Ji-hoon Jung;Young-Hoon Jo;Yeo Ju Kim;Seunghun Lee;JeongAh Ryu
Journal of the Korean Society of Radiology
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v.85
no.1
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pp.171-183
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2024
Purpose This study aimed to investigate which indirect parameters on preoperative MRI were the principal predictors of subscapularis tendon tears (STTs) requiring surgical repair. Materials and Methods Preoperative MRI scans of 86 patients were retrospectively reviewed for visual assessment of the STT, pathology of the long head of the biceps tendon (LHBT), posterior decentering (PD) of the humeral head, humeral rotation, fatty degeneration, and subscapularis muscle atrophy. To evaluate atrophy, visual grading using the anatomical line connecting the coracoid tip to the glenoid base, designated as the base-to-tip line (BTL), and thickness measurements were performed in the en-face view. Results Arthroscopically, 31 patients (36%) exhibited Lafosse type III or IV STT and underwent surgical repair. LHBT pathology (p = 0.002), PD of the humeral head (p = 0.012), fatty degeneration (p < 0.001), and BTL grade (p = 0.003) significantly correlated with STT. In the multivariate analysis, PD of the humeral head (p = 0.011, odds ratio [OR] = 5.14) and fatty degeneration (p = 0.046, OR = 2.81) were independent predictors of STT. Conclusion PD of the humeral head and fatty degeneration of the subscapularis can help to diagnose clinically significant STT. Interpretation of these findings may contribute to the planning of an optimal surgical strategy.
Cause of skeletal Class III malocclusion in growing patients can be classified into maxillary deficiency, mandibular overgrowth, and combination of the two. Use of Protraction Head Gear(P.H.G.) has been recommended for treatment of growing Class III malocclusion patients, for it results in forward & downward movement of maxilla and backward & downward rotation of mandible. Numerous animal experiments were performed and clinical study data have been reported ; nevertheless, studies on soft tissue profile change and comparison of treatment effects among the patients who had undergone treatment are considered to be somewhat insufficient. The author selected 93 patients, who had been diagnosed as skeletal Class III malocclusion with maxillary deficiency and then treated with P.H.G. ; the sample group was divided according to sex, treatment beginning age, palatal suture opening(intraoral appliance), and facial growth pattern. For each group, changing patterns of hard and soft tissue profile observed, and comparision with 20 normal group(Angle's Class I) patients of statistical significance in amount of growth and treatment of hard and soft tissue was done. The following results were obtained. 1. Skeletal, dental, and soft tissue measurements indicated that more growth changes was induced in the sample group that used P.H.G. compared to the growth amount of normal group. 2. No statistical significance was observed in the amounts of maxillary forward movement and mandibular backward & downward rotation depending on treatment beginning age in both sex group. 3. R.P.E. showed more significant maxillary forward movement and less protrusion of upper incisor than La-Li. 4. There was no statistical significance in the amount of maxillary forward movement depending on facial growth pattern. On the other hand, measurements indicating mandibular downward & backward rotation indicated greater change in counterclockwise growth pattern group than the clockwise. 5. Changes in upper and lower lip thicknesses showed a close relationship with positional changes in underlying bone tissue and upper and lower teeth, and upper lip height and nasolabial angle increased and mentolabial angle decreased.
The majority of the commonly used protraction headgears for the protraction of small and/or retropositioned maxilla not allow a change in the point of force application or direction of the force delivery to attain predictable results because of the position of the upper and lower lips to avoid discomfort to the patient. The purpose of this study was to investigate the initial reaction of maxillofacial complex according to the change of force variables such as direction and point of force application with designing an antenna type-modified protraction head gear. A macerated human skull with well aligned upper teeth was used to experimental model and the investigation was done by double exposure holographic interferometry. Fringe patterns of each protraction conditions were compared and analized. The results were as follows. (Frontal view) 1. The Counterclockwise rotation of the maxilla was showed by parallel protraction to occlusal plane and the fringe was decreased in number as higher point of force application. 2. Generally, the number of fringe was increased in 500gm of protraction force than in 300gm. 3. When apply the protraction force to the maxilla with rapid palatal expansion, the direction of fringe patterns was differed from the protraction without expansion. 4. In most of cases, the counterclockwise rotation was decreased in case of the direction of the force is $20^{\circ}$ downward to occlusal plane compared to the parallel direction. 5. At the point of force application is 15mm above and the direction of force is 20 downward to occlusal plane , the translation of the maxillary complex was showed. (Lateral view) 6. The direction of fringe patterns of the facial bones were differed each other by the sutures, and showed almost parallel when apply the 300gm and 500gm of protraction force. 7. In case of rapid palatal expansion with protraction of the maxilla, the fringe patterns between the maxillary area and the area from the posterior of the maxillary first molar to the pterygomaxillary fissure were differed. In case without rapid palatal expansion, the changes of direction and point of the force application did not affect to the direction and the number of the fringe patterns.
We measured the glenohumeral and scapulothoracic movements during abduction of the arm in the coronal plane with radiologic analysis in the 30 shoulders of normal male adults who were without pain, limitation of motion, and history of trauma. In the resting position, the glenoid cavity of the scapula faced somewhat superiorly in over 80 percents of the individuals, the mean superior tilting was 5.7 degrees. The mean total scapulothoracic movement was 65.8 degrees and the mean total glenohumeral movement was 106.8 degrees during abduction of arm in the coronal plane. The mean ratio of the glenohumeral movement to the scapulothoracic movement was 1.6 and this GH/ST ratio was decreased toward the extreme abduction. When the arm was abducted, external rotation of the humeral head occurred and this external rotation was increased smoothly during 0 degree through 90 degrees, but steeply above 90 degrees. The acromiohumeral interval was 10.9 mm at the resting positon, and this interval decreased during the arm abduction. The superior migration of the humeral head was 3.1 mm while abducting the arm. Our measurement of the relationships of glenohumeral and scapulothoracic movements at the coronal plane would be useful in the understandings of the biomechanics of shoulder, but further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.
In spite of remarkable improvement of surgical skills and anesthesia, local failure still occurred in 36-45$ \% $ of locally advanced colorectal cancer after curative resection with or without pre-or post-operative irradiation. Intraoperative radiation therapy(IORT) is the ideal modality which resectable lesions are removed surgically 3nd the remaining cancer nests are sterilized by irradiation during a surgical procedure. Therefore, the excellent local control without the damage of the adjacent normal tissues can be achieved. In IORT, judicious set up of the treatment cone on the treatment surface of the patient is required for accurate and homogenous dose distribution within treatment field, especially on the slopping surface of sacrum and pelvic sidewall which are the common sites of the local recurrence in rectal cancer. For this purpose, adequate co-ordination of gantry rotation and table tilting are essential. Adjusting gantry rotation is not difficult but tilting of the table is impossible inconventional treatment couch. Department of Therapeutic Radiology in Yeungnam University Medical Center developed the IORT table for colorectal cancer which is easy to set up and detach on the Linac treatment couch within 5 minutes. The range of tilting with head-up and head-down is about 30 degree which is efficient and easy-to-use, not only for IORT but also for colorectal surgery. So far, authors performed IORT with newly developed treatment table in 2 patients with rectal cancer and we found that this newly developed table could contribute in improving the dose distribution of IORT and surgical procedure for colorectal cancer.
Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.
The purpose of This study's aim is to examine the difference in the changes of body segment movement, variables for ball quality, and carry at golf driver swing according to the ball quality using comparative analysis. Regarding the impact variables according to the ball quality using the track man and carry, club speed was the fastest at draw shot, ball speed was the fastest at straight shot, and smash factor was the lowest at draw shot. About the vertical launch angle, the fade shot showed the highest launch angle while the max height of the ground and ball was the highest at fade shot. And carry was the longest at draw shot. For the flight time, it was the longest at draw shot. The landing angle was the largest at fade shot. About the club head position change and trajectory, at the overall event point, the fade shot drew a more outer trajectory at the point of the follow through(E6) than the straight or draw shot. Regarding the angular speed of shoulder rotation, at the overall event point, the fade shot showed the greatest angular speed change in the follow through(E6). Also, about the angular speed of pelvic rotation, at the overall event point, the draw shot showed the greatest angular speed change at the point of down swing(E4). Concerning the stance angle change, both straight and fade shots were open as the concept of open stance whereas the draw shot was close as that of close stance. Regarding the previous study, the most important factor of deciding Ball Quality is the club face angle's open and close state at Impact. In short, the Ball Quality and carry were decided by this factor.
The purpose of this study was to investigate the changes in walking pattern of the elderly during inclined walkway with uneven surfaces and level walking. 10 young($26.3{\pm}1.3$ years, $174.3{\pm}5.3\;cm$, $69.5{\pm}9.5\;kg$) and 13 elderly($72.4{\pm}5.2$ years, $164.5{\pm}5.4\;cm$, $66.1{\pm}9.6\;kg$) male subjects were participated in the experiment. Experiment consisted of 2 walking conditions: horizontal and inclined walkway with uneven surfaces. 3D motion capturing system were used to acquire and analyze walking motion data with sampling frequency of 120 Hz. To compare differences between conditions, kinematic variables(walking speed, stance-swing ratio, hip joint angle, knee joint angle, ankle joint angle, pelvic rotation angle) were used. Results showed that there were some changes of elderly walking pattern in inclined walkway with uneven surfaces: hip joint(adduction and rotation) and pelvic movement pattern. These changes by inclination and surface may affect gait pattern of young subjects as well as elderly subjects. However, in case of elderly it revealed more unstable gait than the young. Further study is necessary to clarify changes in walking pattern for elderly by considering various gait variables including head movement and various walkway conditions.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.5
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pp.359-367
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2004
Purpose: After the surgical correction with sagittal split ramus osteotomy, the position of the mandibular condyle in the glenoid fossa and the proximal segment of the mandible change because of bony gap between proximal and distal segment, especially in case of mandibular setback asymmetrically. In this study, positional changes in the condyle and proximal segment after BSSRO were estimated in the mandibular asymmetry patient by analyzing the in submentovertex view and P-A cephalogram for identification of ideal condylar position during surgery. Patients and Methods: The 20 patients were selected randomly who visit Dankook Dental Hospital for mandibular asymmetry. Bilateral sagittal split ramus osteotomy with rigid fixation was performed and P-A cephalogram and submentovertex view was taken at the time of preoperative, immediate postoperative, 3 month postoperative period. Results: Intercondylar length and transverse condylar angle was increased due to inward rotation of proximal segment and anteromedial rotation of lateral pole of condyle head. The condylar position had a tendency to return to the preoperative state and after 3 months return up to about half of the immediate post-operative changes, and all the results showed more changes in asymmetry patient and deviated part of the mandible. Conclusion: Based on all these results above, surgeon should make efforts to have a precise preoperative analysis and to have a ideal condylar position during rigid fixation after BSSRO.
Sapphire is currently used as a substrate material for blue light-emitting diodes (LEDs). The market for sapphire substrates has expanded rapidly as the use of LEDs has extended into various industries. However, sapphire is classified as one of the most difficult materials to machine due to its hardness and brittleness. Recently, a lap-grinding process has been developed to combine the lapping and diamond mechanical polishing (DMP) steps in a single process. This paper studies, the effect of wafer surface roughness on the chemical mechanical polishing (CMP) process by pressure and abrasive concentration in the lap-grinding process of a sapphire wafer. In this experiment, the surface roughness of a sapphire wafer is measured after lap-grinding by varying the pressure and abrasive concentration of the slurry. CMP is carried out under pressure conditions of 4.27 psi, a plate rotation speed of 103 rpm, head rotation speed of 97 rpm, and slurry flow rate of 170 ml/min. The abrasive concentration of the CMP slurry was 20wt, implying that the higher the surface roughness after lapgrinding, the higher the material removal rate (MRR) in the CMP. This is likely due to the real contact area and actual contact pressure between the rough wafer and polishing pad during the CMP. In addition, wafers with low surface roughness after lap-grinding show lower surface roughness values in CMP processes than wafers with high surface roughness values; therefore, further research is needed to obtain sufficient surface roughness before performing CMP processes.
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