• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.283-293
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• 2021

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

• Proceedings of the KSME Conference
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• 2005.11a
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• pp.154.2-154.2
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• 2005

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.48 no.5
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• pp.81-92
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• 2011

In this paper, a new method to estimate the number of MU (motor unit) related to the widths and distribution of end plate in NMJ (neuromuscular junction) of biceps brachii is proposed by varying muscle parameter statistically in EMG model. This work is done by designing MU-simulator and EPZ-simulator. The proposed method was compared with the results of previous researchers. The proposed MU-simulator generates SMUAP (single motor unit action potential) and CMAP (compound muscle action potential) signal similar to detected SMUAP and CMAP signal obtained from muscle. The EPZ-simulator estimate the numbers of MU by varying the widths and distribution of end plate in neuromuscular junction of muscle. The results shows that the numbers of MU was estimated about 450 ea. and muscle fibers was about 340 ea., end plate widths was about 6 mm, and end plate was randomly distributed. The proposed method may be comparable with the method of anatomical studies.

• Journal of Biomedical Engineering Research
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• v.20 no.4
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• pp.451-459
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• 1999

During the electromyographic evaluation for the diagnosis of neuropathy, presence for site of lesion could be predicted by a detection of denervation potentials such as fibrillation potentials or positive sharp waves in a group of muscles. Unfortunately, since denervation potentials are distinguished by examiner's experience, it is possible to make mistake identifying endplate spikes as a denervation potential. The aim of the study was to extract parameters to make an algorithm for quantitative distinction between denervation potentials and endplate spikes. It will help to minimize the examiner's bias and to localize the site of lesion thus increase the reliability on EMG diagnosis. There types of signals, endplate spike, fibrillation potential and positive sharp wave were obtained from the EDB(extensor digitorum brevis) muscle using then neuropathic patients. Eight parameters such as duration, area, slope, peak-to-peak amplitude, positive peak negative peak amplitude, ratio of positive to negative peak amplitude, and number of phase were extracted and compared. As a results, peak-to-peak amplitude, positive peak amplitude, ratio of positive to negative peak amplitude showed statistically significant differences between endplate spikes and denervation potentials. It was concluded that those parameters could be used to establish an algorithm which will improve the accuracies in automated quantitative EMG diagnosis.

• Journal of Biomedical Engineering Research
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• v.22 no.1
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• pp.69-80
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• 2001

본 연구에서는 환자의 골다공증 유무에 따른 내고정 장치 시술 직후 및 융합 후의 안정성을 평가하기 위해 다양한 하중 모드에서 C5-C6 운동분절의 생체역학적 거동을 분석하였다. 이러한 목적으로 먼저, C5-C6 경추부의 유한요소 모델을 구현하여 검증하였다. 모델의 결과는 기존 실험치와 유사하여 신뢰성이 부여되었다. 검증된 모델은 Smith-Robinson 방식으로 골이식물을 삽입한 후 전방 내고정 장치를 적용한 시술 상황을 재현하기 위해 수정되었다. 수정된 모델은 두 종류로 구현되었다. (1) 첫 번째 모델에서는, 시술 직후의 상황을 재현하기 위해 골이식물과 종판의 경계면에 접촉요소를 사용하였다. (2)두 번째 모델에서는 완전히 융합된 상황을 나타내기 위해 골이식물을 종판에 고정하였다. 골다공증의 효과를 예측하기 위하여 두 모델의 해면골에 대한 탄성계수를 변화시켰다(정상: 100MPa, 골다공증: 40MPa). 각 모델의 C5 주체의 상위면에 73.6N의 압축 하중을 가한 후에 108Nm의 굴곡/신전, 굽힘, 비틀림 하중을 가하였으며, C6 추체의 하단면은 모든 방향에 대하여 구속하였다. 전체적인 결과에 있어서 상대적 회전운동, 미끄럼운동, 골이식물 내에서의 von Mises 응력의 경우 정상 모델에 비해 골다공증 모델에서 증가함을 보였으며, 특히 시술 직후의 모델에서 비틀림 하중이 가해진 경우, 상대적 회전운동 및 미끄럼 운동이 가장 높게 예측되었다. 이는 골다공증환자에게 전방 내고정 장치를 시술한 경우 골이식물의 파단 및 유합의 실패가 비틀림 하중에서 발생할 수 있음을 나타낸다. 해면골의 von Mises 응력은 시술 직후에 골다공증 모델의 모든 하중 모드에서, 유합 후에는 굽힘 하중 외의 모든 하중에서 ultimate strength를 초과하는 것으로 나타나 골다공증 환자에게 screw의 해리가 발생할 가능성이 높은 것으로 예측되었다. 따라서 골다공증 환자에게 과도한 운동이 발생하지 않도록 하기 위해서 시술 후 세심한 주의와 halo 같은 견고한 정형술이 필요할 것으로 사료된다.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.383-386
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• 1997

In the EMG evaluation, the neuropathy may be diagnosed by a detection of denervation potentials in the group of muscles. These abnomal potentials might be confused with normal endplate spikes. In this paper we present the software algorithm in C, which automatically detects spontaneous activity such as denervation potentials and endplate potentials and distingushes between those potentials. Parameters with statistically significant differences were used for this automated algorithm. It was concluded that the algorithm established in this study will improve accuracy in EMG diagnosis.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.515-516
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• 2006

The goal of total disc replacement is to restore pain-free mobility to a diseased functional spinal unit, by replacing the degenerated disc with a mobile bearing prosthesis. SB Charite III is named commercial product as the Artificial Intervertebral Disc (AID). SB Charite III consists of sliding core and endplate made by Ultra-high Molecular Weight Polyethylene (UHMWPE) and cobalt chrome alloy, respectively. To evaluate the effect of von-Mises stress in AID, and three-dimensional finite element model of AID analysis was preformed for four different loading types of sliding core. Consequently, endplate was compared with a compressive preload at 400N and flexion moment at $3{\sim}9Nm4. Therefore, this research has obtained result that von-Mises stress of sliding core in AID disc by radius curvature.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.36 no.1
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• pp.29-35
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• 2012

The treatments for spinal canal stenosis are radicular cyst removal, spine fusion, and implantation of an artificial intervertebral disc. Artificial intervertebral discs have been most widely used since the mid-2000s. The study of artificial intervertebral discs has been focused on the analysis of the axial rotation, lateral bending, the degrees of freedom of the disc, and flexion-extension of the vertebral body. The issue of fatigue failure years after the surgery has arisen as a new problem. Hence, study of artificial intervertebral discs must be focused on the fatigue failure properties and increased durability of the sliding core. A finite element model based on an in the artificial intervertebral disc (SB Charit$\acute{e}$ III) was produced, and the influence of the radius of curvature and the change in the coefficient of friction of the sliding core on the von-Mises stress and contact pressure was evaluated. Based on the results, new artificial intervertebral disc models (Models-I, -II, and -III) were proposed, and the fatigue failure behavior of the sliding core after a certain period of time was compared with the results for SB Charit$\acute{e}$ III.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.367-368
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• 2006

Today, the Artificial Intervertebral Disc (AID) is being developed by increasing the oblique of the endplate gradually. In other words, Ultra-high Molecular Weight Polyethylene (UHMWPE) which is apply to the sliding core of the AID, does not change the shape but alters the oblique of endplate. However, the unreasonable increase of degree of freedom (DOF) can result in the aggravation of the bone fusion and the initial stability and it can also lead to the increase of the concentrated force in core. For these reasons, it is necessary to develop the advanced techniques, which choose the most adequate DOF. In this study, the new optimized modeling of the sliding core and the endplate, the fatigue characteristics, the crack propagation and the formation mechanism of wearing debris was studied and the minimizing technique will be derived from this research.