• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.25-30
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• 2014

Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

• 대한방사선치료학회지
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• 제13권1호
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• pp.109-112
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• 2001

1. 목적 : head and neck cancer 환자의, C-T 영상을 이용한 방사선치료계획시 치과 보철물에 의해 발생하는 artifact가 선량 계산에 미치는 영향을 분석하고자 한다. 2. 재료 및 방법:두 경부와 유사한 크기의 Polystyrenes Phantom ($20{\times}20{\times}25cm^3$) 을 제작하고, 팬톰내에 금으로 인공보철물을 제작하여 보철물 부착 전.후를 C-T Scan (High Speed Advantage, GE, US) 하였다. artifact에 의한 영향을 쉽게 분석하기위해 팬톰내에 다른 구조물은 만들지 않았으며 두가지 방법으로 얻어진 영상을 이용하여 조사면의 크기와 조사 방향을 변화 시켜 가며 1문 조사(SSD 100 cm)에 의한 치료 계획(3D RTP system, Prowess, US)을 수립하여 기준점(5,10 cm depth)에서의 선량 변화를 비교 분석하였다. 아울러 3회 반복 scan하여 artifact에 발생 유형과 CTNo을 이용한 density을 분석하였다. 3. 결과: C-T Scan으로 얻어진 image 상에 나타난 Artifact는 CT no $-1000{\sim}+2775$(기준 $-1000{\sim}+3700$)까지의 다양한 값을 가지며 보철물을 기준으로 방사형태로 분포하였다. artifact가 선량 계산에 미치는 영향을 분석한 결과 보철물 사용시 5cm깊이의 기준점에서 절대선량은 평균 $+1.5{\pm}2.8\%$, 10 cm 깊이에서는 $+1.8{\pm}3.5\%$의 오차를 보였다. 조사방향에 의한 오차는 artifact에 대해 측면 조사한(gantry $270^{\circ}$)경우에서 높게 관찰되었다. 4. 결론: 두 경부 종양의 방사선 치료시 치과 보철물에 의한 artifact는 흔히 관찰가능하며 본 실험을 통해 다양한 형태와 다양한 density을 가짐을 알수있었다. 영상에 나타난 정도에 비해 선량계산에 미치는 평균 오차는 낮게 평가되었지만 조사 방향과 보철물의 위치에 따라 변동이 크게 나타날 수 있어 치료 계획시 가능한 artifact의 영향을 적게 받는 빔의 선택이 정확한 선량 계산에 도움을 줄 것으로 사료된다.

• 대한의용생체공학회:의공학회지
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• 제33권2호
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• pp.78-88
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• 2012

Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

• The Journal of Advanced Prosthodontics
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• 제7권3호
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• pp.240-248
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• 2015

PURPOSE. To explore whether there is matching relation between the length and the tilting angle of terminal implants in the All-on-Four protocol by studying the effects of different implant configurations on stress distributions of implant, bone, and framework. MATERIALS AND METHODS. Four implants were employed to support a full-arch fixed prosthesis and five three-dimensional finite element models were established with CT images, based on the length (S and L) and distal tilt angle ($0^{\circ}$, $30^{\circ}$ and $45^{\circ}$) of terminal implants for an edentulous mandible, which named: Tilt0-S, Tilt30-S, Tilt30-L, Tilt45-S and Tilt45-L. An oblique 240 N was loaded at second molar. The von Mises Stresses were analyzed. The implants were consecutively named #1 to #4 from the loading point. RESULTS. 1) Tilt0-S had the greatest stress on the implants, with the other groups exhibiting variable reductions; the four implants of Tilt45-L demonstrated the greatest reduction in stress. 2) Tilt0-S had the greatest stress at bone around #1 implant neck, and Tilt45-L exhibited the least stress, which was a 36.3% reduction compared to Tilt0-S. 3) The greatest stress in the framework was found on the cantilevers distal to #1 implant. Tilt45-S exhibited the least stress. CONCLUSION. Matching different length and tilting angle of the terminal implants led to variable stress reductions on implants, bone and the superstructure. By optimizing implant configuration, the reduction of stress on implants and surrounding bone could be maximized. Under the present condition, Tilt45-L was the preferred configuration. Further clinical testings are required.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.281-284
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• 2010

Purpose: Pseudohypoparathyroidism is a hereditary disorder characterized by symptoms and signs of hypoparathyroidism, typically in association with distinctive skeletal and developmental defects. Hypoparathyroidism is caused by a insufficient end-organ response to PTH (parathyroid hormone). Hypoparathyroidism consists of four types in which the most common form, pseudohypoparathyroidism-Ia, accompany with Albright's hereditary osteodystrophy. We experienced a case of a woman who had been suffering from calcified mass on left foot, diagnosed Albright's hereditary osteodystrophy. Methods: We present a case of a 24-year-old Korean female who visited plastic surgery department with a painful mass on dorsum of the left foot. On the physical exam, bony hard and painful mass, fixed to dermis, was noted. Plain X-ray films demonstrate suspicious calcification on subcutaneous tissue of dorsum of the left foot. The patient was diagnosed pseudohypoparathyroidism 2 years ago at the plastic surgery department. At the visiting time, the laboratory results were within normal range even though the patient actually had a disease. The reason is because the patient has been treated with Vit.D, calcium replacement therapy and thyroid hormone therapy. Moreover, the patient has been treated with anticonvulsant agents due to epilepsy. On the brain computer tomography (CT), calcification was noted on the basal ganglia and dentate nucleus. So we decided the total excision of entire mass from the left foot. Results: We excised main mass with numerous pinhead sized masses which were scattered around the main mass. The $6.0{\times}4.0{\times}0.5\;cm$ sized main mass was bony hard, and its surface was flat and margin was irregular. The permanent biopsy was confirmed that the main mass and all the scattered tiny masses were heterotopic calcification. The patient did not suffer from the pain after the mass excision. The wound has been healed without any problem. Conclusions: Heterotrophic calcification is often accompanied with pseudohypoparathyroidism, but such a huge one is uncommon. We report a case of pseudohypoparathyroidism with heterotrophic calcification developed in dorsum of left foot who was diagnosed by excisional biopsy.

• 대한한의진단학회지
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• 제9권1호
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• pp.23-46
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• 2005

Background and purpose: Maek Kyoung(脈經) is a book written, compiled, and edited by Wang Hui circa 3 A.D. This book is the first technical book devoted to the diagnostics. These are very important data but never make a special study and translate. so I hope this treatise can be great help to understand diagnosis study. Methods: Maek Kyoung(脈經) consists of ten volumes, and the third volume consists of the five chapters, including inter-generation and inter-restriction of the five viscera and the six entrails and prognosis of diseases. This treatise is made up of principal, notes, study and conclusion, we tried to make a translation faithful to the original. Results and Conclusion: Chapter 3 refers to five things. The first is relation between spleen and stomach, the second is how to diagnose diseases by using intergneration and inter-restriction of five elements, the third is roles of spleen that has an influence on four viscera through four seasons, the forth is the fact that quantity of gastroqi decides prognosis of diseases, and the fifth is that climate change has influence on the seriousness of diseases. Chapter 4 refers to four things. The first is relation between lung and large intestines, the second is ordinary and extraordinary pulse condition of lung, the third is that pulse condition including its speed, and the forth is how to diagnose diseases by using intergneration and inter-restriction of five elements and climate change.

• 대한의용생체공학회:의공학회지
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• 제28권1호
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• pp.108-116
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• 2007

Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the mal alignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.

• International Journal of Control, Automation, and Systems
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• 제4권1호
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• pp.30-41
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• 2006

The goal of this work is to develop and test a robot-assisted surgery system for spinal fusion. The system is composed of a robot, a surgical planning system, and a navigation system. It plays the role of assisting surgeons for inserting a pedicle screw in the spinal fusion procedure. Compared to conventional methods for spinal fusion, the proposed surgical procedure ensures minimum invasion and better accuracy by using robot and image information. The robot plays the role of positioning and guiding needles, drills, and other surgical instruments or conducts automatic boring and screwing. Pre-operative CT images intra-operative fluoroscopic images are integrated to provide the surgeon with information for surgical planning. Some experiments employing the developed robotic surgery system are conducted. The experimental results confirm that the system is not only able to guide the surgical tools by accurately pointing and orienting the specified location, but also successfully compensate the movement of the patient due to respiration.

• Radiation Oncology Journal
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• 제34권3호
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• pp.230-238
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• 2016

Purpose: Hypoxia can impair the therapeutic efficacy of radiotherapy (RT). Therefore, a new strategy is necessary for enhancing the response to RT. In this study, we investigated whether the combination of nanoparticles and RT is effective in eliminating the radioresistance of hypoxic tumors. Materials and Methods: Gold nanoparticles (GNPs) consisting of a silica core with a gold shell were used. CT26 colon cancer mouse model was developed to study whether the combination of RT and GNPs reduced hypoxia-induced radioresistance. Hypoxia inducible $factor-1{\alpha}$ ($HIF-1{\alpha}$) was used as a hypoxia marker. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining were conducted to evaluate cell death. Results: Hypoxic tumor cells had an impaired response to RT. GNPs combined with RT enhanced anti-tumor effect in hypoxic tumor compared with RT alone. The combination of GNPs and RT decreased tumor cell viability compare to RT alone in vitro. Under hypoxia, tumors treated with GNPs + RT showed a higher response than that shown by tumors treated with RT alone. When a reactive oxygen species (ROS) scavenger was added, the enhanced antitumor effect of GNPs + RT was diminished. Conclusion: In the present study, hypoxic tumors treated with GNPs + RT showed favorable responses, which might be attributable to the ROS production induced by GNPs + RT. Taken together, GNPs combined with RT seems to be potential modality for enhancing the response to RT in hypoxic tumors.

• 한국진공학회:학술대회논문집
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• 한국진공학회 1998년도 제14회 학술발표회 논문개요집
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• pp.133-133
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• 1998

In the thin film alloy formation of the transition metals ion-beam-mixing technique forms a metastable structure which cannot be found in the arc-melted metal alloys. Sppecifically it is well known that the studies about the electronic structure of ion-beam-mixed alloys pprovide the useful information in understanding the metastable structures in the metal alloy. We studied the electronic change in the ion-beam-mixed ppt-Ct alloys by XppS and XANES. These analysis tools pprovide us information about the charge transfer in the valence band of intermetallic bonding. The multi-layered films were depposited on the SiO2 substrate by the sequential electron beam evapporation at a ppressure of less than 5$\times$10-7 Torr. These compprise of 4 ppairs of ppt and Cu layers where thicknesses of each layer were varied in order to change the alloy compposition. Ion-beam-mixing pprocess was carried out with 80 keV Ae+ ions with a dose of $1.5\times$ 1016 Ar+/cm2 at room tempperature. The core and valence level energy shift in these system were investigated by x-ray pphotoelectron sppectroscoppy(XppS) pphotoelectrons were excited by monochromatized Al K ａ(1486.6 eV) The ppass energy of the hemisppherical analyzer was 23.5 eV. Core-level binding energies were calibrated with the Fermi level edge. ppt L3-edge and Cu K-edge XANES sppectra were measured with the flourescence mode detector at the 3C1 beam line of the ppLS (ppohang light source). By using the change of White line(WL) area of the each metal sites and the core level shift we can obtain the information about the electrons pparticippating in the intermetallic bonding of the ion-beam-mixed alloys.