• Title/Summary/Keyword: repositioning

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The effects of performance, legitimacy, and reference group on strategic positional change - Evidence from North American Crude Petroleum and Natural Gas Industry - (성과 피드백, 정당성, 그리고 준거집단 성과가 리포지셔닝에 미치는 영향 - 북미 원유 및 천연가스 산업 분석을 중심으로 -)

  • Choi, Sung-Ho
    • Management & Information Systems Review
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    • v.36 no.3
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    • pp.17-35
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    • 2017
  • This study investigates the determinants of strategic positional change. Specifically, the study suggests performance feedback affects to a firm's strategic repositioning. Performance feedback is a concept that a firm decides whether success or not by comparing its performance relative to its aspiration level. Prior studies successively discover diverse behaviors. The study suggests three unexplored relationships between performance gaps and strategic positioning. First, when a firm's performance is below relative to its aspiration level, that firm's strategic position will be deviate from the industry norm. Second, as the degree of industrial density increases, the tendency that a firm's strategic position becomes deviate from the industry norm decreases. Third, when the degree of reference group's performance decreases, the tendency that a firm's strategic position becomes deviate from the industry norm decreases. For empirical analysis, this study examines data of 538 firms that in North America crude petroleum and natural gas industry. The result reveals that the direction of a firm's strategic change is shaped when firms' performance is below relative to aspiration level. Also, this relationship is moderated as industrial density changes or when reference groups' performance decreases. This study contributes to the current literature by explaining how a firms' strategic position is decided. Also, this study reveals that reference groups' performance could affect to organizational choice.

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Development of A Fractionated Stereotactic Radiotherapy System (분할 정위방사선 치료 시스템 개발 연구)

  • 이동한;지영훈;이동훈;조철구;김미숙;유형준;류성렬
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.9-14
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    • 2002
  • We invented the newly developed Fractionated Stereotactic Radiotherapy(F.S.R.T) system using combined techniques of couch mounting and pedestal mounting system. Head fixation frame consists of a milled alluminium alloy(duralumin) and is placed to the couch. This frame immobilized patient head using the dental bite, 3.2 mm frontal and occipital thermoplastic mask. To evaluate the coordinate of target isocenter, Brown-Revert-Walls C.T localizer can be attached to this frame. And also, we developed the frame mounting system by developing the modification of pedestal mounting system. This system is fixed to couch floor and can be used to evaluate the isocenteric accuracy of gantry, couch and collimator in Q.A procedure. In order to measure the relocation accuracy, the acrylic phantom and the accurate pointers have been made. The repositioning of the targets in the phantom were estimated by comparing C.T coordinates and E.C.L portal films taken with anterior-posterior and right-left direction. From the results of experiments, the average distance errors between the target isocenter and its mean position were 0.71$\pm$0.19 for lateral, 0.45$\pm$0.15 for inferior-superior, 0.63$\pm$0.18 for anterior-posterior. And the maximum distance error was less than 1.3 mm. The new head fixation frame and frame mounting system were non-invasive, accurately relocatable, easy to use, very light and well tolerable by the results of phantom tests. The major advantage of using this frame mounting system is complete access to any point in the Patients cranium especially posterior direction

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Evaluation of Real-time Target Positioning Accuracy in Spinal Radiosurgery (척추방사선수술시 실시간 추적검사에 의한 병소목표점 위치변이 평가)

  • Lee, Dong Joon
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.290-294
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    • 2013
  • Stereotactic Radiosurgery require high accuracy and precision of patient positioning and target localization. We evaluate the real time positioning accuracy of isocenter using optic guided patient positioning system, ExacTrac (BrainLab, Germany), during spinal radiosurgery procedure. The system is based on real time detect multiple body markers attached on the selected patient skin landmarks. And a custom designed patient positioning verification tool (PPVT) was used to check the patient alignment and correct the patient repositioning before radiosurgery. In this study, We investigate the selected 8 metastatic spinal tumor cases. All type of tumors commonly closed to thoracic spinal code. To evaluate the isocenter positioning, real time patient alignment and positioning monitoring was carried out for comparing the current 3-dimensional position of markers with those of an initial reference positions. For a selected patient case, we have check the isocenter positioning per every 20 millisecond for 45 seconds during spinal radiosurgery. In this study, real time average isocenter positioning translation were $0.07{\pm}0.17$ mm, $0.11{\pm}0.18$ mm, $0.13{\pm}0.26$ mm, and $0.20{\pm}0.37$ mm in the x (lateral), y (longitudinal), z (vertical) directions and mean spatial error, respectively. And body rotations were $0.14{\pm}0.07^{\circ}$, $0.11{\pm}0.07^{\circ}$, $0.03{\pm}0.04^{\circ}$ in longitudinal, lateral, table directions and mean body rotation $0.20{\pm}0.11^{\circ}$, respectively. In this study, the maximum mean deviation of real time isocenter positioning translation during spinal radiosurgery was acceptable accuracy clinically.

A STUDY ON ACCURACY OF MAXILLARY REPOSITIONING BY EXTERNAL MEASURING TECHIQUE (외부계측법에 의한 상악골 이동의 위치적 정확도에 대한 평가 연구)

  • Park, Hyung-Sik;Cha, In-Ho;Park, Hyung-Rae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.44-52
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    • 1991
  • Internal measurement technique has been commonly and classically used to guide down-fractured maxilla by Le Fort I osteotomy into its new position during intraoperative procedure for correlating preoperative model works with surgery. However, It has been challenged now by several authors due to some problems as its inaccuracy in three-dimensional changes at surgery, difficulty to measure during surgery and impossibility of rechecking at the end of surgery etc. The purpose of this study was to evaluate the accuracy of maxillary movement by external measuring technique and to determine its accuracy between the prediction tracing and a new maxillary position. The results indicate that the external measuring technique was predictable in the vertical, horizontal and transverse change of the maxilla as its prediction, however, it has a tendency to shift the maxilla more anterior and inferior in overall direction than prediction. Post-operative canting difference were mimic, however Ehange of the maxillary dental midline was large and had a right-shifting tendency.1 The precise methods to keep maxillary dental midline as same as prediction and the avoidance of uneven force applied to the mandible for autorotation should be necessary during surgery in use of external measurement technique.

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Occlusal Adjustment and Prosthodontic Reconstruction on the Open-bite Patient. - Intentional Decrease of Occlusal Vertical Dimension - (자연치 교합조정에 의한 전치, 구치 개교합의 보철적 수복 - 수직고경의 의도적 감소증례)

  • Lee, Seung-Kyu;Kwon, Kung-Rock;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.133-147
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    • 2000
  • A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

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Correction of Retracted Ala Using Spacer Graft in Secondary Cleft Lip and Nose Deformity (이차 구순비 변형 환자에서 Spacer Graft를 이용한 콧방울뒤당김(retracted ala)의 교정)

  • Han, Kyu-Seok;Choi, Hyun-Gon;Shin, Dong-Hyeok;Kim, Soon-Heum;Hwang, Eun-A;Uhm, Ki-Il
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.376-382
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    • 2011
  • Purpose: In patients with unilateral cleft lip and nose deformity, alar retraction is commonly seen on the non-cleft side after cleft side is corrected. Spacer graft was used to drag down the inferior border of the alar cartilage of the non-cleft side so as to match the cleft side. By performing spacer graft and septal extension graft together, symmetry and cosmetic improvements were achieved. Methods: Seven unilateral cleft lip and nose deformity patients underwent surgery for alar retraction correction. The median age was 24 years (ranged from 15 to 34 years), and the median follow-up period was 7.4 months (ranged from 6 to 12 months). The perpendicular length from the longitudinal axis of the nostril to the alar rim, the nasolabial angle and the ala-labial angle were measured in the lateral view photo. The longest perpendicular length from the cephalic border of the alar rim to the parallel line of the alar base was measured in the frontal view photo. Results: Improvement in alar retraction was seen after the surgery. There were no specific complications during the follow-up and the symmetry of both nostrils was satisfactory. No increase in the nasolabial angle or exposure of the nostrils was seen after the tip projection via tip plasty. Conclusion: The fundamental factor in correcting alar retraction with secondary cleft lip and nose deformity is repositioning the alar rim with spacer graft, which seems to be more physiologic than other methods. The method combining spacer graft with septal extension graft will bring symmetry as well as more cosmetic improvement in correction of alar retraction with secondary cleft lip and nose deformity.

Dasatinib Inhibits Lyn and Fyn Src-Family Kinases in Mast Cells to Suppress Type I Hypersensitivity in Mice

  • Lee, Dajeong;Park, Young Hwan;Lee, Ji Eon;Kim, Hyuk Soon;Min, Keun Young;Jo, Min Geun;Kim, Hyung Sik;Choi, Wahn Soo;Kim, Young Mi
    • Biomolecules & Therapeutics
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    • v.28 no.5
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    • pp.456-464
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    • 2020
  • Mast cells (MCs) are systemically distributed and secrete several allergic mediators such as histamine and leukotrienes to cause type I hypersensitivity. Dasatinib is a type of anti-cancer agent and it has also been reported to inhibit human basophils. However, dasatinib has not been reported for its inhibitory effects on MCs or type I hypersensitivity in mice. In this study, we examined the inhibitory effect of dasatinib on MCs and MC-mediated allergic response in vitro and in vivo. In vitro, dasatinib inhibited the degranulation of MCs by antigen stimulation in a dose-dependent manner (IC50, ~34 nM for RBL-2H3 cells; ~52 nM for BMMCs) without any cytotoxicity. It also suppressed the secretion of inflammatory cytokines IL-4 and TNF-α by antigen stimulation. Furthermore, dasatinib inhibited MC-mediated passive cutaneous anaphylaxis (PCA) in mice (ED50, ~29 mg/kg). Notably, dasatinib significantly suppressed the degranulation of MCs in the ear tissue. As the mechanism of its effect, dasatinib inhibited the activation of Syk and Syk-mediated downstream signaling proteins, LAT, PLCγ1, and three typical MAP kinases (Erk1/2, JNK, and p38), which are essential for the activation of MCs. Interestingly, in vitro tyrosine kinase assay, dasatinib directly inhibited the activities of Lyn and Fyn, the upstream tyrosine kinases of Syk in MCs. Taken together, dasatinib suppresses MCs and PCA in vitro and in vivo through the inhibition of Lyn and Fyn Src-family kinases. Therefore, we suggest the possibility of repositioning the anti-cancer drug dasatinib as a treatment for various MC-mediated type I hypersensitive diseases.

Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

  • Lee, Bu-Kyu;Hong, Jun Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.14.1-14.11
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    • 2020
  • Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

Intrusion of the extruded maxillary central incisor using skeletal anchorage system and unilateral segmental intrusion arch (골성 고정원과 편측 분절호선을 이용한 정출된 상악 중절치의 압하 치료)

  • Kwon, Eun-Young;Baek, Young-Jae;Park, Soo-Byung;Kim, Seong-sik;Kim, Yong-il;Choi, Youn-kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.180-190
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    • 2019
  • Patients who have a moderate periodontitis with pathologic tooth migration of maxillary incisors, it is necessary not only periodontal treatment for reduce periodontal inflammation, but also orthodontic treatment to teeth repositioning. For orthodontic treatment, it is necessary to apply less force and careful considerations of the center of resistance of the tooth and optimal force of tooth movement. At this time, the segmental arch applied only to the target teeth, is more effective and predictable, because applied force and direction can be controlled. In addition, to design the orthodontic appliance that can prevent the unwanted tooth movement that used as an anchorage is important. In recent years, various types of skeletal anchorage system have been used for preventing loss of the anchorage. We reported the patient who had extruded maxillary central incisor due to pathologic tooth migration, treated by a successful periodontal-orthodontic multidisciplinary treatment using an orthodontic appliance designed to apply less traumatic force and reduce an anchorage loss.

Digital workflow for prosthetic restoration in the pan facial fracture patient: A case report (다발성 안면 골절 환자의 보철 수복을 위한 디지털 워크플로우: 증례보고)

  • Kim, Seung-Wan;Park, Geun-Taek;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra;Ko, Kyung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.395-403
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    • 2022
  • In the fracture operation of pan facial fracture, there are many cases where the shape and position of the occlusal and oral structures are abnormally changed because the index for repositioning to the original position is insufficient. And trismus and gag reflex in patients with pan facial fractures increase the difficulty of dental treatment, and the difference in the position of the jaw bone makes it difficult to restore aesthetically and functionally. In this case, digital workflows for minimal intraoral work could be selected to reduce patient discomfort and the difficulty of dental treatment. This case is using a digital workflow from implant planning to final prosthesis production in a patient with acquired skeletal grade III, trismus, and gag reflex due to pan facial fracture 15 years ago. In this case report, the use of digital workflow in a patient who has difficulty in dental treatment was able to minimize patient discomfort and obtain esthetic and functionally appropriate results.