• Title/Summary/Keyword: 사진 구도

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A Case of Bronchus-Associated Lymphoid Tissue(BALT) Lymphoma in the Lung of the Patient with Primary Sj$\ddot{o}$gren's Syndrome (원발성 쇼그렌 증후군(Primary Sj$\ddot{o}$gren's Syndrome) 환자에서 발생한 Bronchus-Associated Lymphoid Tissue(BALT) 림프종 1례)

  • Kang, Min-Jong;Lee, Jae-Myung;Lee, Seung-Joon;Son, Jee-Woong;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.179-185
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    • 2002
  • A bronchus-associated lymphoid tissue(BALT) lymphoma of the lung is a rare disorder of patients with Sj$\ddot{o}$gren's syndrome. A 49-year-old woman was admitted for an evaluation of exertional dyspnea and general weakness which had persisted for two years. The patient had suffered from dry mouth and dry eyes for five years. The physical examinations showed a coarse breath sound with inspiratory crackles on the whole lung field, particularly on the both basal lungs. The laboratory data disclosed high titers of anti-nuclear antibodies, and anti-SSA (Ro), and anti-SSB (La) antibodies. Chest radiographs demonstrated the presence of bilateral, diffuse, reticulonodular densities in both lungs. Thin-section CT scans showed diffusely distributed mosaic pattern of an inhomogeneous attenuation extending over the entire lung zone. The histological findings from an open-lung biopsy specimen revealed an accumulation of lymphoid cells around the bronchioles and an extension of malignant lymphoma cells from the bronchiolar epithelium toward the alveolar space. Immunohistochemically, the neoplastic cells reacted positively to the CD 20 antigen and were focally positive for the UCHL 1 antigen. The histological diagnosis was consistent with a low grade marginal zone B-cell lymphoma originating in the BALT. Here, we present a case of a histologically proven BALT lymphoma of the lung in a patient with primary Sj$\ddot{o}$gren's Syndrome.

Retrospective study of the $Implantium^{(R)}$ implant with a SLA surface and internal connection with microthreads (SLA 표면 처리와 미세나사선을 가진 내측 연결형의 국산 임플란트에 대한 후향적 연구)

  • Doh, Re-Mee;Moon, Hong-Suk;Shim, Jun-Sung;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.136-147
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    • 2009
  • Statement of problem: Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Implantium^{(R)}$ implant, which features a sandblasted and acid-etched surface and internal connection with microthreads. Material and methods: 106 $Implantium^{(R)}$ implants placed in 38 patients at Yonsei University Hospital were examined to determine the effect of various factors on implant success and marginal bone loss, through clinical and radiographic results during a 6 to 30 month period. Results: 1. Out of a total of 106 implants placed in 38 patients, one fixture was lost, resulting in a 99.1% cumulative survival rate. 2. Among the 96 implants which were observed throughout the study period, the survival rates were 97.0% in the maxilla and 100% in the mandible. The survival rate in the posterior regions was 98.9% and 100% in the anterior regions. 3. The mean bone loss during the first year after prosthesis placement was 0.17 mm, while the mean annual bone loss after the first year was 0.04 mm, which was statistically less than during the first year(P<.05). 4. There was no significant difference in marginal bone loss according to age during the first year(P>.05), but after the first year, the mean annual bone loss in patients above 50 years was significantly greater(P<.05) compared with patients under 50 years. 5. No significant difference in marginal bone loss was found according to the following factors: gender, jaw, location in the arch, type of implant(submerged or non-submerged), presence of bone grafts, type of prostheses, and type of opposing dentition(P<.05). Conclusion: Based on these results, the sole factor influencing marginal bone loss was age, while factors such as gender, jaw, location in the arch, type of implant, presence of bone grafts, type of prostheses and type of opposing dentition had no significant effect on bone loss. In the present study, the success rate of the $Implantium^{(R)}$ implant with a SLA surface and internal connection with microthreads was satisfactory up to a maximum 30 month period, and the marginal bone loss was in accord with the success criteria of dental implants.

The effects of local factors on the survival of dental implants: A 19 year retrospective study (임플란트의 생존율에 영향을 미치는 국소적 인자에 대한 19년간의 후향적 연구)

  • Kim, Sung-Hoi;Kim, Sun-Jai;Lee, Keun-Woo;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.28-40
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    • 2010
  • Purpose: The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants. Material and methods: During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio. Results: 1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05). Conclusions: Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival.

The Way of Expression of Wangreungdo(王陵圖: A Kind of A Royal Mausoleum Map) Reflected on Sanhyoungdo(山形圖: A Kind of A Mountain Map) in the Late Nineteenth Century - Centering the Drawings Relevant to Jogyoungdan(肇慶壇) of Lee Han, the Founder of Jeonju Lee Family - (19세기 후반 산형도(山形圖)로 본 왕릉도(王陵圖)의 표현방법(表現方法) -전주이씨(全州李氏) 시조(始祖) 이한(李翰)의 조경단(肇慶檀) 관련 그림을 중심으로-)

  • Kim, Jeong-Moon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.57-65
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    • 2012
  • This work attempted to study the properties of expression of ground, the composition of outlook and the implications of the connotative symbolic scenery throughout investigating the properties of expression content and method of the scenery, outlook, viewpoint, natural features for each drawing and intention of making 4 old maps, which had been made in the period of the Great Korean Empire and had been called 'Wansan-dohyoung(完山圖形),' 'Jogyeongdan- bigak-jaesil-dohyoung(肇慶壇碑閣齋室圖形),' 'Jeonju-geonjisan-dohyoung(全州乾止山圖形)' and 'Jogyeongmyo-gyounggijeon-dohyoung(肇慶廟慶基殿圖形),' and analyzing the correlation between their drawings. For this aim, observatory investigation by using a map, on-spot investigation, analysis involving the satellite images and internet were carried out with literature review simultaneously. The result of investigation could be sum up as follows. Gyounggijeon(1410), Jogyeongmyo(1771) and Jogyeongdan(1899), where are the core space to lay the historically firm foundation for securing the fact Jeonju is the home of the Royal Family of Joseon, had been built, fixed and extended for giving legitimacy to the Joseon Dynasty and a part of strengthening of royal authority. And these had played an important role of spiritual mainstay from early in the Joseon Dynasty to the era of the Great Korean Empire and had been managed and maintained continuously. It is grasped that the 4 maps consist of Sanhyuoungdo(山形圖; a kind of a mountain map), which is the map for showing a burial place of Lee Han(李翰), the founder of the Joseon Dynasty, and its auxiliary drawings and these had been drawn intensively to justify dignity and authority of the Imperial Family and the Emperor after the name of country was renamed the Great Korean Empire as a part of national undertaking. In detail, Wansan-doghyoung is the key map for announcing the existence of Jogyeong-myo, Gyounggijeon and Jogyeongdan in Jeonju and informing their locations and Geonjisan-dohyoung is the map of divination based on topography for highlighting the geomantic justification of the founder's mausoleum. Jogyeongdan-bigak-jaesil-dohyooung is the partial map detailing for Geonjisan-dohyoung. Jeonju-geonjisan-dohyoung and Jogyeongmyo-gyounggijeon-dohyoung had employed the binary reduced scale and the bird-eye view method and in the above maps, Geonji Mountain is the main mountain and these maps make an exaggeration of the main geographical features, centering Wangjabong and Euimyoso, unlike the real geographical features. Also, the other main geographical features, which are found in the burial place, are expressed in detail by changing the view. In the point of view of 1 set being consisted of 4 maps, 'Wansan-dohyoung' has the property not only as Gunhyoundo, which Gun and Hyoun mean a unit of the administrative district, respectively and Gynhyoundo is a kind of the map for recording their locations, but also as the map of showing their locations. On the other side, 'Jogyoungmyogyounggijeondohyoung' is a kind of lay-out drawing as a partially detailed map. In addition, it has been found out that 'Jeonju-geonjisan-dohyoung' and 'Jogyeongdan-bigak-jaesil-dohyoung' is not only Pungsu- hyounggukdo having the function of Sanhyoungdo but also a detail drawing. On the base of these properties, it is considered that the functionality as a serial map had been strengthened, unlike the existing old maps.

A Study of the Current State of the Garden and Restoration Proposal for the Original Garden of Yi Cheon-bo's Historic House in Gapyeong (가평 이천보(李天輔) 고가(古家)의 정원 현황과 원형 복원을 위한 제안)

  • Rho, Jaehyun;Choi, Seunghee;Jang, Hyeyoung
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.118-135
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    • 2020
  • It is not uncommon in Korea to see the structure and function of a garden remain intact as well as its form. Yi Cheon-bo's Historic House (Gyeonggi-do Cultural Heritage Item No. 55), located in Sang-myeon, Gapyeong-gun, Gyeonggi-do, is considered an example of very valuable garden heritage, although its family history, location, and remaining buildings and natural cultural assets are not fully intact. Along with Yi Cheon-bo's Historic House, this study attempted to explore the possibility of restoration of the forest houses and gardens by highlighting the high value of Yi Cheon-bo's Historic House through research into the typical layout of private households in northern Gyeonggi Province and Gapyeong County, comparative review of aerial photographs from 1954, and interviews with those involved. The results of the study are as follows: In this study, the presence of Banggye-dongmun and Bansukam in the Banggyecheon area, where the location of the garden was well-preserved, was examined across the landscape of the outer garden, while the location of Yi Cheon-bo's Historic House, the appearance of feng shui, and the viewing axis were considered. Also, the appearance of the lost main house was inferred from the arrangement and shape of the Sarangchae and Haengrangchae that remain in the original garden, and the asymmetry of the Sarangchae Numaru and the hapgak shape on the side of the roof. In addition, the three tablets (Pyeonaeks) of Sanggodang (尙古堂), Bangyejeongsa (磻溪精舍), and Okgyeongsanbang (玉聲山房) were used to infer the landscape, use, and symbolism of the men's quarters. Also, a survey was conducted on the trees that existed or existed in the high prices. Incidentally, it was confirmed that information on boards and cultural properties of Yeonha-ri juniper (Gyeonggi-do Monument No. 61) was recorded to a much lesser extent than the actual required standard, and the juniper trees remaining in the front of Haengrangchae should also be re-evaluated after speculation. On the other hand, as a result of estimating the original shape as a way of pursuing completeness of the garden through restoration of the lost women's quarters and shrine, it is estimated that the main house was placed in the form of a '口' or a 'be warped 口' on the right (north) side of the men's quarters. By synthesizing these results, a restoration alternative for Yi Cheon-bo's Historic House was suggested.

Monitoring and Preventive Preservation of Cultural Heritages to Maintain Original Wooden Architectural Cultural Heritage (목조건축문화재 원형유지를 위한 문화재돌봄 모니터링과 예방보존)

  • CHUN Kyoungmee
    • Korean Journal of Heritage: History & Science
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    • v.56 no.4
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    • pp.192-214
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    • 2023
  • Wooden architectural cultural heritages are one of the visible legacies that show the national's identity. Even when the concept of 'the original' of cultural heritages was not accurately understood, the emphasis of preservation and management of cultural heritages was placed on 'preservation of the original form' or 'maintenance of the original form'. Moreover, these days, following the trend of international preservation principles, cultural heritages are considered important as "values as historical objects." This paper is the result of an attempt to determine the scope and content of what parts should be monitored to maintain the original form of wooden architectural cultural heritage. The first thing to be done in monitoring wooden architectural cultural heritage is to check the condition of the ground and foundation. The second is the column. This is because the instability of the column causes damage to the joint with each member and the fitting part, resulting in physical changes leading to damage to the wall. The third is monitor the roof tiles. If the leak continues into the building due to the separation or damage of the roof, the defect should be partially dismantled and repaired, so it should be monitored to maintain its original shape as much as possible. The monitoring range of the base, column, and roof serves as a reference point for identifying what damage is being done to the relevant cultural heritages. In other words, the data at the time when monitoring began becomes the 'original' for the year. Alternatives based on the analysis of monitoring for the preservation of original cultural heritages should be actively introduced. In addition, by sharing the current state and situation of cultural heritages as a result of monitoring with various related organizations, preventive preservation should be established rather than preservation of cultural heritages by "intervention."

A Study on the Transitions and Site of temporary palace(Onyanghaenggung) according to the <Oncheonhaenggungdo>(1795) (<온천행궁도(溫泉行宮圖)>(1795)의 온양행궁지 추정 및 온양행궁 변천 고찰)

  • LEE Jeongsoo;KIM Ilhwan;LEE Kyeongmi;JI Wonku;CHOI Jaeseong
    • Korean Journal of Heritage: History & Science
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    • v.56 no.4
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    • pp.94-108
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    • 2023
  • Onyanghaenggung Palace(temporary palace at Onyang) is an important cultural heritage that can substantially confirm the king's onhaeng(溫行) base on literature records such as <Ongungyeonggoedae(溫宮靈槐臺)>, <Oncheonhaenggungdo(溫泉行宮圖)> of 『Ongungsasil(溫宮事實)』『, Younggoedaegi(靈槐臺記)』and cultural property such as Yeonggoedae(靈槐臺) and Shinjeong Monument(神井碑). As the Onyang Tourist Hotel is located in the presumed site of the Onyanghaenggung Palace, even the identity of the Onyanghaenggung Palace site is being threatened without restoration efforts. The purpose of this study is to estimate the location of Onyanghaenggung Palace based on <Oncheonhaenggungdo> before the damages during the Japanese colonial period. To achieve these purposes, records related to Onhaeng during successive kings' terms in the Joseon Dynasty are first reviewed, before changes in the architecture of Onyanghaenggung Palace that took place in the Joseon Dynasty and damage suffered during the Japanese colonial period are summarized, and finally <Oncheonhaenggungdo>, <Eupji>, <Ancient Maps>, <Jijeokwondo> are reviewed. Based on these processes, the location of Onyanghaenggung Palace is estimated by comparing the current Onyang Tourist Hotel and the surrounding area. The results of this study are as follows. First, if the 1,758 cheok(尺) of 「Onyanggun eupji」 and 「Hoseo eupji」 are converted in Jucheok(周尺), the scope of Onyanghaenggung Palace is close to the inner circumference of the site(垈) in Jijeokwondo(1914). Second, the streamlet leading to Oncheoncheon(溫泉川) from the southern side of Onyanggwan(溫陽館), the hot spring hole in use of <Distribution Map of Hot Spring(溫泉分布見取圖)>(1925, 1928), and considering the relationship of the inner east gate(內東門), Bigak(碑閣), Sinjeong(神井) of <Oncheonhaenggungdo>, the building of Hermann Gustav Theodor Sander and the Copyright Commission's Onyang Hot Springs photograph can be estimated as the Onyanghaenggung Palace Hot-spring, namely Tangsil(湯室). Third, in the process of developing to amusement park, the transfer and relocation of the Yeonggaedae site(a governmentowned property) was requested by Gyeongnam Railway Company, but Chungcheongnam-do denied transfer and relocation of the Yeonggaedae because of the importance in the history of Onyang Hot Springs, so the government-owned Yeonggaedae Monument site were permanently preserved at the current location together with the hoe tree(Sophora japonica L.). Also, Yeonggoedae in <Tourists Attractions around Gyeongnam Railway in Joseon (朝鮮京南鐵道沿線名所交通図絵)> (1929) is shown to exist in its current location, and it can be seen that the Shinjeong Monument Pavilion was moved to the front of Shinjeonggwan (神井館). Based on the circumference of Onyanghaenggung Palace, the location of Onyanghaenggung Palace Hot Spring (Tangsil) and Yeonggaedae Monument Pavilion, changes in roads and lots of land during the Japanese colonial period and the modern period, as well as the location of Onyanghaenggung Palace and other major buildings, can be estimated to extend to the current Shimin-ro and Onyang Hot Spring Market.

The Characteristics and Fates of Pulmonary Tuberculosis Patients Seen at Medical Department of A Medium Sized General Hospital (부산에 한 중형 종합 병원 내과에서의 폐결핵 환자의 양상과 귀결)

  • Kim, Young-Hyo;Park, Ki-Chan;Bae, Seong;Lee, Sang-Hun;Chun, Myung-Ho;Lee, Sang-Ki;Jun, Kwang-Su;Lee, Chan-Se
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.417-424
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    • 1992
  • Background: There were many reports about the clinical aspect and outcomes of pulmonary tuberculosis in health center but few in a medium sized general hospital. The purposes of this study were to find any characteristic differencies in the patients and the general outcomes of the treatments and also to give some suggestive points for the insurance policy making. Methods: We made a retrograde analysis of the medical records of 1981 patients (male 992 female 1,059) who attended our clinics of the 4th internal department, Daedong general hospital during two years from January 1989 to December 1990. Result: 1) Of 1981 patients, 96 were diagnosed as pulmonary tuberculosis taking relatively large proportion in the prevalence. The ratio of prevalence between male and female was 7.81% to 2.27%. The 61.46% were the first diagnosis & initial treatment cases and the remaining 38.54% were the retreatment cases with no statistical significance between sex. 2) The most prevalent age group was between 21~40 years old and the prevalence rate was 45.45% of male and 76.76% of female. The lowest age group in male patient was above 61 showed 3.03%, and there was no female patients above age 60 years old. This phenomena could be thought as the negligence for the treatment of pulmonary tuberculosis in the old age groups rather than true tuberculosis prevalence and it could be proved by the higher rates towards old age groups in the national tuberculosis prevalence survey. 3) There were 57.07% of the minimal case, 48.96% of the moderate, 18.75% of the far advanced. The sputum examination showed 37.07% were culture positive, 46.88% were the negative, and 15.63% of the patients had no stutum examination. Moreover, uncoperatives among the far advanced cases were notable showing 22.22% of the stutum examination, where 16.13% in the minimal cases. The stutum positive rate among the initial treatment cases were 41.07% and 55.00% for the retreatment cases. The sputum no examination rates were 17.86% and 12.50% respectively. 4) The classfication of the mode of disease onset showed 68.75% with gradual onset, 9.38% hemoptic, 3.13% acute pneumonic and 18.75% was found through the radiologic examination in various occasions. 5) The percentages of patients who continued their treatment for more than 8 month were 35.71% (for initial treatment), 25.00% (for retrement), 16.13% (for the minimal), 27.78% (for the far advanced). 6) The group of patients who were treated more than 8 months showed the negative conversion rate of 80% on sputum and marked improvement on chest x-ray in 56.67%. However, in far advanced or retreatment cases, the rate of negative conversion on sputum and the rate of improvement on chest x-ray were low being 60% and 20% for the former and 60% and 10% for the latter, each respectively. Conclusion: It would be strongly emphasized that the improvement of National medical insurance system and social welfare system in Korea must be definite to improve overall treatment and control of tuberculosis diseases as well as physician's devotious National tuberculosis control policy.

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Development of Formulas for the Estimation of Renal Depth and Application in the Measurement of Glomerular Filtration Rate in Koreans (사구체 여과율 측정을 위한 한국인의 신장 깊이에 관한 방정식 도출과 이용)

  • Yoo, Ie-Ryung;Kim, Sung-Hoon;Chung, Yong-An;Jung, Hyun-Seok;Lee, Hae-Giu;Park, Young-Ha;Lee, Sung-Yong;Sohn, Hyung-Seon;Chung, Soo-Kyo;Kim, Hyun-Mi;Lee, Hyung-Goo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.418-425
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    • 2000
  • Purpose: There is no established formula for estimating renal depths in Korean. As a result, we undertook this study to develop a new formula, and to apply this formula in the calculation of glomerular filtration rate (GFR). Materials and Methods: We measured the renal depth (RD) on the abdominal CT obtained in 300 adults (M:F: 167:133, mean age 50.9 years) without known renal diseases. The RDs measured by CT were compared with the estimated RDs based on the Tonnesen and Taylor equations. New formulas were derived from the measured RDs in 200 out of 300 patients based on several variables such as sex, age, weight, and height by multiple regression analysis. The RDs estimated from the new formulas were compared with the measured RDs in the remaining 100 patients as a control. In 48 patients who underwent Tc-99m DTPA renal scintigraphy, GFR was measured with three equations (new formula, Tonnesen and Taylor equations), respectively, and compared with each other. Results: The mean values of the RDs measured from CT were 6.9 cm for right kidney of the men (MRK), 6.7 cm for left kidney of the men (MLK), 6.7 cm for right kidney of the women (WRK), and 6.6 cm for left kidney of the women (WLK). The RDs estimated from Tonnesen equation were shorter than the ones measured from CT significantly. The newly derived formulas were 12.813 (weight/height)+0.002 (age)+ 2.264 for MRK, 15.344 (weight/height)+0.011 (age)+0.557 for MLK, 12.936 (weight/height)+ 0.014 (age)+1.462 for WRK and 13.488 (weight/height)+0.019 (age)+0.762 for WLK. The correlation coefficients of the RD measured from CT and estimated from the new formula were 0.529 in MRK, 0.729 in MLK, 0.601 in WRK, and 0.724 in WLK, respectively. The GFRs from the new formula were significantly higher than those from the Tonnesen equation significantly, which was the most similar to normal GFR values. Conclusion: We generated new formulas for estimating RD in Korean from the data by CT. By adopting these formulas, we expect that GFR can be measured by the Gates method accurately in Korean.

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Comparisons of Unicortical and Bicortical Lateral Mass Screws in the Cervical Spine : Safety vs Strength (경추부의 후관절 나사못 고정술에서 단피질삽입법과 양피질 삽입법 간의 특성에 관한 비교)

  • Park, Choon-Keun;Hwang, Jang-Hoe;Ji, Chul;Lee, Jae Un;Sung, Jae Hoon;Choi, Seung-Jin;Lee, Sang-Won;Seybold, Eric;Park, Sung-Chan;Cho, Kyung-Suok;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1210-1219
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    • 2001
  • Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

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