• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.151-156
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• 1999

Purpose : Average humeral head retroversion was showed significant wide range from literatures based on variable measuring technique, We performed computed tomography(CT) study in an effort to define the specific anatomy relationships and evaluate their use. Materials and Methods : Two hundreds shoulders and distal humeri CT scan with no known pathology were examined. The study population was divided to 10 groups by gender and age (from third to seventh decade). The number of each group was twenty. Retroversion of proximal humerus and glenoid were measured using the lines that were connected the central axis of humeral head, central points of the humeral epicondyles paralleling to the trochlea, paralled to the glenoid surface, midpoint between the transverse glenoid diameter and medial edge of the scapular. We also measured the bicipital groove distance from the humeral central axis and scapulothoracic angle. Results: Retroversion of proximal humerus was highly variable, ranging in this study from 13 to 58 degrees(mean 28.73) These values correlated with sex, not age, height or hand dominance. Glenoid retroversion at the inferior sections showed average 1.3 degree, did not signigicant differences. The central axis was an average of l0mm(5-15mm) posterior to the posterior margin of the bicipital groove. Scapulothoracic angle was average 43 degrees(25-53 degrees) Conclusion: Anatomical reconstruction of retroversion angle should be individualized and bicipital groove could be useful as landmark for the lateral fin of the prosthesis to be positioned an average of 10mm posteriorly.

• Imaging Science in Dentistry
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• v.36 no.2
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• pp.95-101
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• 2006

Purpose : Bony strength is dependent on bone mass and bony structure. So this study was designed to investigate the relationship between the bone mass and bony trabecular characteristics. Subjects and Methods : Study subjects were 51 females (average age 68.6 years) and 20 males (average age 66.4 years). Bone mineral density (BMD, $grams/cm^2$) of proximal femur was measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized radiographs of proximal femur. A customized computer program processed morphologic operations (MO) of ROIs. 44 skeletal variables of MO were calculated from ROIs on the Ward's triangle and greater trochanter of femur. WHO BMD classes were predicted by MO variables of the same ROI. Classification and Regression Tree analysis was used for calculating weighted kappa values, sensitivity and specificity of MO. Results : The discriminating factors of morphologic operation were branch point, branch point [per cm sq]. Age also played important role in distinguishing osteoporotic classes. The sensitivity of MO at Ward's triangle and Greater Trochanter was 91.8%, 65.6%, respectively. The specificity of MO was 100% at Ward's triangle and Greater Trochanter. Conclusion : Bony trabecular characteristics obtained using radiological bone morphometric analysis seem to be related to bone mass.

• Imaging Science in Dentistry
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• v.37 no.1
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• pp.27-33
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• 2007

Purpose : The research was done to investigate the effectiveness of 2D bony morphometry and microstructure of micro-computed tomography (micro-CT) on the osteoporotic bony change. We performed the bone morphometric analysis of proximal femur in ovariectomized rabbits with BMD and micro-CT examination. Materials and Methods : Twenty-one female (Newzealand, about 16 weeks old, 2.9-3.4kg) rabbits were used. Three rabbits were sacrificed on the day when experiment began (Baseline). The remaining 18 rabbits were divided into two groups. One group was ovariectomized bilaterally (OVX) and the other animals were subjected to sham operation (Sham). Bone specimens were obtained from the right and left femur of sacrificed rabbits. At intervals of 1, 2, 3, 5, 6 months respectively, BMD tests were performed on the proximal femur by using PIXlmus 2 (GE Lunar Co. USA), 2-dimensional bone morphometric analysis by custome computer program and 2D/3D bone structure analysis by micro-CT (Skyscan 1072, Antwerpen, Belgium). Statistical analysis was carried out for the correlation between bone morphometry, micro-CT and BMD Result : BV/TV, Tb.Th, Tb.N of micro-CT parameters showed higher values in sham group than OVX group. N.Nd/Ar.RI, N.NdNd, N.NdTm, N. TmTm, PmB/Ar.RI, 3-D BoxSlope of 2D morphometric parameters showed higher values in Sham group than OVX group. The micro-CT parameters of Tb.Sp, Tb.N were statistically significant correlated with BMD respectively. Several 2D morphometric parameters were statistically significant correlated with BMD respectively. Conclusion : Several parameters of 2D bony morphometry and micro-CT showed effective aspects on the osteoporotic bony change.

• Journal of Korean Neurosurgical Society
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• v.47 no.2
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• pp.95-101
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• 2010

Objective : Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes. Methods : We analyzed data obtained from 13 consecutive PSO-treated patients presenting with fixed sagittal imbalances from 1999 to 2006. A single spine surgeon performed all operations. The median follow-up period was 73 months (range 41-114 months). Events during peri operative course and complications were closely monitored and carefully reviewed. Radiographs were obtained and measurements were done before surgery, immediately after surgery, and at the most recent follow-up examinations. Clinical outcomes were assessed using the Oswestry Disability Index and subjective satisfaction evaluation. Results : Following surgery, lumbar lordosis increased from $-14.1^{\circ}{\pm}20.5^{\circ}$ to $-46.3^{\circ}{\pm}12.8^{\circ}$ (p<0.0001). and the C7 plumb line improved from $115{\pm}43\;mm$ to $32{\pm}38\;mm$ (p<0.0001). There were 16 surgery-related complications in 8 patients; 3 intraoperative, 3 perioperative, and 10 late-onset postoperative. The prevalence of proximal junctional kyphosis (PJK) was 23% (3 of 13 patients). However, clinical outcomes were not adversely affected by PJK. Intraoperative blood loss averaged 2,984 mL. The C7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusion : Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.223-228
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• 2012

Purpose: To treat hallux valgus in old age patients with chevron metatarsal osteotomy and to see the subsequent clinical and radiological outcomes. Materials and Methods: 23 cases of 18 hallux valgus patients of age 60 years or older who received proximal or distal corrective osteotomy from April 2007 to August 2009 and were followed up for at least 1 year were included in the study. The mean age at operation was 65 years (range, 60~81 years), and the mean follow-up period was 2 years and 6 months (range, 1 year~3 years 6 months). Clinical outcome was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) score, complications, satisfaction rate, as well as measurements and comparison of pre- and postoperative hallux valgus angles, the 1st~2nd intermetatarsal angle, and the position of hallucal medial sesamoid bone. Results: The AOFAS score was improved from preoperative average of 35.1 (range, 13-47) to average 85.1 at last follow-up (range, 75-100). Patients were satisfied about the operation in 21 cases (91.3%). Preoperative hallux valgus angle was $31.7^{\circ}$ on average (range, $19.1^{\circ}-48.9^{\circ}$), and $4.9^{\circ}$ on average at last follow-up (range, $0.3^{\circ}-21.2^{\circ}$). The 1st~2nd intermetatarsal angle was $14.4^{\circ}$on average (range, $8.7^{\circ}-25.7^{\circ}$) and $3.1^{\circ}$ on average at last follow-up (range, $0.6^{\circ}-7.5^{\circ}$). The hallucal medial sesamoid bone position was improved from preoperative average 3.5 (range, 3-4) to postoperative average 1.0 (range, 0-2). Conclusion: Proximal and distal metatarsal osteotomy treatment yielded good clinical and radiological outcomes in old age hallux valgus patients.

• Journal of Gastric Cancer
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• v.17 no.4
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• pp.306-318
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• 2017

Purpose: Guidelines in Western countries recommend retrieving ${\geq}15$ lymph nodes (LNs) during gastric cancer resection. This study sought to determine whether the number of examined lymph nodes (eLNs), a proxy for lymphadenectomy, effects survival in node-negative disease. Materials and Methods: The US National Cancer Database (2003-2011) was reviewed for node-negative gastric adenocarcinoma. Treatment was categorized by neoadjuvant therapy (NAT) vs. initial resection, and further stratified by eLN. Kaplan-Meier and Weibull models were used to analyze overall survival. Results: Of the 1,036 patients who received NAT, 40.5% had ${\leq}10eLN$, and most underwent proximal gastrectomy (67.8%). In multivariate analysis, greater eLN was associated with improved survival (eLN 16-20: HR, 0.71; P=0.039, eLN 21-30: HR, 0.55; P=0.001). Of the 2,795 patients who underwent initial surgery, 42.5% had ${\leq}10eLN$, and the majority underwent proximal gastrectomy (57.2%). In multivariate analysis, greater eLN was associated with improved survival (eLN 11-15: HR, 0.81; P=0.021, eLN 16-20: HR, 0.73; P=0.004, eLN 21-30: HR, 0.62; P<0.001, and eLN >30: HR, 0.58; P<0.001). Conclusions: In the United States, the majority of node-negative gastrectomies include suboptimal eLN. In node-negative gastric cancer, greater LN retrieval appears to have therapeutic and prognostic value, irrespective of initial treatment, suggesting a survival benefit to meticulous lymphadenectomy.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.115-118
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• 2014

Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.173-177
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• 2014

Purpose: The purpose of this study is to evaluate the characteristics of hallux valgus with severe hallux valgus angle (HVA) and moderate intermetatarsal angle (IMA) after proximal chevron osteotomy. Materials and Methods: Between January 2008 and December 2010, 41 patients (48 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic severe hallux valgus deformity ($HVA{\geq}40^{\circ}$). Patients were divided into two groups, group M (IMA< $18^{\circ}$) and group S ($IMA{\geq}18^{\circ}$). Mean age of patients was 55.7 years (34~70 years) in group M and 60.0 years (44~78 years) in group S. Mean duration of follow-up was 20.4 months (12~41 months) in group M and 18.5 months (12~35 months) in group S. Radiographic parameters, including HVA, IMA, sesamoid position, metatarsus adductus angle (MAA), and distal metatarsal articular angle (DMAA), were compared between groups. Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Recurrence rate at the last follow-up was compared between group M and group S. Results: Preoperative HVA and grade of sesamoid position did not differ between the groups. However, immediate postoperative HVA and grade of sesamoid position were significantly larger in group M. Preoperative MAA and DMAA were significantly larger in group M. No significant difference in AOFAS score and VAS was observed between the groups at the last follow-up. Ten of the 27 feet (37.0%) in group M and two of the 21 feet (9.5%) in group S showed hallux valgus recurrence at the last follow-up. Group M showed a significantly higher recurrence rate than group S. Conclusion: Recurrence rate for severe hallux valgus with moderate IMA is higher than that of severe hallux valgus with severe IMA.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.8-13
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• 2016

Purpose: The purpose of the present current study was to examine control of upper limb multi-joint movements with differential coordination stability. To achieve the goals of the study, torque analyses were utilized to answer questions about how torque components were differed among various elbow-wrist coordination patterns. Methods: Eight self-reported right-handed college students (3 males and 5 females, mean age=20.6 yr) were volunteered. The task required participants to rhythmically coordinate the flexion-extension motions of their elbow and wrist with coordination relationship of $0^{\circ}$, $90^{\circ}$, and $180^{\circ}$relative phases between the two joints. Mean relative phase and phase stability (standard deviation of relative phase) were computed to for analysisze of overall coordination performance. To determine the figure out characteristics of torque components in elbow and wrist joints, impulse values of muscle torque (MT) and interactive torque (IT) and MT as a percentage of cycle duration (MT-PCD) were analyzed. Results: Torque results showed that the proximal elbow joint generated motions with mainly muscle efforts regardless of coordination patterns, while the distal wrist joint adjusted the coordination patterns by changing amount of MT. Impulse analyses showed that the least stable $90^{\circ}$ pattern was performed by utilizing a similar coordination strategy of the most stable $0^{\circ}$ pattern. Conclusion: The present current study suggests that the roles of distal and proximal joints differ in order to achieve various multi-joint coordination movements. This study provides information for use in gives an idea to development of rehabilitation or training programs for to persons with an impaired upper limb motor ability.

• Restorative Dentistry and Endodontics
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• v.37 no.2
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• pp.104-109
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• 2012

Objectives: The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods: Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer) were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results: In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion: In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.