• 대한족부족관절학회지
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• 제7권1호
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• pp.7-12
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• 2003

Purpose: To study the relationship of the 1st to 2nd intermetatarsal angle(1-2 IMA) between the intra-operative and weight bearing postoperative anterior-posterior(AP) radiography, and evaluate the intra-operative predictability for the postoperative 1-2 IMA after proximal metatarsal osteotomy(PMO) in the hallux valgus deformity. Materials and Methods: 20 cases of moderate to severe hallux valgus patients were included in this study. After the oblique PMO(Ludloff procedure) was performed and the osteotomy site was fixed temporarily, the AP view was taken intra-operatively. About 10 weeks after surgery, postoperative weight bearing AP view was taken. The pre -. intra -, and postoperative 1-2 IMAs were compared and ana lysed statistically. Results: The 1-2 IMAs of the weight bearing preoperative, non-weight bearing intra-operative and weight bearing postoperative AP view were $15.9^{\circ}{\pm}1.8^{\circ},\;4.7^{\circ}{\pm}2.1^{\circ}$, and $6.8^{\circ}{\pm}2.5^{\circ}$ (Mean${\pm}$SD) respectively. The postoperative 1-2 IMA was greater than intra-operative measurement by $2.1^{\circ}{\pm}1.8^{\circ}$ (range; $-1^{\circ}$ to $6^{\circ}$) which was stastistically significant(p<0.05). To get less than $9^{\circ}$ postoperatively as an average normal, intra-operative 1-2 IMA should be within $3.8^{\circ}$ to $5.2^{\circ}$ (95% confidence interval), and intra-operative 1-2 IMA should be within $3.4^{\circ}{\pm}$to $5.4^{\circ}$(95% confidence interval) to get more than $6^{\circ}$ difference between preoperative and postoperative 1-2 IMA, which is regarded as more than average correction by the distal metatarsal osteotomy. Conclusion: In hallux valgus surgery, it should be considered that intra-operative 1-2 IMA was less than the postoperative. To achieve postoperative 1-2 IMA less than $9^{\circ}$ and more than correction angle of $6^{\circ}$, it is suggested that the intra-operative 1-2 IMA should be measured less than about $5^{\circ}$.

• 사상체질의학회지
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• 제10권2호
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• pp.221-270
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• 1998

Objective This research is a study about constitutional diagnosis through the external appearances as a basic principle, and it is for finding shape differences of the ear, eye, nose, mouth according to the Sasang constitution Method We have collected 209 cases of patients of the Sasang Constitutional Department, including employees of the Kyung-Hee Medical Center and took pictures of the frontal view, lateral view, oblique view of face and measured heights, deapth, breadths of ear, eye, nose, mouth with 'The Measurement of R. Martin'. We analyzed shape differences of the face according to the Sasang constitution with certain results Results We got the morphologic characteristics of ear, eye, nose and mouth according to the Sasang constitution as Table 3. -Table 10. Conclusion : 1. The morphologic characteristics of Ear according to the Sasang constitution (1) Morphologic ear length, Physiognomic ear length, Ear lobule length is longer in Taeumin than Soeumin. (2) Physiognomic ear breadth is wider in Taeumin than Soeumin. (3) Physiognomic ear length, lobule length ratio is higher in Taeumin than Soyangin. 2. The morphologic characteristics of Eye according to the Sasang constitution. (1) Inner Palpebral fissure width, 5th Palpebral fissure length, Bizygomatic breadth-Outercanthal distance is the longest in Taeumin (2) Palpebral fissure inclination is widest in Soeumin. (3) Palpebral fissure length is longer in Taeumin than Soeumin. (4) Pupillary diameter ratio is the lowest in Taeumin (5) Palpebral fissure length, width ratio is higher in Soeumin than Taeumin. (6)zygomatic breadth, Bizygomatic breadth-Outercanthal distance ratio is the higher in Taeumin than Soeumin. 3. The morphologic characteristics of Nose according to the Sasang constitution. (1) Nasion depth is deepest in Soyangin. (2) Nasion to pupillary depth is deeper Soyangin than Taeumin. (3) Nasal tip depth, Nostril to Nasalalar depth is deeper Soyangin than Taeumin. (4) Subnasale to Nasalalar depth is the shallowest in Taeumin (5) Nasalalar height is lowest in Soeumin. (6) Nasalalar to Nostril distance is deeper Taeumin than Soeumin. (7) Nasal tip depth, Nasal depth ratio is the highest in Taeumin (8) Nasal depth Nasalalar heightratio is lowest in Soeumin. (9) Midfaceheight, Nasal tip depth ratio is higher Soyangin than Taeumin. 4. The morphologic characteristics of mouth according to the Sasang constitution. (1) Lower mid lip height, Lower philtrum height, Lower quarter lip height, Total middle lip height, Total philtrum height, Total quarter lip height is the shottest in Soyangin. (2) Upper mid lip height, Upper philtrum height is longer in Taeumin than Soyangin (3) Lip inclination is higher in Soeumin than Soyangin. (4) Intercheilion breadth, total height ratio is lowest in Soyangin. (5) Total lip height, Upper philtrum height ratio is higher in Soyangin than Soeumin. (6) Lower lip height Lower quarter lip height ratio is higher in Soyangin than Taeumin. (8) Total lip area is wider in Taeumin than Soyangin.

• 구강회복응용과학지
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• 제21권2호
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• pp.153-167
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• 2005

The purpose of this study was to compare the v-shape thread with the square shape thread of fixture in the view of stress distribution pattern using finite element stress analysis. The finite element model was designed with the parallel placement of two standard fixtures(4.0 mm diameter ${\times}$ 11.5 mm length) on the region of mandibular 1st and 2nd molars. Three dimensional finite element model was created with the components of the implant and surrounding bone. This study simulated loads of 200 N at the central fossa in a axial direction (load A), 200 N at the buccal offset load that is 2 mm apart from central fossa in a axial direction (load B), 200 N at the buccal offset load that was 4 mm apart from central fossa in a axial direction (load C). These forces of load A',B',C' were applied to a $15^{\circ}$ inward oblique direction at that same site with 200 N. Von Mises stress values were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study : 1. The highest stress concentration occurred at the cervical region of the implant fixture. 2. Von Mises stress value of off-site region was higher than that of central fossa region. 3. Square shape thread type showed more even stress distribution in the vertical and oblique force than V-shape thread type. 4. Stress distribution was the most effective in the case of buccal offset load (2, 4 mm distance from central fossa) in the square shape thread type. 5. V-shape thread type revealed higher von Mises stress value than square shape thread type in all environmental condition. The results from numerical analyses concluded that square shape thread type had the lower destructive stress and more stress distribution between the fixture and bone interface than V-shape thread type. Therefore, square shape thread type was regarded as optimal thread configuration in biomechanical concepts.

• 대한치과보철학회지
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• 제36권6호
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• pp.900-913
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• 1998

임플란트 치과 임상에서, 협, 설측의 골조직 상태는 임플란트 재료의 높은 밀도 때문에 구내용 방사선사진으로는 파악할 수 없으나, 디지털 분석을 이용한 정량적 방사선 분석법을 사용하여 이 부위를 파악하고자 하였다. 건조 하악골에 10개의 직경 3.3mm인 solid screw형태의 $ITI^{(R)}$ 임플란트(Institute Straumann, Waldenberg, Switzerland)을 매식한 다음, 이들을 10개의 골 시편으로 절단한 후, 방사선사진 촬영을 시행했다. 일련의 중첩상을 얻기 위해, 특별히 고안된 방사선필름 고정기와 D속도 필름($Ultra-speed^{(R)}$, Kodak, USA)을 사용했으며, 고 해상도의 디지털 분석을 위해, 비디오카메라($Kodak-Eikonix^{TM}$, USA)로 필름을 scan하고 software(LaboImage, Computing Science Center, Geneva University)를 이용해 정량적 분석을 시행했다. 방사선 촬영은 4 방향(통상적인 periapical projection에 의한 근, 원심(MD)방향 및 협, 설(BL) 조사위, 통상적인 occlusal projection에 준한 25도 경사진 근, 원심(OMD) 및 25도 경사진 협, 설(OBL)조사위)으로 시행했으며, 각 시편에서 4장의 연속 중첩 방사선사진(superimposable radiograph)을 임플란트 매식공 천공 후, 임플란트 매식 후, 임플란트 주변(협,설) 골 손상 후, 임플란트 제거 후의 상황에서 표준화된 방법으로 촬영해서 얻었다. 기술적인 어려움에도 불구하고, occlusal projection으로 촬영하고, 이를 디지털 농도 분석한 방법에서. 치과 임플란트 주변 협, 설측의 미세골 변화를 파악할 수 있을 것으로 보였다. 특히, occlusal projection이 periapical projection에 비해 더욱 민감한 골 변화를 인지하는 것으로 나타났다. 비록 이 실험의 결과가 제한된 조건에서 얻어졌지만, 실제 임플란트 임상에서 임상가들에게 진단적 차원에서의 새로운 가능성과 다양성을 제시해 줄 수 있으리라 사료된다.

• 대한관절경학회지
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• 제16권1호
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• pp.17-25
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• 2012

목적: 급성 전방십자인대 손상 환자의 자기공명영상(magnetic resonance imaging, MRI)에서 나타난 골멍의 형태 및 크기와 전방십자인대의 손상 정도와의 관계를 알아보고 골멍의 발자취(footprint)를 조사해 손상기전을 알아보고자 하였다. 대상 및 방법: 급성 전방십자인대 손상 6주 이내의 급성기에 자기공명영상을 촬영하여 골멍이 나타나는 65명을 대상으로 하였다. 골멍의 형태는 Costa-Paz 분류에 따라, 골멍의 크기는 Kornaat의 방식으로 측정하였다. 자기공명영상의 전방십자인대 관상사면영상(anterior cruciate ligament [ACL] oblique coronal view)에서 손상 정도를 등급화 하였다. 결과: Costa-Paz 분류에 따른 대퇴골 외과의 골멍 형태와 전방십자인대 손상 정도의 관계를 알아본 결과, 부분 파열군(1, 2 등급)에서 제2형이 많고, 완전 파열군(3 등급)에서 제3형이 많았다(P=0.037). Kornaat 총 골멍 점수는 전방십자인대 손상 등급에 따라 차이를 보였으며(P=0.014), 손상기전은 축회전 손상(pivot shift injury)이 가장 많았고 편타 외반 손상 (clip valgus injury) 등이 뒤를 이었다. 결론: 급성 전방십자인대 손상 시 골멍의 형태와 크기는 전방십자인대의 손상 정도와 관련이 있었고, 골멍의 발자취를 통해 손상기전을 유추할 수 있어 급성 전방십자인대 손상의 진단 및 치료에 도움이 되리라 사료된다.

• 대한족부족관절학회지
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• 제10권1호
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• pp.7-10
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• 2006

Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.46-52
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• 2010

Objective : In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels. Methods : Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan. Results : The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were $6.9{\pm}1.34\;mm$, $8.23{\pm}1.18\;mm$, $30.93{\pm}4.65\;mm$, $26.42{\pm}7.91$ degrees, $25.9{\pm}4.83$ degrees, and $10.6{\pm}3.39$ degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group. Conclusion : C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.

• 대한전자공학회논문지
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• 제20권1호
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• pp.63-71
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• 1983

본 논문에서는 디지탈 감산 기법을 이용한 양면 혈관 조영술 영상에서의 대응점 결정을 위하여 조영제 말단 추적 알고리즘을 사용하였고, 이 대응점 정보로부터 혈관의 3차원 영상을 재구성하는 과정을 확립하였으며, 개를 이용한 실험 결과도 포함되어 있다. 저자들에 의해 개발된 본 방법의 정확성을 입증하기 위해 사각에서 잡은 혈관 조영상과 계산을 통해 재구성된 영상을 비교하여 좋은 결과를 얻었다. 본 논문에서는 3가지의 새로운 알고리즘을 개발, 또는 응용하였는바, 첫째는, 순차적인 영상에서 조영제의 말단은 어느 투영면에서도 동일한 형태를 갖게 되므로, 상호 상관 계수의 접합법을 이용하여 조영제 말단을 추적해 가는 알고리즘이고, 둘째는, 기준좌표계에서 시선좌표계로의 전환을 4×4행렬 하나로 표시한 단순화 투시 변환 행렬의 구성이며, 셋째는, 조영제 말단 추적법이 적용될 수 없는 작은 혈관 영상에서의 대응점 확립을 위한 보조알고리즘의 적용이 그것이다. 또한 본 방법은 3차원 공간상에서의 조영제 말단 이동거리에 대한 정보로부터 혈류속도의 측정에도 이용될 수 있다.

• 대한족부족관절학회지
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• 제10권2호
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• pp.242-246
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• 2006

Purpose: Frequency of sesamoid bone on hallucal interphalangeal joint has been described to be low probability in orthopaedic and anatomical literature. We have, however, experienced two cases of interphalangeal joint dislocation giving difficulty to usual manipulative reduction because of presence of sesamoid bone recently. In order to ascertain existence of sesamoid bone on interphalangeal joint of hallux in Korean adults, radiological study have been performed with feet of patients Materials and Methods: Between May 2003 and October 2006, 974 patients with 1098 radiographs of feet which were reached skeletal maturity over 18-year-old were examined. Unilateral or bilateral anteroposterior, lateral and oblique radiographs were observed by one same person and presence was recorded if there was sesamoid in films. Distance of long and short axes were measured in lateral view and cases of two sesamoids in interphalangeal joint were recorded. Statistical differences between left and right side or between men and women were evaluated by chi-square test. Results: Frequency of sesamoid was 980 cases (89.3%) and no occurrence in 118 cases (10.7%). Two sesamoids were observed in 3 cases. Average distance of long axis was 4.9 mm (range, 0.5-11.4) and average distance of short axis was 3.5 mm (range, 0.3-9.3). Unilateral sesamoid was observed in 7 patients (5.6%), bilateral absence was 7 patients (5.6%) and bilateral sesamoids in 110 patients (88.8%) out of 124 patients who took bilateral feet radiographs. Men has less frequency than women significantly (p=0.014) while there was no significant difference in frequency according to side(p>0.05). Conclusion: Sesamoid bone was seen in 980 feet (89.3%) out of 1098 normal Korean radiological studies of feet. We report 3 cases of two seamoids which was extremely rarely reported in literature. Korean frequency is similar with Japanese, but much higher than Caucasians and black Africans.

• 대한족부족관절학회지
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• 제15권4호
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• pp.217-222
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• 2011

Purpose: The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease. Materials and Methods: We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection. Results: According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up. Conclusion: Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.