• Archives of Plastic Surgery
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• v.47 no.3
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• pp.223-227
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• 2020

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6-91 years). The average ISS was 22.01 points (range, 16-75 points). Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

• Archives of Plastic Surgery
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• v.47 no.4
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• pp.305-309
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• 2020

Breast cancer treatment-related lymphedema (BCRL) is a common comorbidity in breast cancer survivors. Although magnetic resonance imaging (MRI) is widely used to evaluate therapeutic response of patients with various medical conditions, it is not routinely used to evaluate lymphedema patients. We conducted a systematic review of the literature to identify studies on the use of MRI to evaluate therapy for BCRL. We hypothesized that MRI could provide information otherwise not possible through other examinations. On October 21, 2019, we conducted a systematic review on the PubMed/MEDLINE and Scopus databases, without time frame or language limitations, to identify studies on the use of MRI to evaluate therapy for BCRL. We excluded studies that investigated other applications of MRI, such as lymphedema diagnosis and surgical planning. Of 63 potential articles identified with the search, three case series fulfilled the eligibility criteria. In total, 53 patients with BCRL were included and quantitatively evaluated with MRI before and after manual lymphatic drainage. Authors used MRI or MR lymphagiography to investigate factors such as lymphatic vessel cross-sectional area, tissue water relaxation time (T₂), and chemical exchange saturation transfer. The only study that compared MRI measurement with standard examinations reported that MRI added information to the therapy evaluation. MRI seems to be a promising tool for quantitative measurement of therapeutic response in patients with BCRL. However, the identified studies focused on only manual lymphatic drainage and were limited by the small numbers of patients. More studies are necessary to shed light on the topic.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.354-359
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• 2012

Background During the planning of a thoracodorsal artery perforator (TDAP) free flap, preoperative multidetector-row computed tomographic (MDCT) angiography is valuable for predicting the locations of perforators. However, CT-based perforator mapping of the thoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thick MDCT images in multiple planes to search for reliable perforators accurately. Methods Between July 2010 and October 2011, 19 consecutive patients (13 males, 6 females) who underwent MDCT prior to TDAP free flap operations were enrolled in this study. Patients ranged in age from 10 to 75 years (mean, 39.3 years). MDCT images were acquired at a thickness of 1 mm in the axial, coronal, and sagittal planes. Results The thoracodorsal artery perforators were detected in all 19 cases. The reliable perforators originating from the descending branch were found in 14 cases, of which 6 had transverse branches. The former were well identified in the coronal view, and the latter in the axial view. The location of the most reliable perforators on MDCT images corresponded well with the surgical findings. Conclusions Though MDCT has been widely used in performing the abdominal perforator free flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap. The results of this study suggest that multiple planes of MDCT may increase the probability of detecting the most reliable perforators, along with decreasing the probability of missing available vessels.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.339-349
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• 2014

If the maxillomandibular relationship is unstable or requires treatment for improved function and esthetics, the first treatment objective is to provide stable occlusal contacts. The patient has moderate mental retardation. Due to inadequate vertical overjet, horizontal arch malrelation and excessive tooth loss, full mouth rehabilitation was required. The purpose of treatment planning is to establish physiologic maxillomandibular relation. Using cephalometrics for occlusal analysis is an aid to make a decision. The amount of horizontal bone reduction was calculated with evaluating soft tissue profile. After provisional denture placement, healing of the surgical site and newly adapted arch relationship was evaluated. The patient satisfied with esthetics and showed stable holding contacts. Periodic examination is needed to exclude occlusal disharmony.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.33.1-33.8
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• 2018

Objectives: This study aimed to investigate the prevalence of a separate distolingual root and to measure the thickness of the buccal cortical bone in mandibular first molars in Koreans using cone-beam computed tomography (CBCT) images. Materials and Methods: High-quality CBCT data from 432 patients were analyzed in this study. The prevalence of a separate distolingual root of the mandibular first molar was investigated. The distance from the distobuccal and distolingual root apices to the outer surface of the buccal cortical bone was measured. We also evaluated the thickness of the buccal cortical bone. Results: The prevalence of a separate distolingual root (2 separate distal roots with 1 canal in each root; 2R2C) was 23.26%. In mandibular first molars with 2R2C, the distance from the distobuccal root apex to the outer surface of the buccal cortical bone was 5.51 mm. Furthermore, the distance from the distolingual root apex to the outer surface of the buccal cortical bone was 12.09 mm. In mandibular first molars with 2R2C morphology, the thickness of the buccal cortical bone at the distobuccal root apex of the mandibular first molar was 3.30 mm. The buccal cortical bone at the distobuccal root apex was significantly thicker in the right side (3.38 mm) than the left side (3.09 mm) (p < 0.05). Conclusions: A separate distolingual root is not rare in mandibular first molars in the Korean population. Anatomic and morphologic knowledge of the mandibular first molar can be useful in treatment planning, including surgical endodontic treatment.

• Imaging Science in Dentistry
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• v.32 no.4
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• pp.207-211
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• 2002

Purpose : The purpose of this study was to determine the prevalence, radiographic appearance, and characteristics of patients with zygomatic air cell defect (ZACD), and to give recommendations concerning radiographic evaluation and surgery. Materials and Methods: Routine panoramic radiographs of 1,400 patients admitted to the Kyungpook National University Hospital Dental Clinic, were retrospectively examined for the clinical and radiographic features of ZACD. Results: ZACD was found in 31 cases, representing a prevalence of 2.2%. Patients with ZACD had a mean age of 27.5 years and a range of 9-52 years. Most ZACD cases were in their thirties. ZACD showed a strong male prediliction, 22 of the 31 subjects were males and 9 were females. Twenty-four cases of ZACD (77.4%) were unilateral, with the half occurring on the right side. In seven cases (22.6%), ZACD was bilateral. Twenty-six (68.4%) of the defects were of unilocular, while twelve (31.6%) of the defects were multilocular. Conclusion: Knowledge of ZACD may be helpful in interpreting images, including panoramic radiographs, in planning surgical treatment of the TMJ and in understanding the spread of pathological processes into the joint.

• Archives of Craniofacial Surgery
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• v.15 no.3
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• pp.117-120
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• 2014

Background: Lipomas can be categorized into deep and superficial lipomas according to anatomical depth. Many cases of forehead lipomas are reported to be deep to the muscle layer. We analyze ultrasound in delineating depth of forehead lipomas. Methods: A retrospective review was performed for all patients who underwent excision of forehead lipomas between January 2008 and March 2013 and for whom preoperative ultrasound study was available. Sensitivity and specificity of ultrasound imaging was evalauted against depth finding at the time of surgical excision. Results: The review identified 42 patients who met the inclusion criteria. Preoperative ultrasound reading was 18 as deep lipomas and 24 as superficial. However, intraoperative finding revealed 2 of the 18 deep lipomas to be superficial and 13 of the 24 superficial lipomas to be deep lipomas. Overall, ultrasonography turned out to be 69% (29/42) accurate in correctly delineating superficial versus deep lipomas. Conclusion: Lipomas of the forehead tend to be located in deeper tissue plane compared to lipomas found elsewhere in the body. Preoperative ultrasonography of lipomas can be helpful, but was not accurate in identifying the depth of forehead lipomas in our patient population. Even if a forehead lipoma is found to be superficial on ultrasound, operative planning should include the possibility of deep lipomas.

• Korean Institute of Interior Design Journal
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• v.17 no.2
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• pp.75-82
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• 2008

Weeks who is an architect in England suggest that let us consider the hospital architecture as not determined architecture but an undetermined architecture. Because it has been changing unexpectedly. The changing process of hospital architecture is required that it has to involve the new function and be a role model because of variations of environmental factors. For silving the requirements above mentioned, hospital architecture takes the way of appropriateness inner origin form and finally it considers new formation. The 53% of hospital buildings in Korea were built in 1980s. For 30years, these buildings have been not only extended a buildings but also changed in parts of functions and sizes on buildings which are original. The purpose of this study is producing the basic references which suggest solution to face on the changing of hospital building during planning it in the future using by analysis of variation inside the hospital building and grasping of characters in each departments. Each department is analyzed as follows. There is no inner change but only expansion partly by enlargement of building. In the outpatient, there is not only expansion by enlargement of building and but also extension toward other parts and the rate of variation of inside is high. In the diagnostic treatment, there are differences in diagnostic treatment. Surgical suit and diagnostic imaging have been expanded by enlargement than the change of inside. But the others of the departments have been changed by change of inside and also there are sometimes changes of inner walls.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.4.1-4.7
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• 2017

Background: This study is a quantitative evaluation of the influence of the mentolabial angle on perceived attractiveness and threshold values of desire for surgery. Methods: The mentolabial angle of an idealized silhouette male Caucasian profile image was altered incrementally between $84^{\circ}$ and $162^{\circ}$. Images were rated on a Likert scale by pretreatment orthognathic patients (n = 75), lay people (n = 75) and clinicians (n = 35). Results: A mentolabial angle of approximately $107^{\circ}$ to $118^{\circ}$ was deemed the most attractive, with a range of up to $140^{\circ}$ deemed acceptable. Angles above or below this range were perceived as unattractive, and anything outside the range of below $98^{\circ}$ or above $162^{\circ}$ was deemed very unattractive. A deep mentolabial angle ($84^{\circ}$) or an almost flat angle ($162^{\circ}$) was deemed the least attractive. In terms of threshold values of desire for surgery, for all groups, a threshold value of ${\geq}162^{\circ}$ and ${\leq}84^{\circ}$ indicated a preference for surgery, although clinicians were least likely to suggest surgery. The clinician group was the most consistent, and for many of the images, there was some variation in agreement between clinicians and lay people as to whether surgery is required. There was even more variability in the assessments for the patient group. Conclusions: It is recommended that in orthognathic and genioplasty planning, the range of normal variability of the mentolabial angle, in terms of observer acceptance, is taken into account as well as threshold values of desire for surgery. The importance of using patients as observers in attractiveness research is stressed.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.7-16
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• 1998

The Scanora/sup (R)/ X-ray unit uses the principles of narrow beam radiography and spiral tomography. Starting with a panoramic overview as a scout image. multiple tomographic projections could be selected. This study evaluated the accuracy of spiral tomography in comparison to routine panoramic radiography for dental implant treatment planning. An experimental study was performed on a cadaver mandible to assess the accuracy of panoramic radiography and spiral tomography film images for measurement of metallic spheres. After radiographic images of the metallic spheres on the surgical stent were measured and corrected for a fixed magnification of radiographic images. following results were obtained. 1. In the optimal position of the mandible. the minimal horizontal and vertical distortion was evident in the panoramic radiography images. The mean horizontal and vertical magnification error in anterior sites was 5.25％ and 0.75％. respectively. The mean horizontal and vertical magnification error in posterior sites was 0.50％ and 1.50％. respectively. 2. In the displaced forward or in an eccentric position of the mandible. the magnification error of the panoramic radiography images increased significantly over the optimal position. Overall, the mean horizontal magnification error of the anterior site in the different positions changed dramatically within a range of -17.25％ to 39.00％, compared to the posterior range of -5.25％ to 8.50％. However, the mean vertical magnification error stayed with the range of 0.5％ to 3.75％ for all the mandibular positions. 3. The magnification effects in the tomographic scans were nearly identical for the anterior and posterior with a range of 2.00％ to 5.75％ in the horizontal and 4.50％ to 5.50％ in the vertical dimension, respectively. 4. A statistically significant difference between the anterior and posterior measurements was found in the horizontal measurements of the panoramic radiography images of the displaced forward and backward position of the mandible(P<0.05). Also a significant difference between the optimal panoramic and tomographic projections was found only in the vertical measurement(P<0.05).