沉寂了幾天，今天要來跟大家介紹
「勒福式骨折第二型」!
掌聲鼓勵鼓勵~

話說上次跟大家說了這個叫做勒福(LeFort)的人，是一個法國的軍醫，在家裡沒事無聊拿一堆頭骨在地上摔，最後將摔出來三種最常見的中臉部骨折的形貌，分別命名為勒福式第一型、第二型、第三型。上次介紹的第一型又稱「水平骨折(horizontal)」，因為這種骨折型態是橫向的(沒有follow到的人可以去看上一張橫向骨折的阿拉伯捧由)，這次介紹的是第二型，又稱「金字塔型骨折(pyramidal)
」，不是我在說，這位綠臉的日本武士(さむらい）捧由骨折的中臉上顎形式，是不是很像個角錐型的金字塔呢^^

聰明的您，一定看出了，勒福式第一型和第二型的骨折都會造成上顎的不穩定，進而咬合都會造成影響。這樣骨折型態的病患，無法使上力氣咬東西，而且整個臉頰都會感到異常的麻木。還是一句老話，傷到下眼窩神經啦！畢竟骨折線都經過眼眶骨下的神經洞了呢！ 除了咬東西使不上力之外，因為骨折線進入了眼底和眼窩內側壁，所以視力、眼球轉動都有可能受影響，有些運氣不好的病患，眼球轉動會產生問題，進而造成複視(看東西兩個影子)、視野受到限制；眼底骨折的部分如果久未處理，可能造成眼球下陷、內陷，兩顆眼睛的高度看起來就會出現落差囉！此時，又要請出我們的「術中導航系統」大大，來幫助整形外科醫師進行困難的重建任務啦！

什麼?我忘了講鼻樑骨！
勒福式第二型的骨折，鼻樑骨是一定要斷一下的😆。不過它可是特別沿著鼻骨和前額骨的交界處斷掉的唷。

手術時的傷口分別會在嘴巴裡面上牙齦的黏膜處，以及眼結膜或下眼瞼睫毛下方，盡量藏在別人看不見的地方，讓骨頭釘好、眼底骨板墊好後，彷彿不曾受傷過，是不是很神奇呢^^
但我是不歡迎大家來體驗的啦😂😂😂

#日本武士髮型找好久，好不容易找到比較像桃太郎的
#來一個和之前不同的綠色調吧^^
#下一個造型要什麼好呢? 求推薦~

This striking granite mountain in the French Alps’ Mont Blanc massif, is named Aiguille (or “needle”) for its piercing pyramidal form. While it might look like a monolith, there are actually two peaks – the 3,733m (12,247ft) Petit Dru and the 3,754m (12,316ft) Grand Dru – and the mountain is also commonly known as Les Drus.

📸 K I Photography / Alamy

#兒科醫師觀察日記

夏天因為悶熱小孩又包著尿布的關係，

很容易產生紅疹或癢癢的狀況，

所以這幾天門診來看"鳥事"和"屁事"就多很多啦~

提醒大家要多注意尿布濕了就該換

如果可以的話直接洗洗更好~ 😘

也可能是因為小孩抱怨屁股癢癢，

爸媽打開尿布仔細一看，

唉唷! #肛門周圍12點鐘方位居然有一塊突起的肉肉!

難道是長了痔瘡嗎? 😱

🧐其實ㄚ~ 這個叫做

#嬰兒肛門週圍錐狀突起 (名字超俗😅)

洋名是 Infantile perianal pyramidal protrusion(洋名帥多了)

是正常的

有些人天生就有

有些人是便秘後或是有尿布疹時才會看起來比較明顯

但幾乎都是長大會自己消失不用太緊張啦!

因為放照片肯定會被檢舉18X 🔞

所以請各位忍受我拙劣的小畫家畫工 😂

Bánh giò là một loại bánh dân dã, được làm bằng bột gạo tẻ cùng với nhân là thịt băm với mộc nhĩ. Đây là một món ăn vô cùng đơn giản, tự tay ta làm ở nhà thì sẽ ngon và đảm bảo vệ sinh hơn rất nhiều. Hãy cùng tôi thực hiện món bánh này để đãi cả gia đình nhé ?.
#BepOngTho #Huongviquehuong
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Video Title: Why Japan's Great Pyramid of Giza Can't be Built Until 2110

"London. October, 1992. A Japanese man entered a government building near Chancery Lane, and made his way up to an office on the first floor. This was the London branch of the UK’s Patent Office. You see, this man was there on behalf of Japan’s renowned Shimizu Corporation - a leading architectural and engineering firm that was (and is) among the top in the world, and he was there to apply for a patent. To secure their ideas globally it was necessary to apply not just in Japan. Now this particular patent was for no ordinary idea. It was for something grand, something spectacular. The idea was to build giant pyramids in the middle of some of the largest and busiest urban centers in the world - starting with Tokyo. These infrastructures would be so large, they could house entire cities. But why? What was this for? And who exactly is the Shimizu Corporation? To understand this, we need to go back in time, back over 200 years ago to the company’s inception..."

Talking Points:
- Shimizu Megacity Pyramid TRY-2004
- Megastructures
- Pyramidal structures
- Japanese architectural & engineering companies
- Kisuke Shimizu
- Edo period
- Japan's population decline
- Tokyo's overpopulation & overcrowding
- Large scale construction projects
- Floating cities, underwater cities, space hotels
- Blade Runner (Tyrell Corporation headquarters pyramid)
- Egypt's Great Pyramid of Giza
- Burj Khalifa & Jeddah Tower
- 2 kilometer high building
- Tokyo Bay
- Megatrusses & suspended skyscrapers
- Renewable energy of solar, wind, algae & waves
- Japanese earthquakes & tsunamis
- Pacific Ring of Fire
- X-Seed 4000 (Taisei Corporation)
- Mega-City Pyramids in Singapore, Hong Kong, Mumbai, Delhi & Dhaka
- Largest man-made structure in history
- Hong Kong's Kowloon Walled City