Osteotomy

https://www2.aofoundation.org/wps/portal/surgerymobile?contentUrl=/srg/95b/05-RedFix/P370-SurgAssRapPalExp/04_Osteotomy.jsp&soloState=precomp&title=&Language=en

A periosteal elevator is inserted between the nasal mucosa and the lateral wall of the nose on one side. A curved retractor is inserted behind the maxillary tuberosity. A further instrument is used to retract upwards the lip and mucoperiosteal flap, exposing the lateral maxilla.
Horizontal osteotomies


The horizontal osteotomy is usually made at the level of the nasal floor, a safe distance (~5 mm) from the apices of the teeth.
Posterior and vertical osteotomies


A curved pterygoid chisel is placed with the curvature pointing medially and inferiorly between the tuberosity and the pterygoid plates.

A mallet is used to drive the osteotome medially to complete the pterygomaxillary dysjunction. The position of the tip of the osteotome can be checked with a palpating finger.


Pitfall: An upward and posteriorly oriented osteotome will not reliably separate the maxilla from the pterygoid plates. It is also associated with increased risk of bleeding from the pterygoid plexus and internal maxillary artery.
Separation of the nasal septum from the palate


The nasal septum has to be separated from the palate with either an osteotome or septum scissors.

Special "guarded" osteotomes are used for this purpose to protect the nasal mucosa.
Separation of the lateral nasal walls


The lateral nasal wall is then separated using a nasal osteotome or saw.

Special "guarded" osteotomes are used for this purpose to protect the nasal mucosa.

Pitfall: This osteotomy should end anteriorly to the greater palatine vessels and nerve to prevent bleeding.
Sagittal osteotomy of the anterior alveolar crest and the palate


The sagittal osteotomy is usually made between the roots of the central incisors. To avoid iatrogenic damage of those roots it is recommended to first mark the position and penetrate the outer cortex with a small burr or with a piezoelectric device.


The osteotomy is continued posteriorly through the alveolus and the palate, usually with a thin straight scaled osteotome. Care must be taken not to penetrate the palatal mucosa. The course of the chisel tip as it goes posteriorly is monitored with a palpating finger, which is difficult with a tooth borne expansion device in place.
Check of segment mobility


After completion of the osteotomies, the mobility of the segments must be checked. The palatal expansion device can now be inserted, if not already in place.

Downfracture and mobilization of the maxilla

https://www2.aofoundation.org/wps/portal/surgerymobile?contentUrl=/srg/95a/05-RedFix/CLP/P040-LeFortI/04_DownfractureMobilizationMaxilla.jsp&soloState=precomp&title=&Language=en

Downfracture





The lower part of the maxilla is then mobilized initially by digitally pushing it downwards. The term downfracture was coined to describe this downward movement and the fracture of the posterior wall of the maxilla which has not been cut with either saws or chisels.


The remainder of the clefted nasal mucosa can now be visualized and sharply separated from the palatal mucosa to allow completion of the mobilization.


Pitfall: Incomplete osteotomies and excessive force during the downfracture are thought to have caused fracture of the posterior wall of the maxilla running up into the orbit and as a result causing blindness. Consequently excessive force during downfracture and incomplete osteotomies should be avoided.


If major resistance is encountered, the following action should be taken:
Re-examine all of the osteotomy cuts especially in the posterior pterygoid region
Ensure all of the cuts have been completed successfully and if not, complete them
At downfracture it is usually possible to visualize the maxillary sinuses through the cuts and across the sinus to see the posterior wall of the maxilla. The posterior wall can be gently osteotomized under that direct vision using a fine osteotome taking care not to cause major bleeding.





During downfracture it is possible to visualize both the lateral wall of the nose, the nasal septum and the posterior wall of the maxilla across the maxillary sinus. Where the bone cuts are incomplete it is possible to complete the maxillary osteotomy with fine osteotomes under direct vision.





It may be necessary to trim the lateral wall of the nose and the nasal septum with bone rongeurs.
Mobilization





Digital manipulation (twisting) of the down fractured maxilla is performed to continue the mobilization.





Once initial mobilization digitally has been accomplished, Rowe's maxillary disimpaction forceps or similar devices may be used and the mobilization of the maxilla is completed. This should only be performed after inserting a custom made cast steel palatal protection plate to avoid damaging the palate or accidently fracturing the maxilla.


The mobilization is carried out by downward circular movements and then twisting the maxilla on each side in turn. During this procedure it is necessary to ensure that the mucoperiosteal pedicle to the maxilla postero-laterally does not tear.





It is often necessary to break down posterior scar tissue in the region of the soft palate either digitally or very carefully with blunt end dissection scissors. If this is not done, that scar tissue will be a major factor for future relapse.





It is sometimes useful also to use Tessier mobilizers which are inserted behind the maxilla on each side in order to pull the maxilla forwards.


At this point the mobilized maxilla should be free and able to be advanced by the surgeon by his or her hand much more than is actually required.
Trimming of osteotomy lines





With the maxilla displaced downwards, bony interferences on the lateral nasal wall and the anterior and posterior wall of the maxilla are removed. This can be done initially with rongeurs but usually bone has to be removed with a drill whilst carefully protecting the soft tissues. The greater palatine vessels may need to be sacrificed if they interfere with complete mobilization of the maxilla.


In order to prevent unfavourable pressure on the nose (widening of the alar base etc.) the piriform rims are rounded off and the anterior nasal spine reduced.

2 COLLECTED IMAGES

转：K.EricDrexler的《创造的发动机》关于新技术的结论

http://tieba.baidu.com/p/126924564
《创造的发动机》一书从一个具有洞察力的论点开始，即我们能做什么取决于我们能造什么，由此开始引导我们仔细地分析堆叠原子的可能途径，然后Drexler问道：“我们用这些原子堆叠机器能做什么？”首先，我们可以制造比细胞还要小的组装机器，并且可以制造更轻和更结实的材料。因而，可以建造更好的宇宙飞船；因而，可以建造更微小的装置，它们可以在毛细血管中穿行并进入和修复活细胞；因而，可以治疗疾病，恢复青春，以及是我们的身体更快速和强壮。我们可以制造象病毒那么小的机器，和能以我们不能体会到的速度工作的机器。然后，一旦我们学会了怎么去做之后，我们就会想要用无数个这类微小机械去组装成智能机器，也许是基于上万亿个纳米尺度上的并行处理机来描述、比较和记录各种图案，并可以开发以前经历的记忆。因此这些新技术将不仅改变我们改造周围的物理世界的材料和方法，而且还能激发我们深入任何一个我们创造的世界的活力。
　　现在，我们回到克拉克的那个预测五十年后的难题，我们会看到Drexler处理的那些问题使得这个看起来几乎毫无意义。一旦原子堆叠处理启动，那么“仅仅五十年”将会带来比中世纪以来的所有改变更多的改变。对我来说，尽管我们听到了很多有关现代技术革命的东西，它们并没有象过去的半个世纪给我们生活带来的改变那么巨大。电视真的改变了我们的世界了吗？当然没有无线电带来的改变那么大，甚至比电话的改变还要小。那么飞机呢？它们仅仅是把旅行的时间从几天缩短为几小时——而在此之前铁路和汽车已经把这个时间从数周缩短到几天了！但是《创造的发动机》把我们带到了一个真正重大的变革的门槛之前。纳米技术将比物质世界领域中的前两项重大的发明给我们带来影响更大——用金属代替石头和木棒，以及电能的利用。同样地，我们也可以比较人工智能给我们的思想带来的影响——和我们将如何看待自己——相较于这个领域的另外两个早前的发明：语言和文字。
　　我们很快就要面对这些前景与选择。我们应该怎样去处理呢？《创造的发动机》说明了这些选择将如何导向很多与人类发展关系重大的问题：富裕与贫穷，健康与疾病，和平与战争。 Drexler不仅客观地列出了可能性的目录，也提供了很多的想法和如何处理的建议。《创造的发动机》是目前为止对人类未来的思考的最好的尝试，我们将坚持发展新的技术。

Darwin Toolbox

http://www.darwintoolbox.com

自愧不如啊

把蚊子(最好是刚吸完血的)抓住放在一个注射器里面,用手指堵住另一头,然后推或者拉来改变注射器腔内压强,可以看到蚊子的肚子被压得扁扁的然后又被涨得鼓鼓的,折磨死它.

lol

The interaction between nonsense and science...

Shintaro kago 病气百景&Beauty Illustrations

I like this illustration above coz everytime when I was sitting on my ass in the lectrue theater listening lectures, there were always someones sitting behind me blew their nose and sneeze loudly. I kind of doubt if they would blow their weasands and all mucus out...lol

face on the back

过程

        还有两样东西是必须带着的，一是送给“刀子匠”的礼物，一般是一个猪头或一只鸡，外加一瓶酒。二是手术期间所用的物品，包括30斤米、几篓玉米棒、几担芝麻秸及半刀窗户纸。其中，米是净身者一个月的口粮，玉米棒烧炕保暖用，芝麻秸烧成灰后用来垫炕，窗户纸则用来糊窗子，以免手术后受风。“刀子匠”要准备两个新鲜的猪苦胆、臭大麻汤和麦秆。猪苦胆有消肿止痛的作用，手术后敷在伤口处；臭大麻汤的功用很多，手术前喝一碗让人迷糊，起麻醉作用，手术后再喝，让手术者泻肚，以减轻小便的排泄量，保证手术成功；麦秆的功用不言自明，即手术后插入尿道。
　　然后，选上一个好日子——最好在春末夏初，气温不高不低，没有苍蝇蚊子，因为手术后约一个月下身不能穿衣服。选好了日子之后，要把净身者关在房间里。那房间必须密不透风，让净身者先清理粪便，然后锁在房里。在这段禁闭期间，绝对不能饮食，免得有排泄的秽物沾染手术后的创口，致使伤口恶化，危及生命。之所以要密不透风，也是为了净身者的安全。这样，经过三四天之后，才能让“刀子匠”进行实施手术的准备工作。
      被手术的人被蒙上眼睛，脱尽衣裤，采用半卧姿势仰倒在床位上，手脚像一个“大”字被绑得结结实实。助手将他的下腹及双股上部用白布扎紧、固定。还需有助手抓牢他的头、肩、膊，压着他的腰——为的是防止他因痛极拼命、流血过多而呜呼哀哉，另外的人则用“热胡椒汤”把被阉割的部位清洗、消毒。
　　手术刀是一种呈镰状弯曲的利刃，使用时通常并没有特别的消毒措施，在火上烤一下，便算是消毒了。然后，主刀者即用手术刀进行切除手术。手术完成后，由两名“刀子匠”搀扶被手术的人在房里缓行两三个时辰后，才允许躺卧。
　　手术后3天内不准喝水，据说由于干渴和伤痛，其间必须忍受非常的痛苦。3天过后才能大功告成。手术做完后，伤口即使能快长好也不能让它快长好，而要故意偎脓长肉，这样伤口才能平复。净身与疗养前后需100天左右。


There were two necessities, one was the present to the holder of cleaver which was generally a pork head or a chicken, plus a bottle of wine. Another was the essential stuff of the operation, including 15 kilograms rice, a couple basket of corns and sesame straws and some paper used to make windows. Rice was half month's food of the operator. Corn was used for heating operating table which would be cushioned by the ash got after burning sesame straws. Window paper was used for making windows, preventing the boys from trapping wind.

The operator would prepare two fresh and bitter pork gallbladder, stinky cannabis soup and wheat straw. The pork gallbladder applied on the wound could help reduce swelling and ease pain. Stinky cannabis soup had lots of functions. It can anesthetise patients who have it before operation while can cause

diarrhea by drinking after operation and reduce the pee and guarantee the success of the operation. The function of wheat straw is obvious, or inserting into urethra after operation. 

Then, choosing a perfect date -- the end of spring and the beginning of summer would be the best because of the moderate temperature and there would be no flies and mosquitos.  

The cases in physical computer tutorial（8）

David Bowen: Tele-Present Water

VernissageTV:

http://www.youtube.com/user/henrichy0205yt

Stelarc at WRO Media Art Biennale 2011

Media Art Biennale 2013:

http://www.wrocenter.pl/en/

http://wro2013.wrocenter.pl/site/en

The cases in physical computer tutorial（7）

Vending machine by Eille Harrison
http://www.ellieharrison.com/index.php?pagecolor=3&pageId=project-vendingmachine

The cases in physical computer tutorial（6）

Audience by rAndom international & Chris O'Shea 

rAndom International

https://vimeo.com/randomvids

Reflex by rAndom International // Wellcome Trust London 2011

https://vimeo.com/23255773

The Modest Victorian Proposal To Electroplate Corpses Into Beautiful Statues

http://www.atlasobscura.com/articles/morbid-monday-electroplating-corpses

“We are told that 'in effect it transforms the corpse into a beautiful statue — form, features, and even expression being perfectly preserved.' This may appear so very charming to those who think it desirable to furnish their homes with a collection of the dead bodies of departed friends and relations.”

A bit hilarious...

Morbid Monday:
http://www.atlasobscura.com/categories/morbid-monday

The "Mind Maps: Stories from Psychology" exhibition in science museum

Today I went to science museum to have a look at "Mind Maps: Stories from Psychology" exhibition. These are some intriguing stuffs I found.

1. Avatar Therapy, using avatar to cure some people's illusion disorders..

2. Electromagnetic cage. Quite cult! This medicinal apparatus is just like barnacles. Actually there are many more medicinal apparatus like barnacles. I think I will make a collection next time.

3. Electrical belt for men. It is quite like some SM apparatus, frankly....Furthermore, it can even generate electric current...

4. A experiment proved the existence of animal electricity.

5. Frog pistol. Like a cult joke!

6. I have not yet utterly comprehended what it is....

Blumhouse Productions LOGO 2012

Making Dead Bodies Beautiful

"Have you ever thought about what you're going to look like when you're dead? Well for the girl you're about to meet it's exactly what she spends her days doing - that is making dead bodies beautiful.Unless you're an embalmer or a funeral director you often won't get to see the inside of a mortuary, however The Feed's Patrick Abboud gained unprecedented access to bring you this story. Warning: this story contains images of the deceased that some may find disturbing. "