Purpose: Restoration of ankle stability through the strengthening exercise of peroneus muscles is considered an important factor for achievement of successful outcomes, in the rehabilitation program following ankle ligament injuries. However, there were few definitive data on normal muscle strength, including eversion power by peroneus muscles. This study was conducted to evaluate the muscle strength of ankle joint measured using an isokinetic dynamometer in normal Koreans. Materials and Methods: Sixty adults (120 ankles) were recruited and divided into three groups (20 in their twenties, 20 in thirties, and 20 in forties). Each group consisted of 10 males and 10 females. The selection criteria were no history of ankle injury and no evidence of instability. The peak torque, total work, and deficit ratio were measured using the Biodex$^{TM}$ (Biodex Medical Systems). Differences in muscle strength by age, gender and dominant versus non-dominant side were analyzed. Results: The peak torque of dorsiflexion was average 31.5 Nm at $30^{\circ}/s$ of angular velocity and 18.8 Nm at $90^{\circ}/s$; average 69.3 Nm ($30^{\circ}/s$) and 42.4 Nm ($90^{\circ}/s$) on plantarflexion; average 19.6 Nm ($30^{\circ}/s$) and 10.8 Nm ($90^{\circ}/s$) on inversion; average 12.9 Nm ($30^{\circ}/s$) and 8.0 Nm ($90^{\circ}/s$) on eversion. The deficit ratio of strength in women was average 61.1% of men on dorsiflexion; average 66.2% on plantarflexion; average 48.5% on inversion; average 55.4% on eversion. The deficit ratio in non-dominant foot was average 88.6% of dominant foot on dorsiflexion; average 90.1% on plantarflexion; average 85.1% on inversion; average 85.6% on eversion. Conclusion: The muscle strength of the ankle joint showed a tendency to weaken with age. There were significant differences in muscle strength by gender and dominancy. Further studies for comparison of patients with ankle instability, a comparison between before and after surgery for instability, the correlation between clinical outcomes and the recovery in muscle strength will be needed.
Statement of problem: It was reported high success rate of implant-supported fixed prostheses using with $5{\sim}6$ implants on anterior mandible. Recently, immediate loading protocol was focused to overcome disadvantages of classic 2-stage delayed loading protocol. Purpose: This clinical study was to evaluate stability changes with time of immediately loaded and delayed loaded implants in edentulous mandible and to compare stability changes with time according to implantation sites. Materials and methods: Five or six implants were placed on anterior mandible depending on the arch shape. The immediately loading group was consisted of 8 patients received their prostheses within $24{\sim}48$ hours after implantation. The delayed loading group was consisted of 8 patients received their definitive prostheses following classical prosthetic procedures after a healing period of 3 months. All patients were recalled every 6 months for check-up. The evaluations of radiographic examination, ISQ value measurement and recording of complication were done. To evaluate marginal bone level, intraoral periapical radiographs were taken with long cone paralleling technique. At every evaluation recall, all prostheses were removed and ISQ values were measured with OsstellTM on individual implants. Results: 1. None of implants was failed. All implants showed stable marginal bone levels and ISQ values. 2. Marginal bone level changes with time showed statistically significant difference between immediately loading group and delayed loading group (P<0.001). 3. ISQ value changes with time did not show statistically significant difference between immediately loading group and delayed loading group (P=0.079). ISQ value decreased with time in both groups, however, all implants showed stable ISQ value at 30 months-recall evaluation. 4. Marginal bone level changes with time did not show statistically significant differences among implantation sites (P=0.604). 5. ISQ value changes with time showed statistically significant differences among implantation sites (P=0.047). ISQ values of most posterior implants decreased with time comparing to other implants. Conclusion: Although the marginal bone level of the terminal abutment didn't different with the other implants, ISQ value of the terminal abutment was lower than that of the other implants. Therefore, further clinical evaluation would be needed in this point of view.
People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.
Kim, Ye-Jin;Lee, Young-Hoon;Ko, Kyung-Ho;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
The Journal of Korean Academy of Prosthodontics
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v.56
no.4
/
pp.317-322
/
2018
The tongue, especially its lateral part, is the most common site of oral tumors. Patients who undergo glossectomy for the treatment of tongue cancer may experience difficulty in proper functioning for pronunciation, chewing, swallowing, and oral hygiene maintenance; therefore, a palatal augmentation prosthesis can be used to restore function of the tongue. In this case, an implant overdenture was used in a patient who had residual ridge resorption and obliteration of alveololingual sulcus after undergoing glossectomy for tongue cancer treatment. In addition, a palatal augmentation prosthesis with a metal framework, support, and retention part was fabricated. The palatal vault was reduced, so that even with limited tongue movement, adequate tongue-palate contact could be achieved. After placement of the definitive prostheses, the patient showed improvement in the functions of chewing, swallowing, and pronunciation.
Traditional options for posterior edentulous treatment include removable partial dentures and implant fixed prostheses. Recently, the concept of implant assisted removable partial denture, in which two treatments are fused, has been introduced in consideration of systemic health and patient's needs, costs, residual alveolar bone status and so on. Implant assisted removable partial denture has the advantage of increasing the retention and stability of the denture and improving its esthetics in cases of large bone defects or biomechanical disadvantages. In addition, it is possible to strategically place the implants in a site where the alveolar bone is relatively sufficient, thereby overcome the limit of the conventional removable partial denture design as well as reducing the burden on a wide range of implant surgery. Cost reduction is also expected. In this case, the patient was treated by placing the implant in both premolar sites of the mandible and fabricating the distal extension removable partial denture with the implant fixed prosthesis as an abutment. After delivering the definitive prosthesis, the patient showed satisfaction with the masticatory function and esthetics. and has been regularly followed-up for more than one year. The following 20-months follow-up case report describes the design of an implant-assisted-removable partial denture (IARPD) in which two cementretained implant crowns used to provide support and stability.
Journal of the korean academy of Pediatric Dentistry
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v.36
no.2
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pp.288-292
/
2009
A crown-root fracture is defined as a fracture involving enamel, dentin, and cementum. The fractures may be grouped according to pulpal involvement into uncomplicated and complicated. Generally a vertically crown-root fractured tooth must be extracted. However, it should be mentioned that the cases have been reported where bonding of the coronal fragment has led to consolidation of the intraalveolar part of the fracture. Definitive conservative therapy comprises one of four treatment alternatives; fragment removal only, fragment removal with gingivectomy, orthodontic extrusion of apical fragment, and surgical extrusion of apical fragment. The choice is primarily determined by the exact information on the site and the type of fracture, but the cost and the complexity of treatment can also be decisional factors. On the other hand, intentional replantation of the teeth with vertical root facture reconstructed with resin bonding has emerged as a new promising method in recent years. This case presents an intentional replantation of the crown-root fractured maxillary central incisor reconstructed with resin bonding. However, an obvious increase of radiolucency was observed after 4 months and the tooth was re-fractured after 16 months.
Kim, Sung Bin;Park, Jin Hee;Kim, Ye Na;Oak, Chul Ho;Jang, Tae Won;Jung, Man Hong;Chun, Bong Kwon
Tuberculosis and Respiratory Diseases
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v.67
no.6
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pp.545-550
/
2009
Background: Endobronchial ultrasonogram (EBUS) has increased the diagnostic yield of a bronchoscopic biopsy of peripheral pulmonary lesions (PPL). This study evaluated the diagnostic yield of EBUS-guided transbronchial biopsy (TBB) and the visibility of EBUS PPL. Methods: Between August 2007 and November 2008, 50 patients (32 men and 18 women, median age, 61.1${\pm}$10 yrs; range, 16 to 80 yrs) whose PPL lesions could not be detected with flexible bronchoscopy were enrolled in this study. Among the 50 patients, 40 cases were malignant lesions (adenocarcinoma 25, squamous cell carcinoma 10, small cell carcinoma 5) and 10 cases were benign lesions (tuberculoma 7, fungal ball 1, other inflammation 2). Results: The mean diameter of the target lesion was 35.4${\pm}$4.3 mm. Of the 50 patients examined, the overall diagnostic yield by EBUS-TBLB was 46.0% (23/50). The visualization yield of EBUS was 66.0% (33/50). A definitive diagnosis of PPL localized by EBUS was established using EBUS-TBLB in 69.6% (23/33) of cases. The diagnostic yields from washing cytology and brushing cytology from a bronchus identified by EBUS were 27.0% and 45.4% respectively. The diagnostic yields reached 78.7% when the three tests (washing cytology, brushing cytology and EBUS-TBLB) were combined. The visualization yield of EBUS in lesions <20 mm was significantly lower than that in lesions ${\geq}$20 mm (p=0.04). The presence of a bronchus leading to a lesion (open bronchus sign) on the chest CT scan was associated with a high visualization yield on EBUS (p=0.001). There were no significant complications associated with EBUS-TBLB. Conclusion: EBUS-TBLB is a safe and effective method for diagnosing PPL. The lesion size and open bronchus signs are significant factors for predicting the visualization of EBUS.
Background: Lung cancer is the most common cause of cancer mortality in Korea. The TNM stage at presentation in patients with non-small cell lung cancer (NSCLC) has the greatest impact on prognosis. Patients who undergo a complete resection for NSCLC are likely to develop recurrent and/or metastatic disease. There are several factors influencing the development of recurrence. We explored risk factors of recurrence in patients with stages I and II NSCLC, who had undergone curative resection. Methods: We reviewed patients who had complete surgical resection as definitive treatment for stage I or II. Patients followed up for more than 36 months. We evaluated several factors which might have relationship with recurrence, such as patient's demographic factors, TNM staging, pathologic finding, tumor markers and surgical technique. Results: A total of 75 patients were enrolled for analysis, of whom 58 were men and 17 were women with mean age of 61 (range, 37 to 76) years. The average size of tumors was 3.9 cm (0.7 to 10 cm). There were 64 patients with stage I NSCLC and 11 with stage II NSCLC. Among 64 patients with stage I NSCLC, 35 patients showed recurrences whereas 8 patients have recurred in stage II NSCLC. Grade of differentiation of tumor was closely related to the recurrence. Seventy-five percent of patients who had poor tumor differentiation experienced a recurrence. In contrast, 3 patients of twelve had recurrences, who revealed differentiation in their tissue (p<0.05). Conclusion: Tumor differentiation could be a predictive factor for tumor recurrence in patients who have undergone curative resection for stage I or II NSCLC.
The Journal of the Korean bone and joint tumor society
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v.5
no.3
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pp.169-177
/
1999
Osteosarcoma in patients older than 40 years are rare, however they have different clinical, radiological and pathological features from those of younger patients. Sometimes accurate histologic diagnosis is not easy, which is important in determining the correct surgical treatment and appropriate chemotherapy. Since January 1995, 11 patients with osteosarcoma occurring in patients older than 40 years have been diagnosed, treated and followed up for more than 6 months. In contrast to osteosarcoma in children and adolescents, only 4 cases(36.4%) were conventional types, while the others included 2 malignant fibrous histiocytoma-like types, 2 small cell types, 2 periosteal osteosarcomas and 1 giant cell-rich type. Seven cases showed purely osteolytic or predominantly osteolytic bony lesions and 8 were in Enneking stage IIB. Performed surgical treatments included 2 amputations, 6 wide resections and reconstructions, and one curettage and autogenous bone graft. In the remaining 2 cases, definitive surgical treatments included not carried out because of old age, multifocal involvement or poor medical tolerance. Neoadjuvant and adjuvant chemotherapies were performed in 9 of 11 patients. At last follow-up, there were 6 continuously disease-free survivals, 3 alive with diseases and 2 died of diseases. The overall cumulative 4-year survival rate calculated using Kaplan-Meier's productlimit method was 59.3%. For improved oncologic outcomes and survivals, early and accurate diagnosis, surgical treatment with adequate margin and neoadjuvant and adjuvant chemotherapy will be necessary.
Jun, Ji Hee;Choi, Tae-Young;Lee, Myeong Soo;Song, Eunhye;Ang, Lin;Park, Sunju
Journal of Society of Preventive Korean Medicine
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v.24
no.1
/
pp.1-14
/
2020
Objectives : The purpose of this systematic review was to investigate the efficacy and safety of Sanjoin-tang (Suanzaoren decoction, SZRD) for insomnia in menopausal syndromes. Method : We searched the following databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals Database (VIP), Wanfang, Research Information Service System (RISS), OASIS, Korean studies Information Service System (KISS), and National Digital Science Library (NDSL) databases. Randomized controlled trials (RCTs) or quasi-RCTs that used SZRD for women in menopause were included. The methodological quality of each RCT was assessed using the risk of bias tool. Results : In total, nine RCTs were finally included. The included RCTs had a high risk of bias across their domains. Three RCTs examined the effects of SZRD compared with western medicine (WM) in insomnia. Three RCTs showed favorable effects of SZRD with insomnia. Infrastructure also showed that SZRD resulted in better clinical WM (RR 1.19, 95% CI 1.07 to 1.32, P=0.001, I2=0%). Four RCTs showed favorable effects of Modified SZRD with insomnia. Infrastructure also showed that Modified SZRD resulted in better clinical WM (RR 1.13, 95% CI 1.04 to 1.23, P=0.004, I2=0%). Among the 4 RCTs, three RCTs showed an equivalent effect on the total Pittsburh Sleep Quality Index (PSQI). The meta-analysis also showed that Modified SZRD had a superior effect on the total of PSQI (total of PSQI : MD -2.55, 95% CI -3.72 to -1.37, P<0.0001, I2=85%). Only 2 trials reported adverse events and none reported severe adverse events. Conclusion : SZRD appears to be safe, but there is insufficient evidence to make a definitive conclusion because only a few studies reported adverse events. Due to the poor methodological quality of the included studies and the small number of trials included, the evidence cannot be reproduced and assessed. Well-designed RCTs with a larger sample size are needed in the future.
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