Kim, Soo Yeon;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
Journal of Korean Neurosurgical Society
/
v.63
no.1
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pp.89-98
/
2020
Objective : Ossification of posterior longitudinal ligament (OPLL) in the thoracic spine may cause chronic compressive myelopathy that is usually progressive, and unfavorable by conservative treatment. Although surgical intervention is often needed, the standard surgical method has not been established. Recently, it has been reported that posterior decompression with dekyphosis is effective surgical technique for favorable clinical outcome. The purpose of this study was to evaluate the surgical outcomes in patients with thoracic OPLL according to dekyphosis procedure and to identify predictive factors for the surgical results. Methods : A total of 25 patients with thoracic OPLL who underwent surgery for myelopathy from May 2004 to March 2017, were retrospectively reviewed. Patients with cervical myelopathy were excluded. We assessed the clinical outcomes according to various surgical approaches. The modified Japanese orthopedic association (JOA) scores for the thoracic spine (total, 11 points) and JOA recovery rates were used for investigating surgical outcomes. Results : Of the 25 patients, 10 patients were male and the others were female. The mean JOA score was 6.7±2.3 points preoperatively and 8.8±1.8 points postoperatively, yielding a mean recovery rate of 53.8±31.0%. The mean patients' age at surgery was 52.4 years and mean follow-up period was 40.2 months. According to surgical approaches, seven patients underwent anterior approaches, 13 patients underwent posterior approaches, five patients underwent combined approaches. There was no significant difference of the surgical outcomes related with different surgical approaches. Age (≥55 years) and high signal intensity on preoperative magnetic resonance (MR) image in the thoracic spine were significant predictors of the lower recovery rate after surgery (p<0.05). Posterior decompression with dekyphosis procedure was related to the excellent surgical outcomes (p=0.047). Dekyphosis did not affect the complication rates. Conclusion : In this study, our result elucidated that old age (≥55 years) and presence of intramedullary high signal intensity on preoperative MR images were risk factors related to poor surgical outcomes. In the meanwhile, posterior decompression with dekyphosis affected favorable clinical outcome. Posterior approach with dekyphosis procedure can be a recommendable surgical option for favorable results.
Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.
Periodontal disease is one of the major dental diseases. Currently, various methods are used for healing and successful regeneration of periodontal tissue damaged by periodontal disease. The periodontal ligament and alveolar bone have received considerable interest for use in periodontal tissue regeneration and induction. However, as the functions of the factors required for tooth attachment and key regulatory factors for periodontal tissue regeneration in the cementum have recently been identified, interest in cementum formation and regeneration has increased. Dental cementum forms in the late phase of tooth development because of the reciprocal regulatory interaction between cervical loop epithelial cells and surrounding mesenchymal cells, which is regulated by various gene signaling networks. Many attempts have been made to understand the regulatory factors and cellular and molecular mechanisms associated with new cementum formation. In this paper, we reviewed the study outcomes to date on the regulatory factors that induce cementum formation and regeneration, focusing on understanding the roles and functions of Wnt signaling in the regulation of cementum formation. In addition, we aimed to obtain information on the useful reciprocal regulatory factors that mediate cementum formation and regeneration through a series of molecular mechanisms.
Purpose : The purpose of this study is to know sports injury aspects and relationship between exercise stress, tension, exercise habits and sports injuries. Methods : We surveyed 42 professional golf players who attended Korea Tour during the second half of the year 2010 and have sports injuries with self - assessment questionnaires. Results : According to the types, they had myalgia, tendonitis, ligament sprain in the order. According to the body parts, they had injuries in right thoracic, left cervical, left shoulder region in the order. As a result of the analysis of the sports injury frequency according to the exercise stress and tension, there were no significant differences between the high and low level group. But result of injury regions showed high tension level group showed more damages in right thoracic region (p<0.05). Exercise habits appear subjects had lots of training time, however, they used to skip the muscular strengthening exercise during the on season, but had no significant difference between sports injury frequencies and exercise habit. Conclusion : For the improvement of the athletic performance and prevention of the sports injury, warming-up, cooling-down and muscular strengthening exercise program developments are needed.
Kim, Byung-Ju;Song, Chan-Woo;Kim, Jung-Won;Shin, Dong-Yeop;Wang, Ping-Chen
The Korean Journal of Pain
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v.8
no.2
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pp.319-323
/
1995
The implication of cervical pain associated with an elongated styloid process is credited to W.W.Eagle. Even though there were earlier reports of ossification of the stylohyoid ligament, findings in more than 200 cases in 1980s and 1940s resulted in the naming of a clinical syndrome that continues to bear his name, Eagle's syndrome. It is also sometimes called styloid process neuralgia or elongated styloid process syndrome is more common than generally recognized. The clinical symptoms range from a dull nagging pain with occasional radiation to ear, or to a foreign body sensation. Dysphagia and odynophagia may also occur. We successfully treated one case by removal of the elongated styloid process under the general anesthesia and C2 ganglion block. We then reported the clinical feature of one case of the Eagle's syndrome and further researched with the foreign literature.
The Journal of Korea Assosiation for Disability and Oral Health
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v.7
no.2
/
pp.99-102
/
2011
A-12year-old boy visited the clinic with chief complaint of anterior maxillary trauma. He was diagnosed with first degree mental retardation and cerebral disorders. By clinical and radiographic examination, intrusion of maxillary central incisors were found. The intrusion was not severe, teeth were luxated with a slight force and the prognosis was followed. After the first year, external root resorption was seen radiographically. Due to difficult behavior management, one visit root canal filling with OrthoMTA(BioMTA, Korea) which is known to generate of cementum and periodontal ligament was planned along with general anesthesia. OrthoMTA was filled from the apex to 1-2mm below cervical area and composite resin used for crown restoration. 6 months after, further resorption, discoloration and mobility was not found. This case is currently checked yearly and further research is needed for inflammatory root resorption and ankylosis.
Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.
The use of composite restorative materials is established due to continuing improvements in the materials and restorative techniques. Composite resins are widely used for the restoration of cervical lesions because of esthetics, good physical properties and working time. There are several types of cavity design for class V composite resin filling, but inappropriate cavity form may affect bonding failure, microleakage and fracture during mastication. Cavity preparations for composite materials should be as conservative as possible. The extent of the preparation is usually determined by the size, shape, and location of the defect. The design of the cavity preparation to receive a composite restoration may vary depending on several factors. In this study, 5 types of class V cavity were prepared on each maxillary central incisor. The types are; 1) V-shape, 2) round(U) shape, 3) box form, 4) box form with incisal bevel and 5) box form with incisal bevel and grooves for axial line angles. After restoration, in order to observe the concentration of stress at bonding surfaces of teeth and restorations, developing a 2-dimensional finite element model of labiopalatal section in tooth, surrounding bone, periodontal ligament and gingiva, based on the measurements by Wheeler, loading force from direction of 45 degrees from lingual side near the incisal edge was applied. This study analysed Von Mises stress with SuperSap finite element analysis program(Algor Interactive System, Inc.). The results were as follows : 1. Stress concentration was prevalent at tooth-resin bonding surface of cervical side on each model. 2. In model 2 without line angle, stress was distributed evenly. 3. Preparing bevel eliminated stress concentration much or less at line angle. 4. Model with round-shape distributed stress concentration more evenly than box-type model with sharp line angle, therefore decreased possibility of fracture. 5. Adding grooves to line angles had no effect of decreasing stress concentration to the area.
Kim, Min-Ji;Park, Sun-Hyung;Kim, Hyeon-Seong;Mo, Sung-Seo;Sung, Sang-Jin;Jang, Gang-Won;Chun, Youn-Sic
The korean journal of orthodontics
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v.41
no.3
/
pp.191-199
/
2011
Objective: The purpose of this study was to investigate the stress distribution on the orthodontic mini-implant (OMI) surface and periodontal ligament of the maxillary first and second molars as well as the tooth displacement according to the OMI position in the dragon helix appliance during scissors-bite correction. Methods: OMIs were placed at two maxillary positions, between the first and the second premolars (group 1) and between the second premolar and the first molar (group 2). The stress distribution area (SDA) was analyzed by three-dimensional finite element analysis. Results: The maximal SDA of the OMI did not differ between the groups. It was located at the cervical area and palatal root apex of the maxillary first molar in groups 1 and 2, respectively, indicating less tipping in group 2. The minimal SDA was located at the root and furcation area of the maxillary second molar in groups 1 and 2, respectively, indicating greater palatal crown displacement in group 2. Conclusions: Placement of the OMI between the maxillary second premolar and the maxillary first molar to serve as an indirect anchor in the dragon helix appliance minimizes anchorage loss while maximizing the effect on scissors-bite correction.
Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.
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