• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.37-45
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• 2010

Objective : Craniovertebral junction (CVJ) consists of the occipital bone that surrounds the foramen magnum, the atlas and the axis vertebrae. The mortality and morbidity is high for irreducible CVJ lesion with cervico-medullary compression. In a clinical retrospective study, the authors reviewed clinical and radiographic results of occipitocervical fusion using a various methods in 32 patients with CVJ instability. Methods : Thirty-two CVJ lesions (18 male and 14 female) were treated in our department for 12 years. Instability resulted from trauma (14 cases), rheumatoid arthritis (8 cases), assimilation of atlas (4 cases), tumor (2 cases), basilar invagination (2 cases) and miscellaneous (2 cases). Thirty-two patients were internally fixed with 7 anterior and posterior decompression with occipitocervical fusion, 15 posterior decompression and occipitocervical fusion with wire-rod, 5 C1-2 transarticular screw fixation, and 5 C1 lateral mass-C2 transpedicular screw. Outcome (mean follow-up period, 38 months) was based on clinical and radiographic review. The clinical outcome was assessed by Japanese Orthopedic Association (JOA) score. Results : Nine neurologically intact patients remained same after surgery. Among 23 patients with cervical myelopathy, clinical improvement was noted in 18 cases (78.3%). One patient died 2 months after the surgery because of pneumonia and sepsis. Fusion was achieved in 27 patients (93%) at last follow-up. No patient developed evidence of new, recurrent, or progressive instability. Conclusion : The authors conclude that early occipitocervical fusion to be recommended in case of reducible CVJ lesion and the appropriate decompression and occipitocervical fusion are recommended in case of irreducible craniovertebral junction lesion.

• Advances in materials Research
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• 제11권1호
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• pp.59-73
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• 2022

In the construction industry, thin-walled frame elements with very slender open cross-sections and low torsional stiffness are often subjected to a complex loading condition where axial, bending, shear and torsional stresses are present simultaneously. Hence, these often fail in instability even before the yield capacity is reached. One of the most common instability conditions associated with thin-walled structures is Lateral Torsional Buckling (LTB). In this study, a first order Generalized Beam Theory (GBT) formulation and numerical analysis of cold-formed steel lipped channel beams (C80×40×10×1, C90×40×10×1, C100×40×10×1, C80×40×10×1.6, C90×40×10×1.6 and C100×40×10×1.6) subjected to uniform moment is carried out to predict pure Lateral Torsional Buckling (LTB). These results are compared with the Finite Element Analysis of the beams modelled with shell elements using ABAQUS and analytical results based on Euler's buckling formula. The mode wise deformed shape and modal participation factors are obtained for comparison of the responses along with the effect of varying the length of the beam from 2.5 m to 10 m. The deformed shapes of the beam for different modes and GBTUL plots are analyzed for comparative conclusions.

• Journal of Korean Neurosurgical Society
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• 제45권1호
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• pp.24-31
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• 2009

Objective : To investigate the effectiveness of radiographic parameters on segmental instability in the lumbar spine using Kinetic magnetic resonance imaging (MRI). Methods : Segmental motion, defined as excessive (more than 3 mm) translational motion from flexion to extension, was investigated in 309 subjects (927 segments) using Kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration (DD), facet joint osteoarthritis (FJO), and ligament flavum hypertrophy (LFH). These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. Results : The overall incidence of segmental instability was 10.5% at L3-L4, 16.5% at L4-L5, and 7.3% at L5-S1. DD and LFH at L3-L4 and FJO and LFH at L4-L5 were individually associated with segmental instability (p<0.05). At L4-L5, the following combinations had a higher incidence of segmental instability (p<0.05) when compared to other segments : (1) Grade IV DD with grade 3 FJO, (2) Grade 2 or 3 FJO with the presence of LFH, and (3) Grade IV DD with the presence of LFH. At L5-S1, the group with Grade III disc and Grade 3 FJO had a higher incidence of segmental instability than the group with Grade I or II DD and Grade 1 FJO. Conclusion : This study showed that the presences of either Grade IV DD or grade 3 FJO with LFH at L4-L5 were good indicators for segmental instability. Therefore, using these parameters simultaneously in patients with segmental instability would be useful for determining candidacy for surgical treatment.

• Journal of Korean Neurosurgical Society
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• 제43권2호
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• pp.111-113
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• 2008

Recently, Harms and Melcher modified Goel's approach, the C1 lateral mass and C2 pedicle screw fixation, and the new technique is currently in favor among neurosurgeons. Comparing to the advantages of Harms construct, the disadvantages were not extensively investigated. We experienced a patient with severe occipital pain developed after the C1 lateral mass screw placement for the traumatic atlantoaxial instability. We reviewed literatures about Harms construct with focus on the occipital neuralgia as a postoperative complication and suggest here technical tips to avoid the troublesome pain.

• Journal of Korean Neurosurgical Society
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• 제52권1호
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• pp.21-26
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• 2012

Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.177-181
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• 2012

We present a case of an athetoid cerebral palsy with quadriparesis caused by kyphotic deformity of the cervical spine, severe spinal stenosis at the cervicomedullary junction, and atlantoaxial instability. The patient improved after the first surgery, which included a C1 total laminectomy and C-arm guided righ side unilateral C1-2 transarticular screw fixation. C1-2 fixation was not performed on the other side because of an aberrant and dominant vertebral artery (VA). Eight months after the first operation, the patient required revision surgery for persistent neck pain and screw malposition. We used intraoperative VA angiography with simultaneous fluoroscopy for precise image guidance during bilateral C1-2 transarticular screw fixation. Intraoperative VA angiography allowed the accurate insertion of screws, and can therefore be used to avoid VA injury during C1-2 transarticular screw fixation in comorbid patients with atlantoaxial deformities.

• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.528-531
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• 2011

Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.

• 대한화학회지
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• 제38권3호
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• pp.208-213
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• 1994

니트로벤젠용액내에서의 i-브롬화브텔의 용해도를 19, 25, 40$^{\circ}C$에서 브롬화갈륨이 있을 때와 없을때에 각각 측정하여 보았다. 브롬화갈륨이 존재할 때에는 용액내에서 i-브롬화부틸과 브롬화갈륨의 1:1착물,$ i-C_4H9Br{\cdot}GaBr_3$가 형성된다. 이 착물형성의 instability constant K는 다음 식으로 계산된다. $i-C_4H9_Br{\cdot}GaBr_3{\rightleftharpoons}C_4H_9Br + 1/2Ga_2Br_6.$ 따라서 브로화갈륨과 각 브롬화알킬간의 착물형성의 안정도를 비교검토한 결과 이들 브롬화알킬의 carbonium ion의 안정도와 직접적인 관계가 있다고 본다.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• 천문학회보
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• 제41권2호
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• pp.61.2-61.2
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• 2016

Nuclear rings at centers of barred galaxies exhibit strong star formation activities. They are thought to undergo gravitational instability when sufficiently massive. We approximate them as rigidly-rotating isothermal objects and investigate their gravitational instability. Using a self-consistent eld method, we first construct their equilibrium sequences specified by two parameters: ${\alpha}$ corresponding to the thermal energy relative to gravitational potential energy, and $R_B$ measuring the ellipticity or ring thickness. The density distributions in the meridional plane are steeper for smaller ${\alpha}$, and well approximated by those of infinite cylinders for slender rings. We also calculate the dispersion relations of nonaxisymmetric modes in rigidly-rotating slender rings with angular frequency ${\Omega}$ and central density ${\rho}_c$. Rings with smaller are found more unstable with a larger unstable range of the azimuthal mode number. The instability is completely suppressed by rotation when ${\Omega}$ exceeds the critical value. The critical angular frequency is found to be almost constant at $0.7(G{\rho}_c)^{1/2}$ for ${\alpha}$ > 0.01 and increases rapidly for smaller ${\alpha}$. We apply our results to a sample of observed star-forming rings and confirm that rings without a noticeable azimuthal age gradient of young star clusters are indeed gravitationally unstable.