• Title/Summary/Keyword: 방사선적 지표

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Clinical Evaluation of Passive Eruption Using Occlusal Reduction on Periodontium (교합면 삭제(occlusal reduction)를 이용한 수동적 정출 (passive eruption)이 치주조직에 미치는 영향)

  • Kim, Yoo-Jin;Kim, Sung-Jo;Choi, Jeom-Il;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.1
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    • pp.15-25
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    • 2012
  • The relationship between occlusion and periodontal health has been extensively studied. However, reports on the effects of passive eruption using occlusal reduction has not been sufficient. The purpose of the present randomized clinical trial was to assess the influence of passive eruption using occlusal reduction on the clinical periodontal parameters consisting of attachment level, pocket depth, tooth mobility, width of keratinized gingiva and osseous defect. The study was performed on 40 teeth of 16 subjects who have been treated for the moderate periodontitis at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, after hygienic-phase and after 6 month from passive eruption using occlusal reduction, clinical parameters were monitored and radiographs were taken. The 20 teeth in the test group received passive eruption using occlusal reduction while the 20 control teeth did not receive any occlusal reduction. The results were as follows; 1) Degree of inflammation of periodontium was improved by initial therapy 2) Teeth received passive eruption using occlusal reduction demonstrated significantly greater reduction in pocket depth, tooth mobility and amount of bone loss, and increase in the width of keratinized gingiva, but no significant changes in the attachment level compared to the control teeth 3) There was significantly greater reduction in pocket depth, mobility, amount of bone loss and attachment level in the test teeth after initial hygienic phase when compared with baseline data. Taken together, these results suggest that the passive eruption using occlusal reduction would be helpful to improve periodontal health.

Reliable Radiologic Parameters to Predict Surgical Management for Clubfoot Treated with the Ponseti Method (Ponseti 방법으로 치료를 시작한 선천성 만곡족 환자에서 수술적 치료 여부를 예측할 수 있는 방사선적 지표)

  • Song, Kwang Soon;Yon, Chang Jin;Lee, Si Wook;Lee, Yong Ho;Um, Sang Hyun;Kwon, Hyuk Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.59-66
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    • 2019
  • Purpose: Several radiologic reference lines have been used to evaluate individuals with a clubfoot but there is no consensus as to which is most reliable. The aim of this study was to identify which radiologic parameters have relevance to the predictability of additional surgery after Ponseti casting on clubfoot and the effect of clubfoot treatments that contain Ponseti casting and additional surgery. Materials and Methods: A total of 102 clubfeet (65 patients, 37 bilateral) were reviewed from 2005 to 2013. The patients were divided into two groups (Group A, those for whom the result of the Ponseti method was successful and did not require additional surgery; and Group B, those for whom the result of the Ponseti method was unsuccessful and required additional surgery), and the following parameters were measured on the plain radiographs: i) talo-calcaneal angle on the anteroposterior and lateral view, ii) talo-1st metatarsal angle on the anteroposterior view, and iii) Tibio-calcaneal angle on the lateral view with the ankle full-dorsiflexion state. Each radiograph was reviewed on two separate occasions by one orthopedic doctor to characterize the intra-observer reliability, and the averages were analyzed. Next, 20 cases were chosen using a random number table, and two orthopedic doctors measured the angle separately to characterize the interobserver reliability. Results: Groups A and B included 73 clubfeet (71.6%) and 29 clubfeet (28.4%), respectively. The initial talo-calcaneal angle and tibiocalcaneal angle in the lateral view were significantly different among the groups. In addition, inter- and intra-observer biases were not detected. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view were significantly different after treatment in both groups. Conclusion: Congenital clubfeet treated with the Ponseti method showed successful results in more than 70% of patients. The initial talocalcaneal angle and tibio-calcaneal angle on the lateral view were the radiologic parameters that could predict the need for additional surgical treatments. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view could effectively evaluate the changes in clubfoot after treatment.

Surgical Treatment of Osteoporotic Vertebral Compression Fractures at Thoraco-Lumbar Levels: Only Pedicle Screw Constructs with Polymethylmethacrylate Augmentation (흉요추부 골다공증성 척추 압박 골절의 수술적 치료: 골시멘트 보강술을 이용한 척추경 나사 고정)

  • Jun, Deuk Soo;Baik, Jong-Min;Park, Ji Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.327-335
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    • 2019
  • Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm2. The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

Hydrogeological characteristics of the LILW disposal site (처분부지의 수리지질 특성)

  • Kim, Kyung-Su;Kim, Chun-Soo;Bae, Dae-Seok;Ji, Sung-Hoon;Yoon, Si-Tae
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.6 no.4
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    • pp.245-255
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    • 2008
  • Korea Hydro and Nuclear Power Company(KHNP) conducted site investigations for a low and intermediate-level nuclear waste repository in the Gyeong Ju site. The site characterization work constitutes a description of the site, its regional setting and the current state of the geosphere and biosphere. The main objectives of hydogeological investigation aimed to understand the hydrogeological setting and conditions of the site, and to provide the input parameters for safety evaluation. The hydogeological characterization of the site was performed from the results of surface based investigations, i.e geological mapping and analysis, drilling works and hydraulic testing, and geophysical survey and interpretation. The hydro-structural model based on the hydrogeological characterization consists of one-Hydraulic Soil Domain, three-Hydraulic Rock Domains and five-Hydraulic Conductor Domains. The hydrogeological framework and the hydraulic values provided for each hydraulic unit over a relevant scale were used as the baseline for the conceptualization and interpretation of flow modeling. The current hydrogeological characteristics based on the surface based investigation include some uncertainties resulted from the basic assumption of investigation methods and field data. Therefore, the reassessment of hydrostructure model and hydraulic properties based on the field data obtained during the construction is necessitated for a final hydrogeological characterization.

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Diagnostic Coincidence of Radiologic Measurement Methods of the Proximal Femur Anterior-posterior Projection for Assessment of Osteoporosis (근위대퇴부 정면 영상을 이용한 골다공증 평가 시 방사선적 계측의 진단일치도)

  • Kang, Yeong-Han;Cho, Kwang-Ho
    • The Journal of the Korea Contents Association
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    • v.12 no.6
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    • pp.353-360
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    • 2012
  • The purpose of this study was to determine whether there are relationships between radiologic parameters for osteoporosis by the proximal femur radiograhps and bone mineral density, as assessed by Dual Energy X-ray Absorptiometry(DEXA). Proximal femur anterior-posterior projection were taken from 112 individuals who undergoing DEXA. Radiographic parameters including canal-to-calcar ratio(CCR) and cortical thickness indices(CTI) were measured and compared with bone mineral density($g/cm^2$), T-score. The intramedullary femoral canal width(FW) and calcar width(CW) at osteoporosis group was significantly larger than that of control group. The CCR were correlated negatively with bone mineral density($g/cm^2$)(r=-0.340, p<0.01), and the CTI were correlated positively(r=0.624). The diagnostic accuracy of CCR for osteoporosis was 63.4%, and kappa value was 0.271. And the accuracy of CTI was 67.0%, and kappa value was the level of fair agreement(${\kappa}$=0.258). The proximal femur with large CCR and small CTI had lower T-scores. When evaluating proximal femur anterior-posterior radiographs, those patients with the thinnest femur diaphyseal cortices should be referred for further osteoporosis investigation.

A cephalometric study in patients with obstructive sleep apnea after use of oral appliance (폐쇄성 수면 무호흡 환자에 있어서 구내장치 반응성에 대한 두부 방사선적 연구)

  • Kyung, Seung-hyun;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.287-296
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    • 2000
  • It is well known that oral appliance could improve respiratory difficulty in patients with obstructive sleep apnea (OSA). To evaluate the effect of oral appliance, polysomnography and cephalometry were performed in OSA patients before and after oral appliance was used. Twenty four OSA patients were included in this study. Respiratory difficulty index (RDI) was obtained from polysomnography and the movement of soft palate, tongue, posterior pharygeal wall, hyoid bone, and mandible and the variables of the facial pattern were measured on the cephalogram. The changes of cephalometric parameters were compared to the RDI changes and the correlation was tested. After oral appliance was used, RDI decreased from 46.8 to 13.3. There was significant relationship between RDI improvement and the anterior movement of the mandible and superior movement of the hyoid bone. In 8 patients whose RDI was most improved, RDI improvement rate was correlated with the anterior movement of the tongue and anterior-posterior (AP) diameter of the airway at the levels between the lower portion of the soft palate and epiglottis. These results could conclude that anterior movement of the tongue and superior movement of the hyoid bone would be favorable cephalometric parameters for the improvement of OSA.

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Clinical Results of ACL Reconstruction in the Immature Adolescent via Transphyseal Approach in Tibia Based on a New Indication Paradigm (새로운 수술적응증에 의한 골 미성숙 전방십자인대 손상 환자에서의 성장판을 통과하는 전방십자인대 재건술의 결과)

  • Lee, Dong Chul;Shon, Oog Jin;Park, Chul-Hyun;Kwon, Moon Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.1-8
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    • 2012
  • Purpose: To evaluate clinical and radiologic outcomes of transphyseal anterior cruciate ligament (ACL) reconstruction in patients with open physes who were selected with authors' new operative indications. Materials and Methods: We evaluated 15 patients with open physes who underwent a transtibial ACL reconstruction and were followed up for 4~6 years after surgery. Our operative indications involved 1) choronologic age of ${\geq}$ 16 in male and ${\geq}$ 14 in female, 2) open physes of ${\leq}$ 2 mm width, and 3) Risser sign and Tanner stage of ${\geq}$ 3. Tibialis anterior tendon allograft was used in all patients, and endobutton and bioscrew were used for femoral and tibial fixations, respectively. Functional outcomes were evaluated using Lysholm Knee Scoring scale, Tegner activity scale, and International Knee Documentation Committee (IKDC) 2000 subjective score. Physical examinations to evaluate stability involved Lachman and pivot shift tests. For radiographic results, we evaluated side to side differences of anterior displacement in stress views. In addition, with use of scannograms taken at last follow-up, we examined side to side differences of femorotibial angles, anatomical and mechanical lateral distal femoral angles, mechanical medial proximal tibial angles and leg lengths. Results: The mean Lysholm Knee score was 51(40-61) points preoperatively and 97(94-100) points at last follow up. The mean Tegner activity score was 2.6 points preoperatively and 7.1 points at last follow up. The mean IKDC score was 32.6 points preoperatively and 88.3 points at last follow up. The mean anterior displacement of the tibia was improved from 6.7(${\pm}1.0$) mm to 1.9(${\pm}0.9$) mm. There were no leg length discrepancies over 5 mm and no statistically significant differences in all the radiographic variables representing growth disturbance. Conclusion: This study suggests that patients with open physes who selected by authors' new indication would safely undergo transphyseal ACL reconstruction with successful outcomes.

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Arthroscopic Full-Thickness Rotator Cuff Repair in Elderly Patients (고령 환자의 관절경적 회전근 개 봉합술의 결과)

  • Cheon, Sang Jin;Lee, Dong Ho;Park, Yong Geon;Son, Seung Min
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.38-45
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    • 2020
  • Purpose: To examine the clinical and structural outcomes of an at least two-year follow-up of arthroscopic full-thickness rotator cuff repairs with a single-row or suture-bridge technique in patients more than 65 years of age. Materials and Methods: Patients diagnosed with a full-thickness rotator cuff tear who were more than 65 years of age, underwent arthroscopic rotator cuff repair after at least six months of conservative treatment, agreed to take a follow-up magnetic resonance imaging (MRI) six months postoperatively, and visited outpatient for at least two years were enrolled in this study. Clinical evaluations were done using The University of California Los Angeles score, Constant Shoulder Score, and visual analogue scale evaluated two years after the surgery. The structural integrity was analyzed using follow-up MRI. During surgery, a suture-bridge technique was used if the rotator cuff tendon could cover half of the footprint under constant tension. Otherwise, single-row repair was performed. Results: The samples were 158 cases, consisting of 93 single-repairs and 65 suture-bridge repairs. A preoperative comparison of the age distribution, fatty degeneration of supraspinatus and infraspinatus muscle, medial retraction of torn cuff tendon, and tear size between the two groups were not significant. The clinical scores were improved significantly in all cases. The distribution of the structural integrity by Sugaya classification were 49 cases in type 1 (31.0%), 62 cases in type 2 (39.2%), 30 cases in type 3 (19.0%), 11 cases in type 4 (7.0%), and six cases in type 5 (3.8%). The re-tear rate of the single-row group was 9.7% (nine out of 93 cases) and 12.3% (eight out of 65 cases) for the suture-bridge group. Conclusion: Satisfactory clinical and radiological outcomes were achieved after arthroscopic full-thickness rotator cuff repair in patients more than 65 years of age. Both single-row and suture-bridge techniques would be beneficial for the elderly.

Clinical Comparison of Two Types of Hook Plate in Surgical Treatment of Acromioclavicular Dislocation - AO Hook Plate and Wolter Plate - (견봉 쇄골 관절 탈구의 수술적 치료에서 두 가지 갈고리 금속판의 임상적 비교 - AO Hook Plate와 Wolter Plate -)

  • Choi, Jea-Yeol;Kim, Eugene;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Se-Jin;Lee, Seung-Hee;Lee, Jae-Wook;Choi, Kyu-Bo
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.123-129
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    • 2012
  • Objective: To evaluate if acromial locking in hook plate is necessary for surgical treatment of acromioclavicular dislocation by compare Wolter plate and AO hook plate. Methods: Seventy one patients who have Rockwood type III to V acromioclavicular joint dislocation treated with AO hook plate and Wolter plate were involved. Among them, 39 patients were treated with Wolter hook plate and 32 patients with AO hook plate. The Constant-Murley score and the range of motion of shoulder joint were measured on postoperative 1st ,$3^{rd}$, $6^{th}$ and $12^{th}$ months, and the radiological complications involving plate and bone were investigated. Results: Constant-Murley score of postoperative one year were $83.2{\pm}6.8$ in AO hook plate group and $85.2{\pm}5.3$ in Wolter plate group without statistical difference (p<0.05). Faster recover of forward elevation and external rotation were examined in Wolter plate group at first and third months after surgery than those of AO hook plate group, but there were no significant difference between after six months or later after surgery. Four cases of loosen or broken screws and one case of pull-out of plate were found in Wolter plate group. Seven cases of subacromial bony erosion and one periprosthetic fracture were found in AO hook plate group. Conclusion: Although clinical outcomes of both two methods were same, no matter if acromial locking system was or not. More radiological complication of plate and bone were found in AO hook plate than that of Wolter plate. However also had disadvantage like larger incision during surgery.

Long-Term Results of Surgical Treatment for the Idiopathic Clubfoot (선천성 만곡족의 장기 수술적 치료 결과)

  • Kim, Hui Taek;Kim, In Hee;Cho, Yoon Je;Ahn, Tae Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.547-556
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    • 2019
  • Purpose: This study evaluated the results of surgical treatment for residual or recurrent deformity after the conservative treatment of idiopathic clubfoot. Materials and Methods: Fifty-one cases (32 patients), who were followed up to skeletal maturity, were reviewed retrospectively. The mean age at the last follow-up was 18.7 years. The surgical options included selective or comprehensive soft tissue release, tendon lengthening and transfer, and various types of osteotomy. The radiology measurements included the talocalcaneal angle and talo-first metatarsal angle in the anteroposterior (AP) view, and the talocalcaneal angle and calcaneal pitch in the lateral view. The radiology measurements were compared with the normal values for adults. The clinical evaluations were made using the ankle-hindfoot score and the midfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS): excellent (>85), good (71-85), pair (56-70), and poor (<56). Results: At the last follow-up, the percentages of the 51 cases, whose parameter values fell within the normal ranges were as follows: in the AP view, 41.2% (talocalcaneal angle); and 90.2% (talo-first metatarsal angle). In the lateral view, the percentage was 84.3% (talocalcaneal angle). For the calcaneal pitch, the percentages were 61%. The mean AOFAS score was 88.1±10.7 on the ankle-hindfoot score and 86.7±11.5 on the midfoot score. Conclusion: The long-term outcome of patients with idiopathic clubfoot, who underwent surgical treatment after conservative treatment, was found to be 43%-90% of the normal range of radiographic indices. Clinically, the mean AOFAS scores were "excellent". Therefore, a satisfactory result can be obtained by analyzing the elements of deformity more accurately and then using the selective operation method, even if the non-surgical correction method fails.