• Title/Summary/Keyword: Proper posterior

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Usefulness of Hepatocellular Carcinoma by Hepatic Arterial Perfusion Scintigraphy with $^{99m}Tc$-MAA ($^{99m}Tc$-MAA를 이용한 간세포암의 간동맥 관류 스캔의 유용성)

  • Jeong, Ji-Uk;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Moo-Seok;Song, Hyeon-Seok;Park, Se-Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.155-158
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    • 2010
  • Purpose: $^{99m}Tc$-macroaggregated albumin (MAA) hepatic arterial perfusion scintigraphy was known for useful method to evaluate patients receiving intraarterial chemotherapy for liver cancer. This study evaluate about usefulness of normal liver on hepatocellular carcinoma (HCC) from HCC patients. This study is to see the usefullness of Hepatic Arterial Perfusion Scintigraphy (HAPS) by measuring mass size, shape, lung shunting and tumor to normal ratio (T/N ratio) in relative blood stream of HCC patients compared with HCC on normal liver. Materials and Methods: From June 2009 to September 2009, HAPS studies were performed on 7 patients (men 6, women 1, mean 64) who were diagnosed HCC. HAPS was performed after proper hepatic artery $^{99m}Tc$-MAA of 5 mCi (185 MBq) injection by catheter. We performed anterior, posterior, both lateral view, SPECT of chest and abdomen. Then we set up ROI and calculated lung shunting, T/N ratio for each count, count/pixel (mean value). Results: Tumor and liver size analyzed by ROI of anterior, posterior view are 2.0-10.8 cm (mean 3.75 cm), 8.8-18.5 cm (mean 14.6 cm). T/N ratio analyzed by total tumor and total normal mean value are 2.41-5.76 (mean 3.8). lung shunting analyzed by total liver count is 3.14-13.92% (mean 6.77%). Conclusion: HAPS with $^{99m}Tc$-MAA can evaluate mass size, location, quantitative analysis through T/N ratio. also HAPS can evaluate detection of arteriovenous shunt through lung uptake before radioisotope therapy. Therefore HAPS with $^{99m}Tc$-MAA can be useful method in aspect of evaluation and treatment of HCC.

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Bone changes around the maxillary posterior teeth opposing the implants in mandible: a clinical study (하악 임플란트에 대합되는 상악 구치의 주변골 변화에 대한 임상연구)

  • Park, Chan-Jin;Huh, Yoon-Hyuk;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.301-309
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    • 2015
  • Purpose: When the edentulous area is restored by implant prostheses, the opposing hypofunctioned teeth will receive physiologic mechanical stimuli. This study evaluated the bone changes around the maxillary teeth opposing an implant restoration installed in the mandibular posterior area. Materials and Methods: Radiographs of the opposing teeth were taken at prostheses delivery (baseline), 3 and 6 months later. A customized film holding device was fabricated to standardize the projection geometry for the serial radiographs of the opposing teeth. The gray values of the region of interest of each digital image were compared according to time. Repeated measured analysis of variance was performed at the 95% significance level. Results: The gray values of the alveolar bone around the antagonist teeth of implants increased with time. The changes in gray values of the middle area were greater than those of the crestal area. However, the gray values of the mesial and distal areas were not different. The changes in gray values were different according to the unloaded time. Conclusion: A change in bone tissue will occur if a proper physiologic load is again applied to the bone tissues around a hypofunctioned tooth.

Changes of Ground Reaction Forces by the Change of Club Length in Golf Swing (클럽의 길이 변화에 따른 골프 스윙의 지면반력 변화)

  • Sung, Rak-Joon
    • Korean Journal of Applied Biomechanics
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    • v.17 no.2
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    • pp.31-40
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    • 2007
  • Proper weight shifting is essential for a successful shot in golf swing and this could be described by means of the ground forces between the feet and ground. It is assumed that the ground forces would different according to the club used because the length and swing weight of each club is different. But, in present, it is not clear what changes are made by the change of clubs and this affect the swing motion. Therefore this study focused on the investigation of the changes of the ground forces and ground reaction forces (GRF) by the change of club length. The subjects were three professional male golfers. Four swings (driver, iron 3, iron 5, and iron 7) for each subject were taken by two high speed video cameras and two AMTI force platforms were used to measure the GRF simultaneously. Kwon GRF 2.0 and Mathcad 13 software were used to post processing the data. Changes of the three major component of GRF (Vertical, lateral, anterior-posterior force) at 10 predefined events were analyzed including the maximum. Major findings of this study were as follows. 1. Vertical forces; - There were no significant changes until the top of backswing. - Maximum was occurred at the club horizontal position in the downswing for both feet. The shorter club produced more maximum forces than longer ones in the left foot, but reverse were true for the right foot. - Maximum forces at impact shows the same patterns. 2. Lateral forces; Maximum was occurred at the club horizontal position for both feet, but there were no lateral forces because the direction of two forces was different. Maximum force pattern by different clubs was same as the vertical component. 3. Anterior-posterior forces; - This component made a counter-clock wise moment about a vertical axis located between two foot until the club vertical position was reached during the backswing, and reverse moment were produced when the club reached horizontal at the downswing. - Also this component made a forward moment about a horizontal axis located in the CG during the fore half of the downswing, and a reverse moment until the club reached vertical at the follow through phase. Maximum was occurred at the club vertical in the downswing for both feet. The longer club produced more maximum forces than shorter ones for both feet.

Comparison of SpineJet$^{TM}$ XL and Conventional Instrumentation for Disk Space Preparation in Unilateral Transforaminal Lumbar Interbody Fusion

  • Huh, Han-Yong;Ji, Cheol;Ryu, Kyeong-Sik;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.370-376
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    • 2010
  • Objective : Although unilateral transforaminal lumbar interbody fusion (TLIF) is widely used because of its benefits, it does have some technical limitations. Removal of disk material and endplate cartilage is difficult, but essential, for proper fusion in unilateral surgery, leading to debate regarding the surgery's limitations in removing the disk material on the contralateral side. Therefore, authors have conducted a randomized, comparative cadaver study in order to evaluate the efficiency of the surgery when using conventional instruments in the preparation of the disk space and when using the recently developed high-pressure water jet system, SpineJet$^{TM}$ XL. Methods : Two spine surgeons performed diskectomies and disk preparations for TLIF in 20 lumbar disks. All cadaver/surgeon/level allocations for preparation using the SpineJet$^{TM}$ XL (HydroCision Inc., Boston, MA, USA) or conventional tools were randomized. All assessments were performed by an independent spine surgeon who was unaware of the randomizations. The authors measured the areas (cm2) and calculated the proportion (%) of the disk surfaces. The duration of the disk preparation and number of instrument insertions and withdrawals required to complete the disk preparation were recorded for all procedures. Results : The proportion of the area of removed disk tissue versus that of potentially removable disk tissue, the proportion of the area of removed endplate cartilage, and the area of removed disk tissue in the contralateral posterior portion showed 74.5 ${\pm}$ 17.2%, 18.5 ${\pm}$ 12.03%, and 67.55 ${\pm}$ 16.10%, respectively, when the SpineJet$^{TM}$ XL was used, and 52.6 ${\pm}$ 16.9%, 22.8 ${\pm}$ 17.84%, and 51.64 ${\pm}$ 19.63%, respectively, when conventional instrumentations were used. The results also showed that when the SpineJet$^{TM}$ XL was used, the proportion of the area of removed disk tissue versus that of potentially removable disk tissue and the area of removed disk tissue in the contralateral posterior portion were statistically significantly high (p < 0.001, p < 0.05, respectively). Also, compared to conventional instrumentations, the duration required to complete disk space preparation was shorter, and the frequency of instrument use and the numbers of insertions/withdrawals were lower when the SpineJet$^{TM}$ XL was used. Conclusion : The present study demonstrates that hydrosurgery using the SpineJet$^{TM}$ XL unit allows for the preparation of a greater portion of disk space and that it is less traumatic and allows for more precise endplate preparation without damage to the bony endplate. Furthermore, the SpineJet$^{TM}$ XL appears to provide tangible benefits in terms of disk space preparation for graft placement, particularly when using the unilateral TLIF approach.

Full-mouth rehabilitation of a patient with reduced occlusal vertical dimension due to severe wear: a clinical report (심한 마모로 인하여 교합 고경이 감소된 환자의 완전 구강 회복술)

  • Kim, Min-Jung;Kim, Hyeong-Seob;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.39-46
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    • 2013
  • The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

Clinical Experience of Currarino Syndrome (큐라리노 증후군의 임상 경험)

  • Kim, Tae-Hoon;Cho, Min-Jeong;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.65-71
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    • 2011
  • Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis. pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and W8re diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid Cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malforlnation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

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Successful Conservative Surgical Treatment of Ameloblastic Fibroma in the Posterior Maxilla : A Case Report (상악 구치부에 발생한 법랑모세포섬유종의 성공적인 보존적 수술 : 증례 보고)

  • Lee, Youngeun;Ahn, Hyojung;Lee, Sooeon;Kim, Euncheol;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.321-327
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    • 2013
  • Ameloblastic fibroma (AF) is a rare odontogenic ectomesenchymal tumor that is frequently seen in the first two decades of life, and occurs in the mandible. The most proper management of AF has been a recent topic of debate because of its recurrence and malignant transformation. This report describes AF in a 4-year-old male, which was a unilocular radiolucency on the maxillary right primary molar area with a scalloped border and corticated margin. The tumor was treated conservatively with enucleation and curettage, and the decision was made to preserve the right primary second molar. A biopsy confirmed it as AF. During the 43 months of follow-up, the patient had no evidence of recurrence or malignant transformation. Moreover, the radiographic examination revealed the generation of tooth germ to be a permanent second premolar. This report shows a case of AF in the posterior maxilla of a 4-year-old boy and discusses the conservative therapeutic approach to this tumor. Therefore, the age of the patients should be an important consideration when choosing conservative or radical surgery in a young AF patient.

A study of Bayesian inference on auto insurance credibility application (자동차보험 신뢰도 적용에 대한 베이지안 추론 방식 연구)

  • Kim, Myung Joon;Kim, Yeong-Hwa
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.4
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    • pp.689-699
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    • 2013
  • This paper studies the partial credibility application method by assuming the empirical prior or noninformative prior informations in auto insurnace business where intensive rating segmentation is expanded because of premium competition. Expanding of rating factor segmetation brings the increase of pricing cells, as a result, the number of cells for partial credibility application will increase correspondingly. This study is trying to suggest more accurate estimation method by considering the Bayesian framework. By using empirically well-known or noninformative information, inducing the proper posterior distribution and applying the Bayes estimate which is minimizing the error loss into the credibility method, we will show the advantage of Bayesian inference by comparison with current approaches. The comparison is implemented with square root rule which is a widely accepted method in insurance business. The convergence level towarding to the true risk will be compared among various approaches. This study introduces the alternative way of redcuing the error to the auto insurance business fields in need of various methods because of more segmentations.

Occlusal Adjustment and Prosthodontic Reconstruction on the Open-bite Patient. - Intentional Decrease of Occlusal Vertical Dimension - (자연치 교합조정에 의한 전치, 구치 개교합의 보철적 수복 - 수직고경의 의도적 감소증례)

  • Lee, Seung-Kyu;Kwon, Kung-Rock;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.133-147
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    • 2000
  • A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

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Microsurgical DREZotomy for Deafferentation Pain (구심로 차단 동통에서의 미세 후근 진입부 절제술)

  • Kim, Seong-Rim;Lee, Kyung Jin;Cho, Jeong Gi;Rha, Hyung Kyun;Park, Hae Kwan;Kang, Joon Ki;Choi, Chang Rak
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.85-90
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    • 2001
  • Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

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