• Title/Summary/Keyword: 금속 대 금속 관절

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Comparison of Metal Artifact Reduction Algorithms in Patients with Hip Prostheses: Virtual Monoenergetic Images vs. Orthopedic Metal Artifact Reduction (고관절 인공치환술 환자에서 금속 인공물 감소 방법의 비교: 가상 단일에너지영상 대 금속 인공물 감소기법)

  • Hye Jin Yoo;Sung Hwan Hong;Ja-Young Choi;Hee Dong Chae
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1286-1297
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    • 2022
  • Purpose To assess the usefulness of various metal artifact reduction (MAR) methods in patients with hip prostheses. Materials and Methods This retrospective study included 47 consecutive patients who underwent hip arthroplasty and dual-energy CT. Conventional polyenergetic image (CI), orthopedic-MAR (OMAR), and virtual monoenergetic image (VMI, 50-200 keV) were tested for MAR. Quantitative analysis was performed in seven regions around the prostheses. Qualitative assessments included evaluation of the degree of artifacts and the presence of secondary artifacts. Results The lowest amount of image noise was observed in the O-MAR, followed by the VMI. O-MAR also showed the lowest artifact index, followed by high-keV VMI in the range of 120-200 keV (soft tissue) or 200 keV (bone). O-MAR had the highest contrast-to-noise ratio (CNR) in regions with severe hypodense artifacts, while VMI had the highest CNR in other regions, including the periprosthetic bone. On assessment of the CI of pelvic soft tissues, VMI showed a higher structural similarity than O-MAR. Upon qualitative analysis, metal artifacts were significantly reduced in O-MAR, followed by that in VMI, while secondary artifacts were the most frequently found in the O-MAR (p < 0.001). Conclusion O-MAR is the best technique for severe MAR, but it can generate secondary artifacts. VMI at high keV can be advantageous for evaluating periprosthetic bone.

Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury (견봉 쇄골 관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료)

  • Kang, Ho-Jung;Koh, Il-Hyun;Joo, Jong-Hwan;Chun, Yong-Min;Kim, Hyung-Sik
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.59-66
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    • 2011
  • Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

Intercalary Tricortical Iliac Bone Graft in the Surgical Treatment of Nonunion of Midshaft Clavicular Fractures (쇄골 간부 불유합에서의 개재 삼면피질 장골 이식술)

  • Cho, Chul-Hyun;Jang, Hyung-Gyu
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.32-36
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    • 2012
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures. Material and Methods: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed. Results: Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection. Conclusion: Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.

Comparative Study for the Fixation Method in the Danis-Weber Type B Lateral Malleolar Fractures: An Antiglide Plate Fixation versus A Lateral Plate Fixation (Danis-Weber B형 족관절 외과 골절의 고정방법 비교연구 : Antiglide 금속판 고정술 대 외측 금속판 고정술)

  • Shin, Hun-Kyu;Choi, Jae-Yeol;Kang, Dong-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.201-206
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    • 2006
  • Purpose: To evaluate the advantages of the antiglide plate fixation procedure for Danis-Weber type B lateral malleolar fractures of ankle compared to other methods of lateral plate fixation. Materials and Methods: We reviewed 70 cases that antiglide plate fixation and lateral plate fixation procedures were performed from Mar. 2001 through Mar. 2006. Of the total 70 cases, they were divided into two groups ; 22 cases were treated with the antiglide plate procedure (Group I) and 48 cases were treated with the lateral plate procedure (Group II). The results of the two groups were analyzed both radiographically and clinically using Ankle-Hindfoot scale of the American Orthopedic Foot and Ankle Society (AOFAS). Results: All fractures were healed at average of 8 weeks both radiographically and clinically. According to the Ankle-Hindfoot scale, all cases of Group I and 48 cases of Group II were above 80 points. 2 cases (9%) in Group I complained of peroneal tendinitis, while 19 cases (39%) in Group II showed skin irritation resulting from the screw or the plate. A total of 6 cases (27%) in Group I and 27 cases (55%) in Group II complained cosmetic problems. Conclusion: we concluded that the antiglide plate fixation for Danis-Weber type B lateral malleolar fractures is one of the good methods. But, further analysis will be need to find a solution for the peroneal tendinitis.

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Evaluation of the Effect of Metal Artifacts Varying the Parameters of the Attenuation Map for the artificial Hip Joint in SPECT/CT (SPECT/CT에서 인공고관절에 대한 감쇠보정지도(Attenuation Map)의 매개변수 변화에 따른 금속 인공물(Metal Artifact)의 영향 평가)

  • Kim, Sang Gyu;Kim, Jung Yul;Park, Min Soo;Jo, Seung Hyun;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.3-7
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    • 2014
  • Purpose SPECT/CT scan to be performed attenuation correction on the basis of CT induce an overestimation of the site due to the beam hardening artifact by metal cover and reduce the images quality. Therefore, this study using a phantom that has been inserted artificial hip joint investigated that effect on the SPECT/CT image causing by metal artifact for varying the parameters of the Attenuation Map. Materials and Methods Siemens Symbia T16 SPECT/CT equipment was used. Artificial hip joint was inserted to SPECT/PET phantom, 17 mm sphere of Bright Streak area in CT image was filled with Tc-99m so that the radiation activity was 8 times compared to background. And then Hot and Background was measured in varying Wide Beam Coefficient on Attenuation Map and RBR (Region to Background Ratio) of Metal and Non-Metal was calculated and analyzed depending on the presence or absence of the hip joint. Results It tended to hot count of Non-Metal and Metal to increase as the value of the manual mode is increased, hot count ratio with the group of both manual mode 0.5 and 0.4 is the best match. Also, in automatic mode, the ratio of RBRNon-Metal and RBRMetal was 1.135, statistically significant difference was not observed in the manual mode 0.5 and 0.4. Conclusion In the automatic mode of Wide Beam Coefficient in attenuation correction map, it was found that it is over-correction by 13.52%, it was possible to minimize the over-correction by the artifact in 0.5 and 0.4 of manual mode. Further studies should be performed in order to apply to a patient with the help of this and it is considered possible to reduce the over-correction by the metal artifact of an artificial hip joint for Hip-Resurfacing Arthroplasty patients, and to improve the diagnostic performance.

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Changes of Occlusion following the Placement of Preformed Metal Crown to the Permanent First Molar in Children and Adolescents (소아청소년에서 제1대구치의 기성금속관 수복 후 교합 변화)

  • Kim, Jiwoong;Lee, Nanyoung;Jih, Myeongkwan;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.1
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    • pp.45-56
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    • 2022
  • The purpose of this study is to evaluate changes of occlusion following the placement of preformed metal crown in the permanent first molar affected by severe caries or hypomineralization. The study was conducted on 24 patients who met the criteria among the patients with occlusion in the permanent first molar reaching the occlusal plane. Restorative treatment was performed on one first molar using preformed metal crown. Before treatment, immediately after treatment, after 4 weeks, and after 8 weeks, the T-scan III was used for measuring distribution of bite force at the maximum intercuspal position, and overbite was measured with digital vernier calipers and change of dental midline was surveyed. After 8 weeks, questionnaires survey was conducted. In most cases, immediately after treatment, the distribution of bite force between the restored side and non-restored side of arch was reversed compared to before treatment, and the overbite was decreased. However, after 4 weeks, bite force of the left and right side was balanced and the distribution of bite force on the restored and non-restored permanent first molars had similar values. Also, the changed overbite and midline were returned to pre-treatment status and there was no significant temporomandibular joint and masticatory discomfort after treatment. In this study, it was confirmed that spontaneous occlusal equilibrium was achieved one month after the placement of preformed metal crown.

Analysis of Anatomical Conformity of Straight Antegrade Humeral Intramedullary Nail in Korean (한국인에서의 직선형 전향적 상완골 골수 내 금속정의 해부학적 적합성 분석)

  • Choi, Sung;Jee, Seungmin;Hwang, Seongmun;Shin, Dongju
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.498-503
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    • 2021
  • Purpose: The aim of this study were to find ideal entry point of straight antegrade humeral intramedullary nail (SAHN) for the treatment of proximal humerus fracture in Korean and to analyze anatomical conformity using computed tomography. Materials and Methods: From May 2014 to October 2016, the study was conducted retrospectively on 74 Korean patients who had taken computed tomography on both normal and affected shoulder joint as result of shoulder injury. The mean age of the patients was 64.5 years (range, 22-95 years). Radiologic evaluation was done using multiplanar reconstruction technique of the computer tomography on normal proximal humerus. We located ideal entry point of SAHN as the point where humerus intramedullary center axis and humeral head meet. Distance between the entry point and local anatomical landmark was measured. We defined the critical distance as the distance between entry point and the most medial point of the supraspinatus attachment site. For adequate fixation and avoidance of injury to rotator cuff, critical distance should be over 8 mm according to Euler, and we defined the critical type when it is less than 8 mm. Critical distance, sex, age, height, body weight, body mass index was evaluated for the statistical significance. Results: The ideal entry point was as follows: the mean anteroposterior distance, the sagittal distance to the lateral margin of bicipital groove, was 11.5 mm and the mean mediolateral distance, the coronal distance to the lateral margin of grater tuberosity, was 20.5 mm. The mean critical distance, distance from the entry point to the just medial to insertion of the supraspinatus tendon, was 8.0 mm. Critical type with critical distance less than 8 mm was found in 41 in 74 patients (55.4%). Conclusion: The ideal entry point of SAHN in Korean was located on 11.5 mm posteriorly from the lateral margin of bicipital groove and 20.5 mm medially from lateral margin of greater tuberosity. More than half of the cases were critical type. Since critical type can possibly cause rotate cuff injury during nail insertion on entry point, surgeon should consider anatomical variance before choosing surgical option.

Comparison between Screw Fixation and Modified Tension Band Wiring for Medial Malleolar Fracture (족관절 내과 골절에 대한 금속나사고정술과 변형 긴장대고정술의 임상적 비교)

  • Ko, Sang-Hun;Park, Young-Jun;Jeong, You-Young;Kim, Woo-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.54-59
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    • 2002
  • Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.

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A Study of Causes for Removal of Fixed Prostheses and Fate of Abutment (고정성 치과보철물의 제거원인 및 지대치 재사용에 관한 연구)

  • Mok, Won-Kyun;Kim, Hee-Jung;Jeong, Chae-Heon;Oh, Sang-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.1
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    • pp.1-17
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    • 2008
  • The purpose of this study were to report the reasons for removal of fixed prostheses and survival rate of abutment teeth. A total 192 fixed prostheses removed at Chosun university Dental Hospital and 308 abutment were investigated. The most frequent reason of removal was periodontal problem(30.7%), followed by caries(29.7%), then periapical problem(18.8%) and defective margins(14%). In metal ceramic crown, periodontal problem was the most frequent reason of removal. In complete cast crown, caries was the most frequent reason of removal. Periapical and periodontal problem was the most frequent reason people under forties and over fifties, respectively. Of the 308 abutment teeth, vital and non-vital teeth were 135(43.8%) and 173(56.2%), respectively. Of 135 vital abutment teeth, 39(28.9%) were extracted and of 173 non-vital abutment teeth, 85(49.1%) were extracted. Each risk factor for removal of fixed prostheses and extraction of abutment should be evaluated more clearly for prediction of prognosis of final prostheses and abutment teeth.

Reliability Evaluation of ACP Component under a Radiation Environment (방사선환경에서 ACP 주요부품의 신뢰도 평가)

  • Lee, Hyo-Jik;Yoon, Kwang-Ho;Lim, Kwang-Mook;Park, Byung-Suk;Yoon, Ji-Sup
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.5 no.4
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    • pp.309-322
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    • 2007
  • This study deals with the irradiation effects on some selected components which are being used in an Advanced Spent Fuel Conditioning Process (ACP). Irradiation test components have a higher priority from the aspect of their reliability because their degradation or failure is able to critically affect the performance of an ACP equipment. Components that we chose for the irradiation tests were the AC servo motor, potentiometer, thermocouples, accelerometer and CCD camera. ACP facility has a number of AC servo motors to move the joints of a manipulator and to operate process equipment. Potentiometers are used for a measurement of several joint angles in a manipulator. Thermocouples are used for a temperature measurement in an electrolytic reduction reactor, a vol-oxidation reactor and a molten salt transfer line. An accelerometer is installed in a slitting machine to forecast an incipient failure during a slitting process. A small CCD camera is used for an in-situ vision monitoring between ACP campaigns. We made use of a gamma-irradiation facility with cobalt-60 source for an irradiation test on the above components because gamma rays from among various radioactive rays are the most significant for electric, electronic and robotic components. Irradiation tests were carried out for enough long time for total doses to be over expected threshold values. Other components except the CCD camera showed a very high radiation hardening characteristic. Characteristic changes at different total doses were investigated and threshold values to warrant at least their performance without a deterioration were evaluated as a result of the irradiation tests.

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