posteriorly, hence to overcome the speech and swallowing problems, but broad postoperative palatal scar might interfere the normal maxillary growth. If the velar muscles were not reoriented, it could result in incomplete speech recovery. In this case report, the modified two-flap palatoplasty with minimal pushback was successfully applied to a 21 month-old girl who has had incomplete cleft palate extended to the posterior third of hard palate. The speech evaluation was confirmed as functional reconstruction of cleft palate was achieved.
The purposes of this study were 1) to understand customers' expectations and satisfaction on menus in family restaurants, 2) to compare customer satisfaction and brand image for positioning new menus, and 3) to analyze customer satisfaction and loyalty to each menu. From May 8th to 28th, 2004, a total of 3,594 membership customers responded to the email survey. Statistical analyses such as t-test, ANOVA and Pearson Correlation were performed using SPSS 12.0. The results of this study consist of four major parts: general findings, customer expectation analysis, new menu positioning and customer satisfaction analysis. The customer expectation analysis discovered that taste was the most expected attribute in menus of family restaurants, followed by quantity, appearance and price. Statistically different expectations existed among different customer groups categorized by their general characteristics including demographics. Also, high correlations existed among the expectations over all the attributes: food quality, shape, quantity and price of food. Over all the attributes, customer expectation was higher than customer satisfaction. Thus, a discrepancy existed between expectation and satisfaction. Positioning of new menus was determined by brand image and customer satisfaction. Lastly, the customer satisfaction analysis revealed that customers in different gender and age have different satisfaction. In addition, high correlation existed between satisfaction and loyalty on new menus of a family restaurant. In consequence, the research findings suggest managers should understand customer expectation and satisfaction and reposition their menus regularly by menu engineering.
Park, Jung-Eun;Bae, Seon-Hye;Choi, Young-Jun;Choi, Won-Cheul;Kim, Hye-Won;Lee, Ui-Lyong
Maxillofacial Plastic and Reconstructive Surgery
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v.39
/
pp.22.1-22.9
/
2017
Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.5
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pp.499-503
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2007
Introduction: In orthognathic surgery, internal fixation has been usually done with titanium plates and screws. Recently, Biodegradable plates and screws have been frequently used but the reports of long term results of postoperative stability are rare, especially after maxillary reposition in orthognathic surgery. Objective: In order to clarify the clinical utility of self-reinforced bioresorbable poly-70L/30DL-Lactide miniplates & screws in maxillary fixation after LeFort I osteotomy, this study examined the postsurgical changes in maxilla and complications of biodegradable plates and screws. Study design: Nineteen patients who had undergone maxillary internal fixation using biodegradable plates and screws were evaluated radiographically and clinically. A comparison study of the changes in maxilla position after surgery in all 19 patients was performed with 1-week, 1-month, 3-months, 6-months and/or 1-year postoperative lateral cephalograms by tracing. Complication of the biodegradable plates and screws was evaluated by follow-up roentgenograms and clinical observation. And one-way ANOVA test was used for statistical analysis. Results: The position of the maxillary bone was stable after surgery and was not changed significantly from 1 week to 1 year after operation. And we could not find any complication of biodegradable plates and screws. Conclusions: Internal fixation of the maxilla after LeFort I osteotomy using self-reinforced biodegradable plates and screws is a reliable method for maintaining postoperative position of the maxilla after LeFort I osteotomy.
This study conducted a network meta-analysis to compare the effectiveness and ranking of pressure ulcer preventive programs in intensive care units. A frequency network meta-analysis was performed to identify evidence from relevant randomized control trials. A total of 10 randomized control trials involving 5 intervention subgroups were included in this study. Based on the ranking probabilities(P-Score), preventive materials was ranked as the most effective among all programs (P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49). Next was silicone foam dressing(P-Score 84.5%: OR=0.14, 95% CI: 0.05, 0.38), care bundle(P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), reposition (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) and synthetic fabrics (P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65). It is necessary to develop practical and efficient interventions that can prevent pressure ulcers in intensive care unit patients, improve patient safety, and reduce nurses' workload.
Kim, Tae-Hoon;Cho, Min-Jeng;Park, Jeong-Jun;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
Advances in pediatric surgery
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v.17
no.2
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pp.133-138
/
2011
Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.
Books in libraries can be highly refined information. Google invests digitization of books in libraries. But the digitization of books that has a variety of interests, coupled with several problems, including class action, in addition the many critical discussions are underway. Korea pushed the national digitization projects, what are libraries' digitizing their collection of many books. Of course, in publishing and digitization of the target is limited to books published ahead of Google. However, the Library Act was amended for the reposition of online materials, but only in the ways that Google's case is different. Library Act permits collection of online resources through the library to allow, the legislation can be considered as leading act. However, online data is publicly not available through the Internet, so this service hae limited means and range unlike Google. This paper, the digitization of books in the library due to copyright, examines the legal issues looking for the desirable solution. Physical library's main role had been kept the book, but we use the book in terms of policies needed to consider. To overcome these limitations of Copyright Act, this paper researches the relation of Google Book Search in our Copyright Act, and considers introduction as the fair use doctrine and the digital repository system.
Journal of the Korean Society of Physical Medicine
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v.3
no.2
/
pp.63-74
/
2008
Purpose : The purpose of this study was to compare trunk repositioning errors between subjects with and without low back pain in sitting and standing. Methods : Total 81 participants were recruited who consisted of 41 subjects with low back pain and 40 normal subjects. The subjects were instructed to replicate the predetermined target positions of the trunk toward upright and $30^{\circ}$ flexion in sitting and standing. During each of movement, digital inclinometer was used to measure the angular movement of $T_{12}$ spinal process. Repositioning error was calculated as the absolute difference between the predetermined target positions and replicated target positions. Results : In subjects with low back pain, upright repositioning error was $1.26^{\circ}{\pm}0.14^{\circ}$ in sitting and $1.55^{\circ}{\pm}0.24^{\circ}$ in standing, and $30^{\circ}$ flexion repositioning error was $3.23^{\circ}{\pm}0.33^{\circ}$ in sitting and $5.50^{\circ}{\pm}0.50^{\circ}$ in standing. In subjects without low back pain, upright repositioning error was $1.38^{\circ}{\pm}0.15^{\circ}$ in sitting and $1.67^{\circ}{\pm}0.18^{\circ}$ in standing, and flexion repositioning error was $2.61^{\circ}{\pm}0.28^{\circ}$ in sitting and $3.70^{\circ}{\pm}0.52^{\circ}$ in standing. It was demonstrated that flexion repositioning error increased significantly in standing position. In subjects with low back pain, $30^{\circ}$ flexion repositioning error was significantly higher in standing than in sitting. Conclusion : The repositioning error of subjects with low back pain increased during flexion and it implies that some aspects of proprioception are decreased in subjects with low back pain. Therefore, it will be emphasis that a clinical trial to increase the trunk flexion stability of subjects with low back pain in standing.
Kim, Yong-Ha;Kim, Sung-Ho;Seul, Jeung-Hyun;Lee, Kyung-Ho
Journal of Yeungnam Medical Science
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v.13
no.1
/
pp.22-31
/
1996
It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.
Journal of the Korean Society of Marine Environment & Safety
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v.17
no.1
/
pp.61-68
/
2011
The "ship's routeing" system was adopted by IMO and has been operated on the major sea routes of all over the world for the prevention of marine casualty and the improvement of marine traffic flow. Thereupon, also in Korea, the "Hong-do" and "Bogil-do" sea routes on southern coast were designated to mandatory sea area by traffic separation scheme(TSS) in 2003, and the "Geomun-do" sea route on southern coast was designated in 2005. But there were few or no studies on the effect of designated traffic separation scheme in Korea. For this reason, in this paper, we evaluated the contribution of traffic separation scheme to the prevention of marine casualty and the improvement of marine traffic flow after designation of domestic traffic separation scheme using data of the marine casualties and ship's tracks from AIS information. The results of evaluation showed that on the contrary, the cases of marine casualties were increased on some sea routes and regular traffic flows were disturbed by some vessels after designation of traffic separation scheme. For the safer and better sea routes, alternative ideas such as reposition of ship's routing on "Hong-do" and "Bogil-do" sea areas were suggested.
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