• Title/Summary/Keyword: 치상돌기

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Conservative Management for a Highly Displaced Dens Fracture in a Two-Year-Old Child (2세 유아에서 발생한 고도 전위성 치상돌기 골절의 보존적 치료)

  • Lim, Sung Joon;Kim, Geon Jung;Kim, Yong Min
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.530-534
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    • 2021
  • Fractures of the dens (odontoid process) in children's cervical spine are rare, with very few case reports dealing with these injuries. In particular, a treatment modality has not been established for severe displaced fractures. Surgical fixation can theoretically afford early reduction and better maintenance, but it requires a very delicate and cautious procedure and results in permanent fusion of 1-2 cervical articulation. The authors chose conservative management for a displaced dens fracture in a two-year-old toddler and achieved a promising result. We report this case with a review of the relevant literature.

Location Error of the Dens in a Two-Dimensional Set-up Verification During Head and Neck Radiotherapy (뇌.두경부 방사선치료 시 전자조사문영상장치를 이용한 세트업 오차 확인에서 제2경추 치상돌기 위치의 임상적 의의)

  • Kim, Dong-Hyun;Kim, Won-Taek;Ki, Yong-Gan;Nam, Ji-Ho;Lee, Mi-Ran;Jeon, Ho-Sang;Park, Dal;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.107-114
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    • 2011
  • Purpose: To assess the degree and clinical impact of location error of the dens on the X-axis during radiotherapy to brain and head and neck tumors. Materials and Methods: Twenty-one patients with brain tumors or head and neck tumors who received three-dimensional conformal radiation therapy or intensity-modulated radiation therapy from January 2009 to June 2010 were included in this study. In comparison two-dimensional verification portal images with initial simulation images, location error of the nasal septum and the dens on the X-axis was measured. The effect of set-up errors of the dens was simulated in the planning system and analyzed with physical dose parameters. Results: A total of 402 portal images were reviewed. The mean location error at the nasal septum was 0.16 mm and at the dens was 0.33 mm (absolute value). Location errors of more than 3 mm were recorded in 43 cases (10.7%) at the nasal septum, compared to 133 cases (33.1%) at the dens. There was no case with a location error more than 5 mm at the nasal septum, compared to 11 cases (2.7%) at the dens. In a dosimetric simulation, a location error more than 5 mm at the dens could induce a reduction in the clinical target volume 1 coverage (V95: 100%${\rightarrow}$87.2%) and overdosing to a critical normal organ (Spinal cord V45: <0.1%${\rightarrow}$12.6%). Conclusion: In both brain and head and neck radiotherapy, a relatively larger set-up error was detected at the dens than the nasal septum when using an electronic portal imaging device. Consideration of the location error of the dens is necessary at the time of the precise radiation beam delivery in two-dimensional verification systems.

Microsurgical Anatomy in Transoral Odontoidectomy (경구강 치상돌기제거술의 수술해부학)

  • Park, Kwan;Lee, Sang Koo;Cho, Tae Goo;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.309-316
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    • 2000
  • Objective :The transoral approach allows direct view of the ventral craniovertebral junction and provides useful management of the various lesions of this area. We present a step by step guide to the performance of the transoral excision of the odontoid process in the cadaveric model. Methods : Ten cadaver heads were used in fixed or unfixed state. We describe the relevant surgical anatomy in the cadaveric dissection and surgical technique of transoral transpharyngeal odontoidectomy. Results : The surgical procedure of transoral odontoidectomy was categorized by six steps;soft palate, posterior pharyngeal wall, muscular structures, osseous structures, odontoid process and ligaments, cruciate ligament and dura. Conclusion : With anatomical knowledge of these regions neurosurgeons can deal with wide variety of lesions in the ventral craniovertebral junction.

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Clinical and MR Predictors of Retro-Odontoid Pseudotumor Regression Following Posterior Fixation in Patients with Atlantoaxial Instability (환축 불안정 환자에서 후방 고정술 후 치상돌기 후방 가성종양 퇴행의 임상 및 자기공명영상 예측 인자)

  • Jisu Kim;Youngjune Kim;Eugene Lee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.754-768
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    • 2024
  • Purpose To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability. Materials and Methods We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann-Whitney and Fisher's exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression. Results We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31-84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression. Conclusion Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.

A taxonomic study of Viola section Chamaemelanium in Korea-based on morphological characters (한국산 제비꽃속 노랑제비꽃절의 분류학적 연구 -형태학적 형질을 중심으로)

  • Whang, Sung Soo
    • Korean Journal of Plant Taxonomy
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    • v.32 no.4
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    • pp.397-416
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    • 2002
  • A taxonomic study of Viola section Chamaemelanium in Korea, based on morphological characters, was conducted with light microscopy and scanning electron microscopy. Two species, V. orientalis W. Becker and V. brevistipulata (Fr. et Sav.) W. Becker, are recognized by rhizome and cauline habits, trichomes on the ovary and the shape and beards of stigmas. The latter can be split further into three varieties, var. brevistipulata, var. minor Nakai and var. laciniata (Boiss.) W. Becker, according to the leaf morphology in particular. Viola brevistipulata var. laciniata has the most tooth number, and its teeth are irregular erose but the other two varieties are regular sinuate or serrate. As for the size of leaves, V. brevistipular var. brevistipulata is the largest but V. brevistipulata var. minor is the smallest among the varities. Of them, V. brevistipulata var. laciniata is newly recorded in Korea. It was also revealed that both development and arrangement of the beards developed on the ovary and stigma were particularly diagnostic in the identification of the Viola section Chamaemelanium species.

Morphological Study of Contracaecum rudolphii (Nematoda: Anisakidae) from White Pelican (페리칸에서 분리한 Contracaecum rudolphii (Nematoda: Anisakidae)의 형태학적 연구)

  • Kim, Hyeon-Cheol;Kim, Nam-Soo;Son, Hwa-Young;Kwon, Bo-Keun;Hur, Jin;Cho, Jeong-Gon;Park, Bae-Keun
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.11-16
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    • 2010
  • A white pelican, Pelecanus onccrotalus, was imported from Tanzania and died 5 days later in Daejeon zoo in Korea. The proventriculus of bird was found to contain parasites. The taxonomic status of the nematodes was studied by morphological and morphometric analysis using light and scanning electron microscopy. Only one species Contracaecum occurred in the proventriculus with high values of infection. Morphological characters of the parasite were as follows: The worms have three lips without cuticular dentigerous ridges, and well developed interlabia. The interlabia have a triangular shape, non-bifurcated. Males possess numerous preanal papillae (69-79 pairs) arranged in single subventral rows. Paracloacal papillae were separated 5 postanal papillae and 1 larger pairs. All the characters of the above studied specimens are very similar to those of C. rudolphii complex. Accordingly, the parasites from white pelican were identified belong to the C. rudolphii complex.

The Cervical Spinal Fractures: Comparison of the Sites and Incidences According to the Causes and the Types of the Injuries (경추 골절의 원인과 형태에 따른 위치와 빈도의 비교)

  • Cho, Jae-Ho;Cho, Kil-Ho;Byun, Woo-Mock;Kim, Sun-Yong;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.114-126
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    • 1993
  • The fractures of the cervical spine are relatively uncommon, but they may cause serious neurologic deficits temporarily or permanently. So, it is very important to treat the patients early by way of exact evaluation for the sites and the mechanisms of the injuries. The authors reviewed retrospectively 188 cervical spinal fractures in 100 patients from Sep. 1984 to Aug. 1990. Commonly involved levels were $C_5$ and $C_6$ in lower cervical level and $C_2$ in upper cervical level and the sites in each spine were body, lamina and odontoid process. The hyperflexion injury was the most common type of the cervical spinal fractures occupying 53% of all cervical fractures and cause more multiple fractures(2.26 fractures/patient) than in hyperextension(1.68 fractures/patient). In hyperflexion injuries, body, transverse and spinous process were commonly involved but lamina fracture was relatively common in hyperextension injury. The dislocations associated with fractures were developed most commonly in hyperflexion injury and 70% of these were anterior dislocation and the most commonly involved levels were $C_{5-6}$ and $C_{6-7}$. In conclusion, hyperflexion injury needs more close examination for the entire spinal levels than injuries of other mechanisms because it results in more severe fractures with or without dislocation and relatively frequent multiple fractures in different levels.

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Plant Regeneration from Zygotic Embryo-Derived Callus in Citrus junos SIEB. (유자(Citrus junos SIEB.)의 접합배로부터 캘러스 유도 및 식물체 재분화)

  • 박민희;정휘현;이숙영;김홍섭
    • Korean Journal of Plant Tissue Culture
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    • v.22 no.4
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    • pp.189-194
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    • 1995
  • Calli were successfully induced from immature embryos of Citrus junos SIEB. cultured on 1/2 MS medium supplemented with 40.4 BA. Plant were regenerated from immature embryo derived callus on MS medium with 5 $\mu$M BA. The calli were morphologically characterized by two types: one was whitish and the other was yellowish. After 16 weeks of culture, shoots and root were formed on calli. Plantlets were transplanted to soil and successfully grown to a whole plant Also, the arrangement of the cells showed many differences according to developmental stages of callus and organogenesis. The small cells were compact in callus cultured for 6 weeks and the extended cells which divided actively appeared in it after 8 weeks of culture. The globular protrusion of compacted cells occurred in callus after 10 weeks of culture, and the neighboring cells were liquefied. Oil sac surrounded by the liquefied cell was observed in the leaf and was formed by rupture of liquefied cells.

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Anterior Screw Fixation of Type II Odontoid Fracture (제 II 형 치상돌기 골절에서 전방경유 나사못 고정술)

  • Kim, Myung-Jin;Hwang, Jeong-Hyun;Sung, Joo-Kyung;Hwang, Sung-Kyu;Hamm, In-Suk;Park, Yeun-Mook;Kim, Seung-Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1461-1468
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    • 2000
  • Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

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The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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