• Title/Summary/Keyword: timing closure

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SECONDARY CHEILORHINOPLASTY OF BILATERAL CLEFT LIP AND NOSE DEFORMITIES (양측성 구순 비변형 환자의 이차 구순비성형술)

  • Kim, Jong-Ryoul;Hwang, Dae-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.5
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    • pp.422-428
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    • 2007
  • The columella, nasal tip, lip relationship in the secondary bilateral cleft deformity remains an enigma and a great challenge for the cleft surgeon. A subset of patients with bilateral cleft lip still require columellar lengthening and nasal correction, despite the advances in preoperative orthopedics and primary nasal corrections. An approach to correct this deformity is described. This consists of 1) lengthening the columella, 2) open rhinoplasty, allowing definitive repositioning of lower lateral cartilages, ear cartilage grafting to the tip and columella when necessary, 3) nasal mucosal advancement, 4) alar base narrowing and 5) reconstruction of the orbicularis oris as required. In surgical repair of the cleft lip nose, the timing of the operation(during lip closure, before or after the puberty growth sput), and the operative technique play a key role in the final result. In this study, 13 cleft lip patients who had undergone a secondary cheilorhinoplasty at the Department of Oral and Maxillofacial Surgery, Pusan National University Hospital were evaluated to check the proper time and method of the operation.

An EMG Study of the Tense-lax Distinction Theory

  • Kim, Dae-Won
    • Speech Sciences
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    • v.1
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    • pp.7-26
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    • 1997
  • An electromyographic device was used to investigate the relationship between a linguistic hypothesis of tense-lax distinction and muscular activity. Muscle action potentials of the orbicularis oris muscle and the depressor anguli oris muscle were obtained from four subjects using CVCVCV and CVCVC words in English and VCV and CVC words in Korean. Findings: The hypothesis that the speaker may select at least one of muscles involved in the articulation of a phoneme so that the selected muscle could be activated for tense-lax distinction, and either a timing variable or an amplitude variablethe and/or both from the selected muscle distinguish(es) /p/ from /b/ in English and /$p^{h},\;p^{l}$/ from /p/ in Korean, with the English /p/ and the Korean /$p^{h},\;p^{l}$/ being tense, and the Korean unaspirated /p/ and the English /b/ lax, has been verified, except for the case with subject 2 in stressed syllables in English. (2) Thus, the linguistic hypothesis of tense-lax distinction was strongly supported by the muscular activities during the Korean bilabial stops, with /$p^{h}\;and\;p^{l}$/ being tense and /p/ lax. (3) Considering the intermuscle compensation and the interspeaker variabilities in the choice of a muscle or muscles, in English the usability of the feature 'tensity' appeared to be positive rather than negative although further investigations with more subjects remain to take on the muscles associated with the onset/offset of the labial closure, including the respiratory muscles related with the aspiration. The phoneme-sensitive EMG manifestations of stress and possible reasons for the interspeaker variabilities are discussed.

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20-Year Experience of Surgical Treatment for Postpneumonectomy Empyema (전폐절제술 후 사강에 발생한 농흉의 치료)

  • 김형렬;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.542-547
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    • 2002
  • Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

Alveolar ridge preservation using granulation tissue for esthetic implant restoration on maxillary anterior tooth (상악 전치부의 심미적 임플란트 수복을 위한 육아 조직(Granulation tissue)을 이용한 치조제 보존술)

  • Lee Chang Kyun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.16-22
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    • 2023
  • Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

Mathematical Modeling of the Novel Influenza A (H1N1) Virus and Evaluation of the Epidemic Response Strategies in the Republic of Korea (수학적 모델을 이용한 신종인플루엔자 환자 예측 및 대응 전략 평가)

  • Suh, Min-A;Lee, Jee-Hyun;Chi, Hye-Jin;Kim, Young-Keun;Kang, Dae-Yong;Hur, Nam-Wook;Ha, Kyung-Hwa;Lee, Dong-Han;Kim, Chang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.109-116
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    • 2010
  • Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

Occlusal Analysis in the Policemen with Temporomandibular Disorders Using T-scan II System (경찰 종사자의 측두하악장애환자에서 T-scan II System을 이용한 교합분석)

  • Lim, Hyun-Dae;Jung, Seung-Ah;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.365-373
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    • 2006
  • This study suggested correction of excessive mouth opening or maximum occlusal contact to analyse occlusal contact time, occlusal contact number and force through evaluation of occlusal pattern in policemen with temporomandibular disorders. The community of policemen influence on temporomandibular disorder's development and progress due to other condition of mouth opening and maximal occlusal contact. Repeated training or changes of usual life style may cause imbalance of stomatognathic system including the masticatory muscle, then develop or aggravate pain of temporomandibular joints and associated structures. This study uses T-scan II system(Tekscan Co., USA) for evaluation on occlusal pattern may influence temporomandibular disorders, and then the subjects take a sensor at 20 mm opening for maximal occlusal contact force. The policemen with temporomandibualr disorders get more long time on maximum contact timing, more short on end contact timing, and more force on end contact force than general society's. So they get closure of mouth with more short time and more force, then transfer remaining load to temporomandibular joint. There are no statistically significances between affected side and occlusal pattern of occlusal contact time and force. There are Left -right dental arch imbalances seems on Rt. dental arch if affected side is right and Lt. dental arch if affected side is left. In above results, It's worth due consideration that policemen with temporomandibular disorders get more smooth mandibualr movement and less force on maximal occlusal contact position.

Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases

  • Salvatori, Pietro;Mincione, Antonio;Rizzi, Lucio;Costantini, Fabrizio;Bianchi, Alessandro;Grecchi, Emma;Garagiola, Umberto;Grecchi, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.13.1-13.8
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    • 2017
  • Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

(U-Th)/He Dating: Principles and Applications ((U-Th)/He 연령측정법의 원리와 응용)

  • Min, Kyoung-Won
    • The Journal of the Petrological Society of Korea
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    • v.23 no.3
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    • pp.239-247
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    • 2014
  • The (U-Th)/He dating utilizes the production of alpha particles ($^4He$ atoms) during natural radioactive decays of $^{238}U$, $^{235}U$ and $^{232}Th$. (U-Th)/He age can be determined from the abundances of the parent nuclides $^{238}U$, $^{235}U$ and $^{232}Th$ and the radiogenic $^4He$. Because helium is one of the noble gases (non-reactive) with a relatively small radius, it diffuses rapidly in many geological materials, even at low temperatures. Therefore, ingrowth of $^4He$ during radioactive decay competes with diffusive loss at elevated temperatures during the geologic time scale, determining the amount of $^4He$ existing today in natural samples. For example, He diffusion in apatite is known to be very rapid compared to that in most other minerals, causing a significant diffusive loss at ${\sim}80^{\circ}C$ or higher. At ${\sim}40^{\circ}C$, He diffusion in apatite becomes slow enough to preserve most $^4He$ in the sample. Thus, an apatite's (U-Th)/He age represents the timing when the sample passed through the temperature range of $80-40^{\circ}C$. The crustal depth corresponding to this temperature range is called a "partial retention zone." Normal closure temperatures for a typical grain size and cooling rate are ${\sim}60-70^{\circ}C$ for apatite and ${\sim}200^{\circ}C$ for zircon and titanite. Because the apatite He closure temperature is lower than that of most other thermochronometers, it can provide critical constraints on relatively recent or shallow-crustal exhumation histories.

CLEIDOCRANIAL DYSPLASIA : REPORT OF A CASE (쇄골두개 이형성증 환자에 관한 증례보고)

  • Lee, Yeon-Ho;Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.703-708
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    • 2005
  • Cleidocranial Dysplasia(CCD) is a congenital disorder of skeletal and dental anomaly with an autosomal dominant mode of inheritance. CCD Shows a generalized defect in intramembranous bones, such as the skull, clavicles, and endochondral bones, such as the long bones and the remainder of the skeleton. The specific clinical feature of CCD is an aplasia & hypoplasia of one or both clavicles, frontal & parietal bone bossing, incomplete fontanels and sutures closure of cranial bone. Generally, relative mandibular prognathism is seen, because maxillar is underdeveloped. Dental anomalies of CCD are prolonged primary teeth, delayed eruption of the permanent teeth and multiple supernumerary teeth. Almost patients of CCD can not recognize their dental abnormality until the permanent teeth eruption was begining. So it is difficult to decide the proper timing of the treatment of patients of CCD. Pedodontists should understand the development of the dentition in CCD patient and start the treatment of CCD patient in proper time.

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Aoric Valve Lesion in Type I Ventricular Septal Defect (제1형 심실중격결손에서 대동맥판막 병변)

  • 김관창;임홍국;김웅한;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.492-498
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    • 2004
  • Background: In this study, we investigated the risk factors for the development or progression of aortic regurgitation(AR) in patients with type I ventricular septal defect (VSD) to determine the optimal surgical timing and strategy. Material and Method: Three-hundred and ten patients with type I VSD with or without AR were included. The mean of age was 73.7$\pm$114.7 (1-737) months. One hundred and eighty six patients (60%) had no AR, 83 (27%) had mild AR, 25 (8%) had moderate AR and 16 (5%) had severe AR. Aortic valve was repaired in 5 patients and replaced in 11 patients with closure of VSD in the first operation. Four patients required redo aortic valve repair and 11 patients required redo aortic valve replacement. Age at operation, association with aortic valve prolapse, Qp/Qs, systolic pulmonary arterial pressure, VSD size and systolic pulmonary artery to aortic pressure ratio(s[PAP/AP]) were included as risk factors analysis for the development of AR. The long-term result of aortic valve repair and aortic valve replacement were compared. Result: Older age at operation, association with aortic valve prolapse, high Qp/Qs, and s[PAP/AP] were identified as risk factors for the development of AR (p<0.05, Table 2). The older the patient at the time of operation, the higher the severity of preoperative AR and the incidence of postoperative AR (p<0.05, Table 1, Fig. 1). For the older patients at operation, aortic valve repair had higher occurrence of AR compared to those who had aortic valve replacement (p<0.05, Fig. 2). Conclusion: From the result of this study, we can concluded that early primary repair is recommended to decrease the progression of AR. Aortic valve repair is not always a satisfactory option to correct the aortic valve pathology, which may suggest that aortic valve replacement should be considered when indicated.