• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.174-188
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• 1999

The purpose of this study is to evaluate the precision and accuracy of a three dimensional cephalogram constructed by using the frontal and lateral cephalogram of twelve human dry skulls. After achieving the three dimensional image reconstruction program, we tried to apply this program to two dentofacial deformity patients. 1. Conventional nasion relator in cephalostat was used to reproduce the same head position for the same dry skull. The mean difference of the three dimensional cephalogram for the same dry skull was $0.34{\pm}0.33mm$. Closeness of repeated measures to each skull reveals the precision of this method for the three dimensional cephalogram. 2. Concerning the accuracy, the mean difference between the three dimensional reconstruction data and actual lineal measurements was $1.47{\pm}1.45mm$ and the mean magnification ratio was $100.24{\pm}4.68%$. This Diffrerence is attributed mainly to the ill defined cephalometric landmarks, not to the positional change of the dry skull. 3. Cephalometric measurement of lateral and frontal radiographs had no consecutive magnification ratio because of the different focus-object distance. The mean difference between the frontal and lateral cephalogram to the actual lineal measurements was $4.72{\pm}2.01mm$ and $-5.22{\pm}3.36mm$. Vertical measurements were slightly more accurate than horizontal measurements. 4. Applying to the actual patient analysis, it is recommendable to use this program for analyzing the asymmetry or spatial change after operation. The orthodontic bracket would be a favorable cephalometric landmark for constructing the three dimensional images.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.245-253
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• 2003

Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.522-527
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• 2004

Purpose: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. Materials and Methods: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: $67{\pm}8$, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. Results: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type war similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). Conclusion: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.696-703
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• 2009

Background: A Comprehensive Aortic Root and Valve Reconstruction (CARVAR) procedure is comprised of aortic root wall reconstruction and corrections of the leaflets for treating various aortic valve diseases. We evaluated our recent early clinical experience with the CARVAR procedure. Material and Method: From October 2007 to September 2008, 114 cases (66 males) of CARVAR procedures were performed, The mean patient age was 53 years (range: 14~84) The patients were divided into 4 groups: 1) the AAR group: aortic regurgitation with aortic root wall deformity such as annulo-aortic ectasia or ascending aortic aneurysm (n=18), 2) the IAR group: isolated AR with leaflet abnormality (n=42), 3) the IAS group: isolated aortic stenosis (n=51) and 4) the PAVR group: previous aortic valve replacement (n=3). Sinotubular junction (STJ) reduction was done in all the patients, leaflet correction was done in 10 of the AAR group patients and in all the patients of the other groups, annulus reduction was done in 14 of the MR group patients and in 6 of the IAR group patients. Aortic dissection was excluded from this analysis. Result: There was no mortality or follow-up death. The diameter of the aortic sinus decreased from $54.6{\pm}8.4$ mm to $38.3{\pm}3.8$ mm in the AAR group, the mean AR grade decreased from 3.2 to 0.2 in the IAR group, the mean aortic valve pressure gradient decreased from $47.1{\pm}24.4$ mmHg to $15.1{\pm}11.7$ mmHg in the IAS group and the mean AR grade decreased to 0 in the PAVR group. Balloon type coronary perfusion cannula-related coronary ostial stenosis developed in 4 patients and this was treated with OPCAB in three patients and with PTCA in one patient. Two patients developed postoperative infectious endocarditis. All the patients were discharged and followed up in a stable condition. Conclusion: The CARVAR procedure showed excellent short term results, but a good further follow up result is required to apply this procedure to most kinds of aortic valve diseases.

• Anatomy & Biological Anthropology
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• v.29 no.4
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• pp.145-154
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• 2016

The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.154-161
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• 2020

Purpose: To describe the clinical and radiology results of a surgical treatment for clinodactyly due to a longitudinal epiphyseal bracket. Materials and Methods: This study analyzed the records of 11 patients (27 case) with clinodactyly due to a longitudinal epiphyseal bracket who underwent an osteotomy or physiolysis between March 1999 and April 2017. The preoperative range of motion of the proximal and distal interphalangeal joints, the subjective satisfaction of the patient, and the degree of angulation to the ulnar side were examined. The patients were classified into two groups: osteotomy and physiolysis. The results were reviewed retrospectively and compared according to the surgical method. Results: The mean age of the patients who underwent osteotomy was 10.3 years. The average preoperative angle was 25.7° and the average postoperative angle was 13.5° the mean correction rate was 47.4%. The mean age of the patients who underwent physiolysis was 6.0 years the mean preoperative angle was 24.5° and the postoperative angle was 10.7°. The average correction rate was 59.4%. No significant difference in the correction angles was observed between the group who underwent the correction osteotomy and the group who underwent the osteotomy. In each group, the postoperative correction was statistically significant. The range of motion at the last follow-up was not significantly different from the preoperative range of motion. Conclusion: In patients with clinodactyly due to longitudinal epiphyseal bracket, osteotomy or physiolysis may be performed selectively according to age, bone age, and radiological progression. Both surgical methods showed good clinical results and deformity correction.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.110-119
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• 2019

Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.

• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.39-51
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• 2011

The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.