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Positional changes of the mandibular condyle in unilateral sagittal split ramus osteotomy combined with intraoral vertical ramus osteotomy for asymmetric class III malocclusion

  • Park, Jun;Hong, Ki-Eun;Yun, Ji-Eon;Shin, Eun-Sup;Kim, Chul-Hoon;Kim, Bok-Joo;Kim, Jung-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.5
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    • pp.373-381
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    • 2021
  • Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

Evaluation of 99mTc-MAG3-2-nitroimidazole for hypoxic tumor imaging

  • Lee, Yun-Sang;Kim, Young Joo;Jeong, Jae Min
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.5 no.1
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    • pp.18-25
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    • 2019
  • 2-Nitroimidazole derivatives have been reported to accumulate in hypoxic tissue. We prepared a novel $^{99m}Tc-MAG_3$-2-nitroimidazole and evaluated the feasibility for hypoxia imaging agent. $Bz-MAG_3$-2-nitroimidazole was synthesized by direct coupling of $Bz-MAG_3$ and 2-nitroimidazole using dicyclohexylcarbodiimide. $Bz-MAG_3$-2-nitroimidazole was labeled with $^{99m}Tc$ in the presence of tartaric acid and $SnCl_2-2H_2O$ at $100^{\circ}C$ for 30 min. And the reaction mixture was purified by $C_{18}$ Sep-pak cartridge. The labeling efficiency and the radiochemical purity were checked by ITLC-SG/acetonitrile. The tumor was grown in balb/c mice for 8~13 days after the subcutaneous injection of tumor cells, CT-26 (murine colon adenocarcinoma cell). Biodistribution study and tumor autoradiography were performed in the xenografted mice after i.v injection of 74 kBq/0.1 mL and 19 MBq/0.1 mL of $^{99m}Tc-MAG_3$-2-nitroimidazole, respectively. In vivo images of $^{99m}Tc-MAG_3$-2-nitroimidazole in tumor bearing mice were obtained 1.5 hr post injection. The labeling efficiency was $45{\pm}20%$ and the radiochemical purity after purification was over 95%. Paper electrophoresis confirmed negative charge of $^{99m}Tc-MAG_3$-2-nitroimidazole. $^{99m}Tc-MAG_3$-2-nitroimidazole was very stable at room temperature and its protein binding was 53%. The $^{99m}Tc-MAG_3$-2-nitroimidazole exhibited high uptake in the liver, stomach and intestine. In biodistribution study using tumor bearing mice, the uptakes (% ID/g) of the tumor were $0.5{\pm}0.1$, $0.4{\pm}0.0$, $0.2{\pm}0.1$ and $0.1{\pm}0.1$ at 5, 15, 30 min and 4 hrs. Tumor/muscle ratio were $1.4{\pm}0.1$, $2.2{\pm}0.83$, $3.0{\pm}0.9$, and 3.7 (n=2) for 5, 15, 30 min and 4 hrs. The uptake in hypoxic area was found higher than in non-hypoxic area of tumor tissue by autoradiography. In vivo images showed the relatively faint uptake to the hypoxic tumor region. $^{99m}Tc-MAG_3$-2-nitroimidazole was successfully synthesized and found feasible for imaging hypoxia.

Quantitative Comparison of Motion Artifacts in PET Images using Data-Based Gating (데이터 기반 게이팅을 이용한 PET 영상의 움직임 인공물의 정량적 비교)

  • Jin Young, Kim;Gye Hwan, Jin
    • Journal of the Korean Society of Radiology
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    • v.17 no.1
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    • pp.91-98
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    • 2023
  • PET is used effectively for biochemical or pathological phenomena, disease diagnosis, prognosis determination after treatment, and treatment planning because it can quantify physiological indicators in the human body by imaging the distribution of various biochemical substances. However, since respiratory motion artifacts may occur due to the movement of the diaphragm due to breathing, we would like to evaluate the practical effect by using the a device-less data-driven gated (DDG) technique called MotionFree with the phase-based gating correction method called Q.static scan mode. In this study, images of changes in moving distance (0 cm, 1 cm, 2 cm, 3 cm) are acquired using a breathing-simulated moving phantom. The diameters of the six spheres in the phantom are 10 mm, 13 mm, 17 mm, 22 mm, 28 mm, and 37 mm, respectively. According to maximum standardized uptake value (SUVmax) measurements, when DDG was applied based on the moving distance, the average SUVmax of the correction effect by the moving distance was improved by 1.92, 2.48, 3.23 and 3.00, respectively. When DDG was applied based on the diameter of the phantom spheres, the average SUVmax of the correction effect by the moving distance was improved by 2.37, 2.02, 1.44, 1.20, 0.42 and 0.52 respectively.

Changes in the Comfort and Image Quality of the Patient According to the Application of Air Mattresses in the Computed Tomography Table (전산화단층촬영 테이블의 에어 매트리스 적용에 따른 환자의 편안함과 화질 변화)

  • Young-Hee, Lee;Yong-Ki, Lee
    • Journal of the Korean Society of Radiology
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    • v.16 no.7
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    • pp.889-896
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    • 2022
  • This study attempted to evaluate the usefulness of the air mattress by analyzing the subjective comfort of the patient due to the application of the air mattress to the table of computed tomography through a questionnaire and analyzing the change in image quality through quantitative and qualitative evaluation of the patient's clinical images. The subjects who participated in the study were 221 men and 229 women, and the age range was from 18 to 86. To evaluate the change in image quality, a total of 150 patients, 50 patients per group, were selected for quantitative evaluation, and 20 patients per group, a total of 60 patients were selected for qualitative evaluation. As a result of this study, the subjective comfort of patients increased due to air mattresses, and there was no difference in image quality as a result of quantitative and qualitative evaluation of clinical images. From the above results, it is believed that the air mattress can be usefully applied in a way that can increase the subjective comfort of the patient without any harm to the diagnostic image.

Computerized Tomographic Study on the Anatomic Variation of the Paranasal Sinus (전산화단층사진을 이용한 부비동의 해부학적 변이에 관한 연구)

  • Choi Sun-Young;Lim Sug-Young;Park Ju-Mi;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.477-491
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    • 1999
  • Objectives : To evaluate the anatomic variations of the paranasal sinuses on computed tomographs. Materials and Methods : The author examined the CT images of the paranasal sinuses retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. Results : The highest incidence of anatomic variation of the paranasal sinuses in bilateral structures was agger nasi cel1(73.2%), followed by concha bullosa(31.1%), Onodi cell(24.0%), Haller ce1109.8%), maxillary sinus septum(3.0%), paradoxical middle turbinate(2.5%), pneumatized uncinate process(2.0%), and bent uncinate process. The highest incidence of anatomic variation in midline structures was nasal septum deviation(53.2%), followed by nasal septum aerated(29.4%), bulla galli(24.7%) asymmetric intersphenoid septum(22.3%), and nasal septum spur(13.8%). The correlation between anatomic variation and paranasal sinusitis was not found. Conclusions : The results of this study will aid in the diagnosis and treatment of paranasal sinus diseases, especially in the treatment planning before functional endoscopic surgery.

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Clinical Investigation of Pediatric Blunt Thoracic Trauma (소아 흉부 둔상 환자의 임상적 고찰)

  • Chung, Tae Kyo;Hyun, Sung Youl;Kim, Jin Joo;Ryoo, EeIl;Lee, Kun;Cho, Jin Seung;Hwang, Sung Yun;Lee, Suk Ki
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.119-126
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    • 2005
  • Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

A Computed Tomographic Study on the Size and Bone Wall Thickness of the Maxillary Sinus in Normal, Preoperative and Postoperative Maxillary Sinusitis Patients (술전ㆍ후 상악동염환자와 정상인의 상악동 크기 및 골벽두께에 관한 전산화단층방사선학적 연구)

  • Choi Sun-Young;Lee Sang-Rae;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.30 no.2
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    • pp.109-116
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    • 2000
  • Purpose : To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. Materials and Methods : The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. Results: The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). Conclusion : The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

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Application of Calibration Techniques to Enhance Accuracy of Markerless Surgical Robotic System for Intracerebral Hematoma Surgery (뇌혈종 제거 수술을 위한 무마커 수술 유도 로봇 시스템의 정확도 향상을 위한 캘리브레이션 기법)

  • Park, Kyusic;Yoon, Hyon Min;Shin, Sangkyun;Cho, Hyunchul;Kim, Youngjun;Kim, Laehyun;Lee, Deukhee
    • Korean Journal of Computational Design and Engineering
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    • v.20 no.3
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    • pp.246-253
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    • 2015
  • In this paper, we propose calibration methods that can be applied to the markerless surgical robotic system for Intracerebral Hematoma (ICH) Surgery. This surgical robotic system does not require additional process of patient imaging but only uses CT images that are initially taken for a diagnosis purpose. Furthermore, the system applies markerless registration method other than using stereotactic frames. Thus, in overall, our system has many advantages when compared to other conventional ICH surgeries in that they are non-invasive, much less exposed to radiation exposure, and most importantly reduces a total operation time. In the paper, we specifically focus on the application of calibration methods and their verification which is one of the most critical factors that determine the accuracy of the system. We implemented three applications of calibration methods between the coordinates of robot's end-effector and the coordinates of 3D facial surface scanner, based on the hand-eye calibration method. Phantom tests were conducted to validate the feasibility and accuracy of our proposed calibration methods and the surgical robotic system.

Organized Hematoma in the Maxillary Sinus (상악동에 발생한 organized hematoma)

  • Kim, Jae-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.473-477
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    • 2010
  • Organized hematoma of the maxillary sinus is a rare, nonneoplastic benign lesion with locally destructive behavior that may mimic a malignancy. Clinically, symptoms do not usually occur while the lesion remains localized to the maxillary sinus. Because there is gradual enlargement of the lesion causing erosion and displacement of the adjacent bony structures, symptoms such as epistaxis, cheek swelling, nasal obstruc-tion, headache, and exophthalmos become manifest. Radiologically, unilateral cases are much more fre-quent than bilateral, and Waters' view shows complete opacity of the expanded maxillary sinus and some masses. CT scan shows a large heterogeneous enhancing mass causing considerable expansion of the max-illary sinus with bony erosion. On MR imaging, the mass usually has a variable signal intensity on T1- and T2- weighted images, ranging from low to high. After contrast administration, discrete areas of enhance-ment are present within the mass. Although the disease is essentially benign and nonneoplastic, differen-tial diagnosis from neoplastic disease including malignancy both clinically and radiologically has been always problematic. Accurate preoperative diagnosis of organized hematoma of the maxillary sinus is important to avoid unnecessary extensive surgery, because this condition is curative with a simple, conservative surgical approach and rarely recur. Organized hematoma of the maxillary sinus should be included in the differential diagnosis when patients have recurrent epistaxis, slow-growing mass of the cheek, nasal obstruction, and expansile mass in the maxillary sinus. A 33-year-old man was referred to the department of oral and maxillofacial surgery with a three-month history of slowly growing painful swelling of the left cheek. The mass of the maxillary sinus was resected by a Caldwell-Luc approach. Histopahtoly showed only a fibous encapsulated organized hematoma. To our knowledge, organized hematoma of the maxillary sinus has not been previously described in the Korean literature of the oral and maxillofacial surgery. We report a case of organized hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass.

Does matching relation exist between the length and the tilting angle of terminal implants in the all-on-four protocol? stress distributions by 3D finite element analysis

  • Li, Xiaomei;Cao, Zhizhong;Qiu, Xiaoqian;Tang, Zhen;Gong, Lulu;Wang, Dalin
    • The Journal of Advanced Prosthodontics
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    • v.7 no.3
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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.