• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2393-2398
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• 2012

Objectives: The purpose of this study was to evaluate the geometric accuracy of thoracic anatomic landmarks as target surrogates of intrapulmonary tumors for manual rigid registration during image-guided radiotherapy (IGRT). Methods: Kilovolt cone-beam computed tomography (CBCT) images acquired during IGRT for 29 lung cancer patients with 33 tumors, including 16 central and 17 peripheral lesions, were analyzed. We selected the "vertebrae", "carina", and "large bronchi" as the candidate surrogates for central targets, and the "vertebrae", "carina", and "ribs" as the candidate surrogates for peripheral lesions. Three to six pairs of small identifiable markers were noted in the tumors for the planning CT and Day 1 CBCT. The accuracy of the candidate surrogates was evaluated by comparing the distances of the corresponding markers after manual rigid matching based on the "tumor" and a particular surrogate. Differences between the surrogates were assessed using 1-way analysis of variance and post hoc least-significant-difference tests. Results: For central targets, the residual errors increased in the following ascending order: "tumor", "bronchi", "carina", and "vertebrae"; there was a significant difference between "tumor" and "vertebrae" (p = 0.010). For peripheral diseases, the residual errors increased in the following ascending order: "tumor", "rib", "vertebrae", and "carina"; There was a significant difference between "tumor" and "carina" (p = 0.005). Conclusions: The "bronchi" and "carina" are the optimal surrogates for central lung targets, while "rib" and "vertebrae" are the optimal surrogates for peripheral lung targets for manual matching of online and planned tumors.

• Journal of the Korean Society of Radiology
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• v.8 no.5
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• pp.217-223
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• 2014

The aim of this study is evaluation of dose distribution on radiation therapy planning system with the CT image of high-density material inserted phantom. Gammex 467 Tissue Characterization Phantom is used to acquire an image similar to the human tissues and insert a Titanium to generate metal artifact. The acquired images were reconstructed with Metal Artifact Reduction for Orthopedic Implants (O-MAR). By using the treatment planning system, the volume was analyzed and dose distribution was extracted. Photon dose distribution in linear accelerator was measured by the $MapCHECK^{TM}$ and compared with planned and measured dose distributions. In result of the comparative analysis, when artifact is generated by Titanium, The volume applied O-MAR was increased 6.8% to BR-12 Breast and 40.2% to LV 1 Liver. After O-MAR was used, Dose distribution was higher 1.4 to 1.6% than before. Consequently, The artifact caused by metal objects should be removed if possible, and after that used in the radiotherapy treatment plan can be considered to reduce errors.

• Proceedings of the KACD Conference
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• 2008.05a
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• pp.184-197
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• 2008

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

• Restorative Dentistry and Endodontics
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• v.33 no.3
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• pp.184-197
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• 2008

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.238-249
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• 2003

Purpose: To report the clinical result of the intraarticular calcaneus fracture after open reduction and internal fixation with plate by lateral approach. Materials and Methods: Thirty-six calcaneal fractures of 33 patients(29 men and 4 women) were treated by open reduction and internal fixation using an lateral approach from March, 1997 to May, 2002 and were followed more than one year. The autogenous iliac bone graft was done in 2 cases but the others didn't. Radiographically B?hler angle and Gissane angle on simple lateral radiograph were measured and in the 15 cases, the step-off(gap) of posterior facet joint on post-operative CT images were followed. The Salama method was used for evaluation of clinical results. Results: According to Sanders classification, 19 cases of the 36 cases were classified as type II. Type III fracture were found in 12 cases and type IV in 5 cases. The following results were obtained: twenty-two cases(61.1%) out of 36 cases were estimated as good or excellent. The good results or more were obtained in 15 cases(78.9%) in type II and 7 cases(58.3%) in type ill, but no case in type IV. B?hler angles were improved from preoperative average 1.6?to postoperative average 23.4?, Gissane angle was improved from preoperative 107.2?to postoperative 122.8?, respectively. Among 36 cases, Computed tomography was carried out in 15 cases. The postoperative step-off (gap) of posterior facet joint on computed tomography was filled with cancellous bone. Satifactory results was obtained in 7 cases with 2mm gap or less and in 6 cases of 2-5mm. There were no satifactory results in 2 cases with 5mm gap or more. Conclusion: Open reduction and internal fixation for intra-articular fracture of calcaneus was thought to be a good treatment modality. It is thought that the lateral approach is one of the good one for surgical treatment, and that accurate reduction of the posterior facet, acceptable recovery of B?hler angle are more important to obtain best results.

• The korean journal of orthodontics
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• v.39 no.3
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• pp.146-158
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• 2009

Objective: The purpose of this study was to reveal the position of the incisive foramen in relation to the incisive papilla and cusp tips. Methods: Plaster models and CT images of 25 adult orthodontic patients were used to measure the width of the incisive canal and positions of the anterior and posterior borders of the incisive foramen in relation to the incisive papilla. Results: The palatal surface distance from the interdental papilla between the maxillary central incisors to the posterior border of the incisive foramen along the palatal surface was 1.7 fold of the distance from the interdental papilla between the central incisors to the posterior border of the incisive papilla. The distance between the posterior border of the incisive papilla and posterior border of the incisive foramen along the palatal surface was 6.15 ${\pm}$ 1.75 mm. The anteroposterior position of the posterior border of the incisive foramen was slightly anterior to the lingual cusp tips of the maxillary 1st premolars. The width of the incisive foramen was 4.03 ${\pm}$ 0.64 mm, therefore it is recommended to position the mini-implant more than 3 mm laterally when placing a mini-implant lateral to the incisive foramen, from the center. Conclusions: These results can be used as a reference in presuming the position of the incisive foramen when placing mini-implant in the anterior palate area.

• The korean journal of orthodontics
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• v.40 no.3
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• pp.145-155
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• 2010

Objective: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. Methods: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. Results: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. Conclusions: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.39 no.5
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• pp.443-448
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• 2015

Obstructive sleep apnea (OSA) is a syndrome characterized by the repetitive episodic collapse of the upper airway. Maxillomandibular advancement surgery is one of the most effective surgical treatment methods in treating obstructive sleep apnea. The advancement of both maxill and mandible can enlarge the cross-sectional areas and volumes of the postero-superior airway. The purpose of this study is to analyze flow patterns in the upper airway before and after maxillomandibular advancement surgery. Here, we analyzed flow phenomena of inspiration and expiration to prevent obstructive sleep apnea patient from happening side effect. Modeling of the upper airway carried out from clinical CT scanned images. We used time-dependent values for boundary condition. CFD analyses were performed and evaluated section of minimum area (SMA), compared with patient inside upper airway before and after maxillomandibular advancement surgery in SMA, and negative pressure effects. The study showed the greatest enlargment of the section of minimum cross-sectional area. Moreover, the velocity and the negative airway pressure were decreased. According to the result of this study, the maxillomandibular advancement surgery stabilizes the airflow in the postero-superior airway of OSA patients.

• Imaging Science in Dentistry
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• v.46 no.1
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• pp.25-31
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• 2016

Purpose: This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Materials and Methods: Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using 3D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. Results: The mean of the average point-to-point distances on condylar surface was $0.11{\pm}0.03mm$. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. Conclusion: This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.

• Tuberculosis and Respiratory Diseases
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• v.73 no.1
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• pp.22-31
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• 2012

Background: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. Methods: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor ${\alpha}$ (TNF-${\alpha}$) and interleukin $1{\beta}$ (IL-$1{\beta}$) were measured in BALF. Nuclear factor ${\kappa}B$ (NF-${\kappa}B$), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. Results: TNF-${\alpha}$ and IL-$1{\beta}$ concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group ($5.5{\pm}2.8$ nmol/mL vs. $16.5{\pm}1.6$ nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group ($6.4{\pm}1.8$ unit/g vs. $11.2{\pm}6.3$ unit/g, tissue) (p<0.048). The concentration of NF-${\kappa}B$ in NAC treatment group was significantly lower than that of LPS group ($0.3{\pm}0.1\;ng/{\mu}L$ vs. $0.4{\pm}0.2\;ng/{\mu}L$) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. Conclusion: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-${\kappa}B$ activation.