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Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy

  • Son, Byung-Chul;Kim, Deog-Ryeong
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.61-64
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    • 2015
  • A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.

Electrical Compound Action Potential: Effects of different parameters (전기 자극 청신경 복합활동전위: 변인 영향)

  • Heo, S.D.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.8 no.1
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    • pp.9-17
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    • 2014
  • Electrical compound action potential (ECAP) can be recorded on cochlear implant. This study will investigate stimulation and recording to enhance the efficacy of ECAP. 34 articles was used. We analyzed pulse and stimulating condition, artifact suppression, recording condition. The cathod-leading biphasic pulse was used with as short as possible pulse width and inter phase gap for the efficacy of neural firing, stable threshold and preventing neural degeneration. Around C-level was stimulated to apical, middle and basal turn of cochlea. Artifact was eliminated by forward-masking, template-subtraction technique. For clearer waveform, we need to change distance between stimulating and recording electrode, the gain of amplification, number of average.

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Impact of the human body in wireless propagation of medical implants for tumor detection

  • Morocho-Cayamcela, Manuel Eugenio;Kim, Myung-Sik;Lim, Wansu
    • Journal of Internet Computing and Services
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    • v.21 no.2
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    • pp.19-26
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    • 2020
  • This paper analyses the feasibility of using implantable antennas to detect and monitor tumors. We analyze this setting according to the wireless propagation loss and signal fading produced by human bodies and their environment in an indoor scenario. The study is based on the ITU-R propagation recommendations and prediction models for the planning of indoor radio communication systems and radio local area networks in the frequency range of 300 MHz to 100 GHz. We conduct primary estimations on 915 MHz and 2.4 GHz operating frequencies. The path loss presented in most short-range wireless implant devices does not take into account the human body as a channel itself, which causes additional losses to wireless designs. In this paper, we examine the propagation through the human body, including losses taken from bones, muscles, fat, and clothes, which results in a more accurate characterization and estimation of the channel. The results obtained from our simulation indicates a variation of the return loss of the spiral antenna when a tumor is located near the implant. This knowledge can be applied in medical detection, and monitoring of early tumors, by analyzing the electromagnetic field behavior of the implant. The tumor was modeled under CST Microwave Studio, using Wisconsin Diagnosis Breast Cancer Dataset. Features like the radius, texture, perimeter, area, and smoothness of the tumor are included along with their label data to determine whether the external shape has malignant or benign physiognomies. An explanation of the feasibility of the system deployment and technical recommendations to avoid interference is also described.

IN VITRO EVALUATION OF PERIOTEST VALUES UNDER VARIOUS CONDITIONS OF PROSTHESES (보철물 조건에 따른 Periotest수치의 실험적 평가)

  • Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.4
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    • pp.793-800
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    • 1997
  • Periotest(Siemens, Germany) has been used to test mobility of the implants clinically, however the effects of target materials and connection methods on the PTVs(Periotest Values) have not been evaluated. Periotest has been regarded as a reliable and objective tool to test implant and natural teeth mobility clinically, however this instrument showed different PTVs under various test conditions. This in vitro study was designed to compare PTVs of different veneering materials and prosthodontic designs (single and bridge restorations). To compare the effects of veneering materials on PTVs, 1 mm thickness of five different testing materials (porcelain, type III gold alloy, pure titanium, composite resin, acrylic resin) were placed on the resin block. Three full length of 13 mm Mark II implant fixtures were embedded into autopolymerizing resin block to fabricate single and bridge restorations. To evaluate effects of the connection method in single restorations, PTVs of screw retained(UCLA type) and cementation type(Cera-One system) were compared. Finally, to test reliability of PTVs of the final restorations, screw retained three unit short span PFM bridges were fabricated on the standard and Estheti-Cone abutments. All testing components were tightened with torque controller and PTVs of all specimens were measured 15 times for statistical analysis with SAS program. Following conclusions were made within the limit of this in vitro study. 1. PTVs of type III gold alloy, grade II titanium, composite resin veneering materials showed no significant differences, however acrylic resin and porcelain showed significant differences (P<0.05). 2. Single tooth restorations showed consistent PTVs as long as proper torque force was applied. 3. PTVs of bridge type prostheses was inconsistent regardless of abutment types. 4. PTVs of the prostheses showed higher scores and standard deviations than those of abutments regardless types of connection (P<0.05).

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Safety and Availability of Monitored-Anesthesia Care using Propofol during Implant Surgery of the One-day Admission Patients (당일 입원 환자의 치과 수술 시 Propofol을 이용한 Monitored-Aesthesia Care (MAC)의 안정성 및 유용성에 관한 연구)

  • Kim, Bum-Soo;Kim, Young-Kyun;Yun, Pil-Young;Lee, Yong-In
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.2
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    • pp.120-125
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    • 2007
  • Background: Propofol has been used extensively for short-acting intravenous sedative agent during monitored anesthesia care (MAC). This study was designed to evaluate the safety and availability of MAC using propofol in implant surgery of the one-day admission patients. Methods: In this study, subjects were divided into two groups according to ASA physical status. The heart rate, blood pressure, peripheral oxygen saturation and ECG of a patient were estimated under MAC by an anesthesiologist and the vital signs were recorded in recovery room periodically afterwards. The subjective satisfaction with regard to outpatient ambulatory surgery under MAC procedure was evaluated the next day. Results: Systolic and diastolic blood pressure were significantly decreased during MAC in ASA I group, but other remarkable changes in vital sign were not observed. There was no significant difference in pain and anxiety level between ASA I and ASA II, III group. Satisfaction rate was high in both groups. Conclusion: Monitored-Anesthesia Care using propofol during implant surgery of the one-day admission patients might be safe and available procedure because heart rate, blood pressure and oxygen saturation are stable before and during surgery, and adequate control of pain and anxiety is supported.

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Removable Partial Denture Using Anterior Implant-Supported Fixed Prostheses for Edentulous Patients: A Case Report

  • Lee, You-Jin;Bae, Eun-Bin;Jeong, Chang-Mo;Lee, Jin-Ju;Kim, Ji-Young;Huh, Jung-Bo
    • Journal of Korean Dental Science
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    • v.10 no.2
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    • pp.87-95
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    • 2017
  • This case study was to report the possible increase in the denture retention and psychological relief using the implant-supported fixed prostheses in a completely edentulous patient. The implants were placed in the anterior portion of the mandible in a patient who had completely edentulous state following the extraction of residual abutment teeth, and consequently a distal extension removable partial denture was fabricated. The patient's adaptation and satisfaction to the new prosthesis was monitored and confirmed in terms of masticatory function and esthetics, by restoring the oral condition similar to initial status before the residual teeth extraction. After 6 months, radiographic examination confirmed that both the abutment teeth and the implants were stable and well maintained. Considering the relatively short clinical follow-up period, however, continuous long-term monitoring was required.

Surgical extrusion in aesthetic area (심미적인 부위에서의 외과적 정출술)

  • Park, Hyun-Kyu;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.37 no.2
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    • pp.287-295
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    • 2007
  • As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

Fully Porous and Porous Surfaced Ti-6Al-4V Implants Fabricated by Electro-Discharge-Sintering: (1) Fabrication Method and Fundamental Characteristics (전기방전소결에 의해 제조된 다공성 및 다공성 표면을 갖는 Ti-6Al-4V 임플란트 : (1) 제조방법 및 기본적 특성)

  • Hyun, C. Y.;Huh, J. K.;Lee, W. H.
    • Journal of Powder Materials
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    • v.12 no.5 s.52
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    • pp.325-331
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    • 2005
  • Implant prototypes with various porosities were fabricated by electro-discharge-sintering of atomized spherical Ti-6Al-4V powders. Single pulse of 0.75 to 2.0 kJ/0.7 g-powder, using 150, 300, and $450{\mu}F$ capacitors was applied to produce a fully porous and porous surfaced implant compact. The solid core formed in the center of the compact after discharge was composed of acicular ${\alpha}+{\beta}$ grains and porous layer consisted of particles connected in three dimensions by necks. The solid core and neck sizes increased with an increase in input energy and capacitance. On the other hand, pore volume decreased with increased capacitance and input energy due to the formation of solid core. Capacitance and input energy are the only controllable discharge parameters even though the heat generated during a discharge is the unique parameter that determines the porosity of compact. It is known that electro-discharge-sintering of spherical Ti-6Al-4V powders can efficiently produce fully-porous and porous surfaced Ti-6Al-4V implants with various porosities in a short time less then 400 isec by manipulating the discharging condition such as input energy and capacitance including powder size.

Short-term changes of human acellular dermal matrix (Megaderm) in a mouse model

  • Kim, Yang Seok;Na, Young Cheon;Yoon, Hyun Sik;Huh, Woo Hoe;Kim, Ji Min
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.10-16
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    • 2019
  • Background: Physicians tend to overcorrect when applying the acellular dermal matrix for reconstructive option because of volume decrement problem after absorption comparing with initial volume. However, there are no studies on the exact volume decrement and absorption rate with commercial products in South Korea. To figure out absorption rate of acellular dermal matrix product in South Korea (Megaderm), authors designed this experiment. Methods: Nine mice were used and randomly divided into three groups by the time with sacrificing. The implant (Megaderm) was tailored to fit a cuboid form ($1.0cm{\times}1.0cm$ in length and width and 2.0 mm in thickness). A skin incision was made at anterior chest with blade #15 scalpel with exposing the pectoralis major muscle. As hydrated Megaderm was located upon the pectoralis major muscle, the skin was sutured with Ethilon #5-0. After the surgical procedure, each animal group was sacrificed at 4, 8, and 12 weeks, respectively, for biopsies and histological analysis of the implants. All samples were stained with routine hematoxylin and eosin staining and Masson's trichrome staining and the thickness were measured. A measurements were analyzed using Friedman test. Statistically, the correlation between thicknesses of Megaderm before and after implantation was analyzed. Results: After sacrificing the animal groups at postoperative 4, 8, 12 weeks, the mean tissue thickness values were $2.10{\pm}1.03mm$, $2.17{\pm}0.21mm$, and $2.40{\pm}0.20mm$ (p= 0.368), respectively. The remaining ratios after absorption comparing with after initial hydrated Megaderm were 82.7%, 85.4%, and 94.5%, respectively. In histopathological findings, neovascularization and density of collagenous fiber was increased with time. Conclusion: Author's hypothesis was absorption rate of implant would be increased over time. But in this experiment, there is no statistical significance between mean absorption thickness of implant and the time (p= 0.368). Also it can be affected by graft site, blood supply, and animals that were used in the experiment.

Interstitial Vaginal Needle Implantation in Gynecological Tumors : Design and Construction of Applicator (부인과암에서 조직내 삽입 방사선치료 - Applicator의 고안 및 제작-)

  • Kang, Seung-Hee;Chun, Mi-Son;Kang, Hae-Jin;Jung, Chil;Son, Jeong-Hyae
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.167-175
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    • 1998
  • Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.

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