• Title/Summary/Keyword: Radiographic classification

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Short-segment Pedicle Instrumentation of Thoracolumbar Burst-compression Fractures; Short Term Follow-up Results

  • Shin, Tae-Sob;Kim, Hyun-Woo;Park, Keung-Suk;Kim, Jae-Myung;Jung, Chul-Ku
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.265-270
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    • 2007
  • Objective : The current literature implies that the use of short-segment pedicle screw fixation for spinal fractures is dangerous and inappropriate because of its high failure rate, but favorable results have been reported. The purpose of this study is to report the short term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation. Methods : A retrospective review of all surgically managed thoracolumbar fractures during six years were performed. The 19 surgically managed patients were instrumented by the short-segment technique. Patients' charts, operation notes, preoperative and postoperative radiographs (sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis, regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 12-month follow-up were reviewed. Results : No patients showed an increase in neurological deficit. A statistically significant difference existed between the patients preoperative, postoperative and follow-up sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis and regional kyphosis. One screw pullout resulted in kyphotic angulation, one screw was misplaced and one patient suffered angulation of the proximal segment on follow-up, but these findings were not related to the radiographic findings. Significant bending of screws or hardware breakage were not encountered. Conclusion : Although long term follow-up evaluation needs to verified, the short term follow-up results suggest a favorable outcome for short-segment instrumentation. When applied to patients with isolated spinal fractures who were cooperative with 3-4 months of spinal bracing, short-segment pedicle screw fixation using the posterior approach seems to provide satisfactory result.

Effects of AIF on Knee Osteoarthritis Patients: Double-blind, Randomized Placebo-controlled Study

  • Park, Sung-Hoon;Kim, Seong-Kyu;Shin, Im-Hee;Kim, Hyung-Gun;Choe, Jung-Yoon
    • The Korean Journal of Physiology and Pharmacology
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    • v.13 no.1
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    • pp.33-37
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    • 2009
  • Anti-inflammatory factor(AIF) is a water soluble extract of three herbs, Panax notoginseng(Burk.) F. H. Chen, Rehmannia glutinosa Libosch and Eleutherococcus senticosus. The present study aimed to investigate the safety and efficacy of herb extracts, AIF, on Korean knee osteoarthritis patients for six weeks. Fifty seven patients with knee osteoarthritis, ranging from 43 to 73 years of age, who fulfilled the "American College of Rheumatology"(ACR) classification of idiopathic osteoarthritis of knee and radiographic criteria were randomly selected and enrolled for the study. After initial screening and resting period, two capsules each of AIF(Each capsule contains; 400 mg) and similar identical placebo were administered twice a day to both groups. Pain intensity at second, fourth, and sixth weeks of study as well as one week after discontinuation of drugs was assessed by using 100 mm visual analogue scale(VAS). Changes in the Korean version of the Western Ontario and McMaster Universities(K-WOMAC) index score were compared at the initiation and completion of the study. VAS assessed by patients were significantly reduced(at visit 2; $54.64{\pm}14.72$, at visit 4, $37.32{\pm}16.58$, p<0.001) after AIF administration. Results showed an improvement in the physical function of K-WOMAC scale which was significantly higher(p=0.013) in AIF than placebo group, and decreases of total K-WOMAC score were also significantly higher(p=0.030) in AIF groups than placebo group. No serious adverse effect was observed, and there was no difference in incidence of adverse effect between AIF and placebo groups. In this population of Korean patients with knee osteoarthritis, AIF was found to be safe, tolerable and effective for symptomatic improvement of pain and physical function.

A RADIOGRAPHIC STUDY OF MANDIBULAR CONDYLE SHAPE AND POSITION: A COMPARISON OF TRANSCRANIAL RADIOGRAMS AND INDIVIDUALIZED CORRECTED TOMOGRAMS (경두개방사선사진과 측방 개별화 단층방사선사진을 이용한 하악과두의 형태와 위치에 관한 연구)

  • LEE Sang Rae;HWANG Eui Hwan
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.27 no.1
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    • pp.25-41
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    • 1997
  • The purpose of this study was to observe mandibular condyle shape and position in an asymptomatic population. In order to carry out this study, 142 temporomandibular joints in 71 adults(35 males, 36 females), who were asymptomatic for temporomandibular joint disorders and had no history of prosthodontic or orthodontic treatments, were selected, and radiographed using the Accurd-200 head holder(Denar Co., U.S.A) for transcranial radiograms and the Sectography(Denar Co., U.S.A) for lateral individualized corrected tomograms. Mandibular condyles were classified morphologically and evaluated in positional relationships with articular fossae and articular eminences at centric occlusion and 1 inch mouth opening. The obtained results were as follows; 1. In the classification of mandibular condyle shape, the convex type was more prevalent in transcranial radiograms and tomograms taken at medial, central, and lateral locations. 2. In the mandibular condyle position at centric occlusion, the mandibular condyles were placed posterior to the center of articular fossae in transcranial radiograms and anterior to the center of articular fossae in tomograms taken at medial, central, and lateral locations. 3. In the mandibular condyle position in right and left TMJs at centric occlusion, the mandibular condyles were placed bilateral asymmetric relationships to the articular fossae in transcranial radiograms and tomograms taken at medial, central, and lateral locations. 4. In the mandibular condyle position at 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminences in transcranial radiograms and tomograms taken at central location and posterior to the articular eminences in tomograms taken at medial and lateral locations.

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Bifid Mandibular Canal: Radiographic Observation and Clinical Relevance -A Case Report- (이열 하악관(Bifid Mandibular Canal): 방사선적 소견과 임상적 의의 -증례보고-)

  • Lee, Hyun-Woo;Kim, Yeo-Gab;Lee, Baek-Soo;kwon, Yong-Dae;Choi, Byung-Jun;Kim, Young-Ran
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.9 no.1
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    • pp.24-29
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    • 2009
  • When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.

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Wire-guided Localization Biopsy to Determine Surgical Margin Status in Patients with Non-palpable Suspicious Breast Lesions

  • Dogan, Lutfi;Gulcelik, M. Ali;Yuksel, Murat;Uyar, Osman;Reis, Erhan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4989-4992
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    • 2012
  • Purpose: Guide-wire localization (GWL) has been a standard technique for many years. Excision of nonpalpable malignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. The objective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins. Methods: This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesions and breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographic findings, breast density specifications, specimen volumes, menopausal status and family history of the patients and surgical margin status were recorded. Results: Median age was 53.3 years, median tumour size was 1.5 cm and median specimen volume was $71.5cm^3$. In fifteen patients (28%) DCIS and in 38 patients (72%) invasive ductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. The median distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denser breast specifications were found as statistically significant factors for surgical margin status. Median age of the patients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins (p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADS classification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients who had positive or close surgical margins received re-excision (72%). Conclusion: Positive margin rates may be higher because of inherent biological differences and diffuse growth patterns in younger patients. There are also technical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excision rates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions.

Accuracy of Freehand versus Navigated Thoracolumbar Pedicle Screw Placement in Patients with Metastatic Tumors of the Spine

  • De La Garza Ramos, Rafael;Echt, Murray;Benton, Joshua A.;Gelfand, Yaroslav;Longo, Michael;Yanamadala, Vijay;Yassari, Reza
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.777-783
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    • 2020
  • Objective : To compare the accuracy and breach rates of freehand (FH) versus navigated (NV) pedicle screws in the thoracic and lumbar spine in patients with metastatic spinal tumors. Methods : A retrospective review of adult patients who underwent pedicle screw fixation in the thoracic or lumbar spine for metastatic spinal tumors between 2012 and 2018 was conducted. Breaches were assessed based on the Gertzbein and Robbins classification and only screws placed >4 mm outside of the pedicle wall (lateral or medial) were considered breached. Results : A total of 62 patients received 547 pedicle screws (average 8 per patient) - 34 patients received 298 pedicle screws in the FH group and 28 patients received 249 screws in the NV group. There were 40/547 breaches, corresponding to a breach and accuracy rate of 7.3% and 92.7%, respectively. The breach rate was 9.7% in the FH group and 4.4% in the NV group (chi-squared test, p=0.017); this corresponded to an accuracy rate of 90.3% and 95.6%, respectively. Only one patient from the overall cohort (in the FH group) required revision surgery due to a medial breach abutting the spinal cord (1.6% of all patients; 2.9% of FH patients); no patient suffered organ, vessel, or neurological injury from screw breaches. Conclusion : Navigated pedicle screw placement in patients with metastatic spinal tumors has a significantly higher radiographic accuracy compared to the FH technique. However, the revision surgery was low and no patient suffered from clinically-relevant breach. Navigation also offers the advantage of real-time localization of spinal tumors and aids in targeting and resection of these lesions.

The apical root canal shape according to the root canal system of premolars with single root (단근 소구치의 근관계 형태에 따른 치근단 부위의 근관 형태)

  • Park, Min-Soo;Hwang, Ho-Keel;Jo, Hyoung-Hoon
    • The Journal of the Korean dental association
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    • v.55 no.1
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    • pp.63-70
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    • 2017
  • Materials and methods: Sixty extracted premolars were assigned to three groups according to the root canal system (Weine's classification; type I, II and III) of 20 teeth each using radiographic examination. The root tip was cut horizontally 1 mm from the anatomical apex and the apical cross-section was visualized using microscope at x50 magnification and photographed. Minimum and maximum apical root canal diameter of each tooth was measured and classified into three types by canal morphology (round, oval and flattened shape). Statistical analysis was performed to compare the apical root canal diameter and morphology according to the root canal system. Results: In apical root canal morphology at cross-sectional view, the most common shape was round in type I, flat in type II, and oval in type III. In apical root canal diameters at cross-sectional view, there was a significant difference between the minimum and maximum diameter in all types (p<0.05). The maximum diameter was 0.331 mm in type I, 0.519 mm in type II, and 0.310 mm in type III. There was a significant difference among type I, III and type II (p<0.05). Conclusion: The morphology and diameter of apical root canal was different according to the root canal system. Therefore, clinicians should consider the apical file size in view of the apical root canal shape according to the root canal system.

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Feature Extraction of Welds from Industrial Computed Radiography Using Image Analysis and Local Statistic Line-Clustering (산업용 CR 영상분석과 국부확률 선군집화에 의한 용접특징추출)

  • Hwang, Jung-Won;Hwang, Jae-Ho
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.45 no.5
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    • pp.103-110
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    • 2008
  • A reliable extraction of welded area is the precedent task before the detection of weld defects in industrial radiography. This paper describes an attempt to detect and extract the welded features of steel tubes from the computed radiography(CR) images. The statistical properties are first analyzed on over 160 sample radiographic images which represent either weld or non-weld area to identify the differences between them. The analysis is then proceeded by pattern classification to determine the clustering parameters. These parameters are the width, the functional match, and continuity. The observed weld image is processed line by line to calculate these parameters for each flexible moving window in line image pixel set. The local statistic line-clustering method is used as the classifier to recognize each window data as weld or non-weld cluster. The sequential procedure is to track the edge lines between two distinct regions by iterative calculation of threshold, and it results in extracting the weld feature. Our methodology is concluded to be effective after experiment with CR weld images.

A COMPARATIVE STUDY OF RADIOGRAPHIC IMAGINGS IN PATIENTS WITH MAXILLOFACIAL FRACTURES (상안면부 골절에 관한 방사선학적 비교 연구)

  • Hong Seong-Woo;Koh Kawng-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.545-553
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    • 1995
  • The subjects of this study consisted of 58 patients with Le Fort fractures, who were admitted to Chonbuk National University Hospital from Jan. 1988 to Oct. 1995. The author classified the maxillofacial fractures by Le Fort classification and examined the. incidence of Le Fort fractures by age, sex and etiology. The purpose of this study was to compare the imagings of conventional radiograms with those of computed tomograms and to aid in the diagnosis of patients with Le Fort fractures. The obtained results were as follows: 1. The Le Fort fractures occured mainly in 3rd and 4th decades, but there was no significant difference between decades. A ratio of men to women was 5.5 : 1. The major etiologic factors were traffic accident(69%), assault(14%) and fall-down(12%). 2. The most common type of Le Fort fracture was type I(49.3%). The numbers of Le Fort II, ill fractures were 41.3%, 9.4% respectively. And 8.6% were midsagittal splitting fractures. 3. The discontinuity and haziness of the maxillary sinus were easily detected by Waters' view. In skull PI A view, it was difficult to observe fractures due to overlapping of the other structures, but the haziness of the maxillary sinus was sometimes observed. 4. In Le Fort fracture, the fracture pattern of orbit, the wall of maxillary sinus, nasal bone and pterygoid plate were more easily detected in computed tomograms than in conventional radiograms.

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Arthroscopic-assisted Reduction and Percutaneous Screw Fixation for Glenoid Fracture with Scapular Extension

  • Kim, Se Jin;Lee, Sung Hyun;Jung, Dae Woong;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.20 no.3
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    • pp.147-152
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    • 2017
  • Background: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. Methods: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. Results: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. Conclusions: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.