• Title/Summary/Keyword: 기능적 방사선학적 평가

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The effect of enamel matrix derivative (EMD) in combination with deproteinized bovine bone material (DBBM) on the early wound healing of rabbit calvarial defects (법랑기질 단백질 유도체와 혼합된 이종골 이식재가 토끼 두개골 결손부 초기 치유에 미치는 영향)

  • Kim, You-Seok;Jang, Hyun-Seon;Park, Ju-Chol;Kim, Heoung-Jung;Lee, Jong-Woo;Kim, Chong-Kwan;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.199-216
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    • 2005
  • 치주치료의 가장 중요한 목적은 상실된 치주조직의 형태적, 기능적 재건이다. 법랑기칠 단백질 유도체(enamel matrix derivative: EMD)는 치주 병소에 사용시 상피세포의 증식을 억제하며 치주인대 및 백악아세포를 활성화시켜 무세포성 백악질 및 치주인대와 골조직의 생성을 유도한다고 보고되고 있다. 또한 법랑기질 단백칠 유도체는 골모세포의 증식 및 분화를 촉진시키며 alkaline phosphatase의 활성 및 mineralized nodule의 형성을 촉진시킨다고 보고되고 있다. 이에 본 연구에서는 토끼 두개골 결손부에 법랑기질 단백질 유도체와 이종골 이식재를 이식한 후 골밀도를 방사선학적으로 분석하고, 신생골 형성 및 주변 조직 반응을 조직학적으로 관찰, 평가하고자 하였다. 토끼 두개골에 6mm trephine bur(외경 8mm)를 이용하여 경뇌막에 손상을 주지 않도록 하면서 4개의 결손부를 형성하였다. 아무것도 이식하지 않은 군을 음성 대조군으로, 이종골 이식재 ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland)을 이식한 군을 양성 대조군으로 설정하였다. 법랑기질 단백질 유도체 ($Emdogain^{(R)}$, Biora, Inc., Sweden)만 이식한 군과 법랑기질 단백질 유도체와 이종골 이식재를 혼합하여 이식한 군을 설험군으로 설정하였다. 각각의 재료를 이식한 후 비흡수성 차폐막 ($Tefgen^{(R)}$, Lifecore Biomedical, Inc., U.S.A.)을 위치시키고 흡수성 봉합사로 일차봉합을 시행하였다. 각 군당 술 후 1, 2, 4주의 치유기간을 설정하였다. 동물을 희생시킨 후 두개골을 절제하여 먼저 방사선학적인 골밀도측정을 시행한 후 10% formalin에 고정한 후 통법에 따라 조직표본을 제작하여 광학현미경으로 관찰하였다. 1. 방사선학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군에서 더 큰 골의 밀도를 보이고 있었다 (P<0.01). 하지만, 동일한 시기에 대조군과 법랑기질 단백질 유도체만 이식한 군과의 차이는 발견할 수 없었으며 (P>0.05), 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군의 차이 또한 발견할 수 없었다 (P>0.05). 2. 조직학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한군에서 골의 형성이 더 진행됨을 알 수 있었다. 법랑기질 단백질 유도체만 이식한 군이 대조군보다 2주에서 더 많은 신생골을 볼 수 있었으며, 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군이 이종골 이식재만 이식한 군보다 1, 2주에서 더 많은 신생골을 관찰할 수 있었다. 이상의 결과에서 법랑기질 단백질 유도체는 토끼 두개골 결손부 치유단계에서 초기 골 형성을 촉진하는 것으로 사료되며 골 이식시에 법랑기질 단백질 유도체를 적용하는 것은 유용한 술식으로 사료된다.

The Evaluation of Cerebral Executive Function Using Functional MRI (기능적 자기공명영상기법을 이용한 대뇌의 집행기능 평가)

  • Eun, Sung Jong;Gook, Jin Seon;Kim, Jeong Jae
    • Journal of the Korean Society of Radiology
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    • v.7 no.5
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    • pp.305-311
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    • 2013
  • This study involves an experiment using functional magnetic resonance imaging(fMRI) to delineate brain activation for execution functional performance. Participates to this experiment of the normal adult (man 4, woman 6) of 10 people, is not inserts the metal all closed phobia and 24.5 year-old average ages which the operating surgeon experience which are not they were. The subject for a functional MRI experiment word -color test prosecuting attorney subject rightly at magnetic pole presentation time of 30 first editions and after presenting, uses SPM 99 programs and the image realignment, after executing a standardization (nomalization), a difference which the signal burglar considers the timely order as lattice does, pixel each image will count there probably is, in order to examine rest and active crossroad dividing independence sample t-test (p<.05). Overlapped in this standard anatomic image and got a brain activation image from level of significance 95%. With functional MRI resultant execution function inside being relation, the prefrontal lobe, anterior cingulate gyrus, parietal lobe, orbitofrontal gyrus, temporal lobe, parietal lobe was activated. The execution function promotes a recovery major role from occupational therapy, understanding about the damage mechanism is important. When confirms the brain active area which accomplishes an execution function brain plasticity develops the cognitive therapeutic method which is effective increases usefully very, will be used.

RELATIONSHIP BETWEEN NASOPHARYNGEAL SPACE AND VELOPHARYNGEAL INCOMPETENCE IN CLEFT PALATE (구개열환자에서 비인두공간과 비인강폐쇄부전과의 연관성)

  • Cho, Joon-Hui;Choi, Byung-Jai;Shim, Hyun-Sub;Sohn, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.517-523
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    • 2000
  • Nasopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral cavity and the nasal cavity. It participates in physiological activities such as swallowing, breathing and pronunciation. In case of an error in this mechanism, it is called a nasopharyngeal incompetence. The causes of this error are defects in (1) length, function, posture of the soft palate (2) depth and width of the nasopharynx, (3) activity of the posterior and lateral pharyngeal wall. The purpose of this study is to analyze the nasopharynx of cleft palate patients using lateral cephalograms and at the same time, evaluate the degree of hypernasality of each vowels to find its relationship with nasopharyngeal incompetence. The following results were obtained: 1. The length of the soft palate was markedly short than normal. 2. The adequate ratio was smaller than the normal value. 3. As the adequate ratio decreased, when articulating vowels, anatomic mVPI increased. 4. When articulating each vowels, anatomic VPI was in proportion with the degree of hypernasality. 5. The degree of hypernasality was greater in high vowels(/i/, /u/) than low vowel(/a/). From the above results, it can be concluded that in cleft palate patients, lateral cephalograms can be used effectively in diagnosing and evaluating nasopharyngeal incompetence. The anatomic structure of the nasopharynx has close relation to the degree of hypernasality.

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Histomorphometry and Stability Analysis of Loaded Implants with two Different Surface Conditions in Beagle Dogs (하중을 가한 두 가지 표면의 임플란트에 관한 조직형태학적 분석 및 안정성 분석 (비글견을 이용한 연구))

  • Kim, Sang-Mi;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.337-349
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    • 2008
  • Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in delayed loading conditions. A total of 36 solid screw implants (diameter 3.75 mm, length 10mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium Implants served as control. Gold crowns were inserted 3 months. Radiographic assessments and stabilitytests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 1 and 3 months after loading. Histological observations and morphometrical measurements were also performed. Of 36 implants, 32 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels (p=0.413) and RFA values. The mean BIC % in the Mg-implants was $54.4{\pm}20.2%$. The mean BIC % in the turned implant was $48.9{\pm}8.0%$. These differences between the Mg-implant and control implant were not statistically significant (P=0.264). In the limitation of this study, bone-to-implant contact (BIC) and bone area of Mg-incorporated oxidized implant were similar to machine-turned implant. The stability analysis showed no significantly different ISQ values and marginal bone loss between two groups. Considering time-dependent bone responses of Mg-implant, it seems that Mg-implants enhanced bone responses in early loading conditions and osseointegrated similarly to cp Ti implants in delayed loading conditions. However, further investigations are necessary to obtain long-term bone response of the Mg-implant in human.

Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Clinical and Histopathological Study in Repaired Cartilage after Microfracture Surgery in Degenerative Arthritis of the Knee (퇴행성 슬관절염에서 미세 천공술후 재생된 연골의 임상 및 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;So, Jae-Keun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.18-28
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    • 2005
  • Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures (후과 골절이 동반된 경골 원위부 나선상 골절의 치료)

  • Kim, Young Sung;Lee, Ho Min;Kim, Jong Pil;Chung, Phil Hyun;Park, Soon Young
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.317-325
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    • 2021
  • Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

Temporomandibular Disorder Caused by Nasopharyngeal Cancer (비인두암종에 의한 측두하악장애)

  • Byun, Young-Sub;Kim, Ki-Seo;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.395-399
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    • 2008
  • Orofacial pain and limited range of mouth opening as symptoms of temporomandibular disorder are mainly triggered by the structural and/or functional changes of temporomandibular joint and related structure itself. But careful diagnostic evaluation should be needed because they may be occurred by another pathologic conditions such as neoplasm in head and neck region. If there would be atypical pain characteristics or clinical features, systemic comorbid symptoms, or poor response to treatment, advanced imaging modalities such as CT or MRI will be mandatory for differential diagnosis. We experienced the case which was diagnosed as nasopharyngeal cancer mimicking temporomandibular disorder, and reviewed clinical considerations for proper differential diagnosis.

Clinical Result of Arthroscopic Partial Repairs in Massive Rotator Cuff Tears (광범위 회전근 개 파열의 관절경하 부분 봉합술의 임상적 결과)

  • Yoo, Jae-Chul;Ko, Kyung-Hwan;Woo, Kyung-Jea
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.150-158
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    • 2009
  • Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.

Discrepancy and Correlation in the renal length between Kidney CT and 99mTc-DMSA Renal scan (신장 CT 검사와 99mTc-DMSA Renal Scan 검사에서 측정한 신장 길이의 차이 및 상관분석)

  • Jung, Woo-Young;Shim, Dong-Oh;Lee, Dong-Hun;Choi, Jae-Min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.15-20
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    • 2021
  • Purpose This article studies the relationship between the length of a kidney measured by two scanning methods: Kidney Computed Tomography (CT) and 99mTc-Dimercaptosuccinic acid (DMSA) renal scan. Kidney CT provides a better anatomic assessment, while 99mTc-DMSA renal scan is superior in the kidney function test. Materials and Methods From January to December of 2019, two hundred patients who had Kidney CT and Tc99m-DMSA renal scan were chosen for this study. SPSS17.0 was selected for statistical analysis. Results Due to the effect of the breathing and resolution of 99mTc-DMSA renal scan, it showed the kidney's relatively longer length than the length of Kidney CT. For the same kidney, the length comparison among different brands' Gamma cameras was negligible. The length difference within the same age group did not show a noticeable discrepancy. However, there was a length difference between the radio technologists. Kidney CT and 99mTc-DMSA renal scan indicated a strong positive correlation between the length of the left and right kidney. Conclusion It is necessary to establish a standardized measurement method for measuring kidney length using 99mTc-DMSA renal scan. The kidney's functional changes and length changes are indications of Kidney diseases. Especially, pediatric patients tend to use 99mTc-DMSA renal scan for assessing the kidney's shape and the function to avoid potential radiation exposure during the Kidney CT. Therefore, it is significant to provide not only the kidney's functional information but also an anatomic analysis, including the kidney's size, length, and location through the 99mTc-DMSA renal scan.