Big Data Statistical Analysis of Facial Fractures in Korea.

BACKGROUND: The big data provided by Health Insurance Review and Assessment (HIRA) contains data from nearly all Korean populations enrolled in the National Health Insurance Service. We aimed to identify the incidence of facial fractures and its trends in Korea using this big data from HIRA. METHODS: We used the Korean Standard Classification of Disease and Cause of Death 6, 7 for diagnosis codes. A total of 582,318 patients were included in the final analysis. All statistical analyses were performed using SAS software and SPSS software. RESULTS: The incidence of facial fractures consistently declined, from 107,695 cases in 2011 to 87,306 cases in 2016. The incidence of facial fractures was the highest in June 2011 (n = 26,423) and lowest in January 2014 (n = 10,282). Nasal bone fractures were the most common, followed by orbit and frontal sinus fractures. The percentage of nasal bone fractures declined, whereas those of orbital fractures increased from 2011 to 2016 (P < 0.001). Among orbital fractures, inferior wall fractures were the most common, followed by medial wall fractures. Among mandibular fractures, angle fractures were the most common, followed by condylar process and symphysis fractures. Although it was difficult to predict the most common type of zygomatic and maxilla fractures, their incidence consistently declined since 2011. CONCLUSION: We observed trends in facial fractures in Korea using big data including information for nearly all nations in Korea. Therefore, it is possible to predict the incidence of facial fractures. This study is meaningful in that it is the first study that investigated the incidence of facial fractures by specific type.

Clinical Outcomes Between Atrophic and Nonatrophic Mandibular Fracture in Elderly Patients.

The number of elderly patients with mandibular fracture is rapidly increasing. To improve outcome, it is important to understand the age-related characteristics of mandibular fracture. Thus, the aim of this study is to analyze the impact of atrophic change on mandibular fracture in elderly patients. The retrospective study was conducted in patients aged ≥65 years old, who underwent surgery for the treatment of mandibular fracture in our hospital from March 2006 until March 2015. Patient characteristics, such as age and gender, causes of injury, anatomic location of fracture, height of mandibular body, extent of atrophy, location of surgical sites, postoperative outcomes, and the follow-up period, were examined. Descriptive statistics were compared between atrophic and nonatrophic mandibles. The patients included 17 males and 12 females and the mean age was 71.9 years old. The average follow-up period was 6.06 months. Regarding occlusion and complications, there were no statistical differences between the atrophic and nonatrophic mandibular fractures. As major complications, nonunion occurred in 2 patients and malunion in 1 patient. There was no mortality associated with anesthesia or surgery. Atrophic and nonatrophic mandibular fractures in elderly patients can be treated successfully with surgery. There was no significant difference with respect to major complications between patients with atrophic and nonatrophic mandibular fractures.

Simvastatin Reduces Capsular Fibrosis around Silicone Implants.

Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 µm in the simvastatin group and 491.2 µm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P < 0.001). Connective tissue growth factor (CTGF) and transforming growth factor (TGF)-ß1 gene expression decreased significantly in the simvastatin group compared to the control group (P < 0.001). This study shows that simvastatin reduces radiation-induced capsular fibrosis around silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction.

Study on image processing of panoramic X-ray using deviation improvement software.

Utilization of panoramic X-ray device is getting wider. Panoramic X-ray has low resolution than general X-ray device and it occurs to distortion by deviation of image synthesis. Due to structural problems, it has been used restrictively to identify of tooth structure, not for whole head. Therefore, it designed and produced panoramic X-ray device which is possible to diagnostic coverage can be extended and had to be adjusted interval control between X-ray generator and image processing for whole of Maxillofacia's diagnosis. Produced panoramic X-ray device is composed basically of short image synthesis. In addition, it was confirmed the results by used the device which was applied deviation of the brightness of the image, filter to improve the location of the deviation and interpolation method. In this study, it was used 13 images including the front. It occurs to brightness deviation, position deviation, and geometric correction when synthesis of image, but it had been solved by deviation improvement software and a change of CCD camera's scan line which is used for image acquisition. Therefore, it confirmed expansion possibility of utilization range to commonly used panoramic X-ray device.

A novel dermal delivery system using natural spicules for cosmetics and therapeutics.

BACKGROUND: Dermal delivery is versatile in therapeutics as well as cosmetics in pursuit of enhancing safety/efficacy and alleviating pain/fear to alternate oral/injective administrations. Natural siliceous spicules offer a potential approach via simple topical medications to circumvent poor penetrations through the skin barrier by loading, carrying, and releasing the active ingredients in a highly efficient and controlled manner. AIMS: The delivery of ingredients loaded on spicules is assessed to improve the dermal efficacy compared to simple topical treatments. METHODS: First, needle-like spicules were isolated from natural freshwater sponges. Then, the active ingredient was loaded via liposome formations. Finally, the dermal efficiency was evaluated. RESULTS: Natural siliceous spicules were purified, sorted, and fully characterized to appear 250 µm of length and 12 µm of diameter on average. A model ingredient, pectolinarin, was efficiently loaded onto the internal space of spicules via lecithin-based liposome formations. The penetration was visualized using a porcine skin sample with a fluorescent dye and assessed quantitatively by a Franz diffusion cell system. Dermal absorption rate was measured 73.4%, while the percutaneous penetration rate was 2.2%. The release pattern turned out a simple diffusion analyzed by Fick's law and Higuchi model. The liposomes loaded onto spicules were further stabilized by a hydrophobic capsulation, which may benefit the overall efficacy of the ingredient. CONCLUSION: A novel dermal delivery system is beneficial to improve the topical efficacy of biologically active ingredients. The outcomes shed a light upon developing skin-protective/improving cosmetics and therapeutics with enhanced performance.

Cumulative frequency distribution in East Asian facial widths using the facial golden mask.

INTRODUCTION: Many studies have been published on the clinical importance and attractiveness of a face. On the other hand, Asian faces give an impression that is not polished owing to their pronounced cheekbone and mandible. There have already been many studies in progress pertaining to measurements and analyses of Asian facial structure; however, the authors would like to contribute to such research by providing practical analytical data and distributional patterns of the widths of their faces showing how wide their faces are. MATERIALS AND METHODS: The facial golden mask was applied to 1000 facial photographs of Korean college students, of whom 500 were males and 500 were females.The horizontal ratios (HR) of the mid- and lower faces of each student were calculated against the facial golden mask. The results were divided into 3 groups according the degrees of the HR for further analyses: group 1 (HR = 1.0), group 2 (HR > 1.0), and group 3 (HR < 1.0). RESULTS: We obtained an S-shaped cumulative frequency distribution graph for young Koreans per sex, per midface, and per lower face. The graph is dense at the center and is shifted to the right, signifying that the Koreans' midfaces and lower faces are wider than that of the facial golden mask. CONCLUSIONS: Conclusion reached in this study is that the faces of Koreans are wider than those of the facial golden mask as commonly perceived; thus, it is expected that graphs for the cumulative frequency of the distribution will be used extensively in the future.

Inlay implanting technique for the correction of medial orbital wall fracture.

BACKGROUND: For blowout fractures of the medial orbital wall, the goals of treatment are complete reduction of the herniated soft tissue and anatomical restoration of the orbital wall without surgical complications. Surgeons frequently worry about damage to the optic nerve caused by dissection when the part over the posterior ethmoidal foramen is fractured. The authors performed small incision and inlay implantation of porous polyethylene for reconstruction of medial orbital wall fractures. METHODS: Between January of 2007 and December of 2009, 55 patients were included in an analysis of the outcome of corrected medial orbital wall fractures. For 55 patients with posterior comminuted fractures of the medial orbital wall, insertion of porous polyethylene into the ethmoid sinus was performed in multiple layers, through the transconjunctival approach. RESULTS: In all cases, the orbital cavity was restored to its normal anatomical shape. The associated ocular problems disappeared except for mild enophthalmos in three patients and diplopia in one patient. There were no serious surgical complications associated with inlay implantation. CONCLUSIONS: The advantages of the inlay technique include the anatomical reconstruction of the orbital wall, the avoidance of optic nerve injury, the simplicity of the procedure, and consequently the absence of surgery-related complications. This technique is presented as one of the preferred treatments for posterior comminuted fractures of the medial orbital wall.

Serious complication of cement augmentation for damaged pilot hole.

Polymethl methacrylate (PMMA) screw reinforcement is frequently used in osteoporotic bone as well as in damaged pilot holes. However, PMMA use can be dangerous, since the amount of applied cement is uncontrolled. A 47-year-old male with traumatic cervical spondylolisthesis at C6-7 underwent anterior cervical plate fixation. During repeated drilling and tapping for false trajectory correction, a pilot hole was damaged. Although it was an unconventional method, PMMA augmentation was tried. However, PMMA was accidentally injected to the cervical spinal cord owing to lack of fluoroscopic guidance. The PMMA was surgically removed after corpectomy and durotomy. The patient had left side hemiparesis (Grade 2/5) immediately post operation. The patient improved spontaneously (Grade 4/5) except for 4th and 5th digit extension. Here, we report a rare complication of PMMA extrusion in the spinal cord during a damaged pilot hole injection, which has not previously been described.