Restorative procedures can lead to weakening tooth due to reduction and alteraton of tooth structure. It is essential to prevent fractures to conserve tooth. Among the several parameters in cavity designs, cavity isthmus and depth are very important. In this study, MO amalgam cavity was prepared on maxillary first premolar. Three dimensional. finite element models were made by serial photographic method and cavity depth(1.7mm, 2.4mm) and isthmus (11 4, 1/3, 1/2 of intercuspal distance) were varied. linear, eight and six-nodal, isoparametric brick elements were used for the three dimensional finite element model. The periodontal ligament and alveolar bone surrounding the tooth were excluded in these models. Three types model(B, G and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall. Both compressive and tensile forces were distributed directly to the adjacent regions. G model(Gap Distance: 0.000001mm) was assumed the possibility of play at the interface simulated the lack of real bonding between the amalgam and cavity wall (enamel and dentin). When compression occurred along the interface, the forces were transferred to the adjacent regions. However, tensile forces perpendicular to the interface were excluded. R model was assumed non-connection between the restoration and cavity wall. No force was transferred to the adjacent regions. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, von Mises stress, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as follows: 1. G model showed stress and strain patterns between Band R model. 2. B model and G model showed the bending phenomenon in the displacement. 3. R model showed the greatest amount of the displacement of the buccal cusp followed by G and B model in descending order. G model showed the greatest amount of the displacement of the lingual cusp followed by B and R model in descending order. 4. B model showed no change of the displacement as increasing depth and width of the cavity. G and R model showed greater displacement of the buccal cusp as increasing depth and width of the cavity, but no change in the displacement of the lingual cusp. 5. As increasing of the width of the cavity, stress and strain were not changed in B model. Stress and strain were increased on the distal marginal ridge and buccopulpal line angle in G and R model. The possibility of the tooth fracture was increased. 6. As increasing of the depth of the cavity, stress and strain were not changed in B and G model. Stress and strain were increased on the distal marginal ridge and buccopulpal line angle in R model. The possibility of the tooth fracture was increased.
Purpose: Blow-out fractures are reduced through transcutaneous or transconjunctival incisions. But the field of orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital floor, susceptibility of injury of orbital structures. In these situations, the former technique of using an antral balloon catheter has advantages over other methods for reconstruction because of its rapidity, simplicity, and inexpensiveness. Furthermore, the antral balloon catheter allows not only elevation of the orbital bone fragment but also expansion of the maxillary sinus in cases where there is a fracture of its walls. But postoperative follow-up method using computed tomography is expensive. Hence, we report a simple and inexpensive follow-up method using radiopaque dye inflation. Methods: We performed endoscopic transantral approach in 5 cases of blow-out fracture under general anesthesia. To accomplish this technique, a rigid 4 mm, 0 or 30 degree angled endoscopy was inserted into the maxillary sinus. Inflation of the catheter started gradually, with 10 to 15 mL of saline mixed radiopaque dye (saline: dye, 5 : 1) by syringe and while observing the elevation of the fracture site with endoscope until a proper contour was reached. For the maintain of the position of fractured site, 12 French urinary balloon foley catheter were used in fracture site for 7 - 10 days. Results: Postoperative assessment was performed by means of clinical and simple radiographic examination to secure the catheter under the inferior orbital wall and in the maxillary sinus. No specific complications occurred related to this procedure. Results of the surgery and follow-up in all cases were satisfactory. Conclusion: It may be a better alternative to the conventional follow-up method, with less cost and effectiveness of the catheter patency. The advantages of using the urinary balloon foley catheter with the radiopaque dye include the following : it is safe, efficacy, simple, and especially low cost. On drawback of this method is the discomfort to the patient caused by the catheter during the treatment.
The comminuted fracture and dislocation of the proximal humerus occur more frequently in older patient group and operative treatment is difficult due to poor bone quality. Based on Neer's work, hemiarthroplasty has now become widly accepted for the management of the three-part fracture and four-part fracture-dislocation of the proximal humerus in old age group. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after hemiarthroplasty for proximal humerus fractures and dislocations. Authors reviewed and analyzed 14 prosthetic replacement in comminuted proximal humeral fracture and dislocation at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine from March, 1988 to May, 1997. The results were as follows the average age was 58.9years and the ratio of males and females was 5:9. The most common cause of injury was traffic accident(43%). According to the classification of Neer, three part fracture were three(21%), four-part fracture and four-part fracture-dislocation were eleven(79%). The prosthetic replacement was performed within two weeks in eight patient and six were performed after two weeks. The results were analysed according to Neer's criteria and five cases showed satisfactory results. We concluded that hemiarthroplasty for fracture and dislocation of the proximal humerus facilitated the restoration of humerus length and pain relief, thereby allowing earlier motion to prevent the development of painful shoulder: stiffness.
Kim, Eugene;Park, Se-Jin;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Jai Hyung;Lee, Mi Yeon;Tsuyoshi, Murase;Sumika, Ikemototo;Kazuomi, Sugamoto;Choi, Young-Min
Clinics in Shoulder and Elbow
/
v.17
no.1
/
pp.25-30
/
2014
Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.
Fat embolism syndrome is a rare but serious complication occurring mostly in patients with long bone fractures and occasionally in patients who have had an underlying disease. For example, pancreatitis, diabetes mellitus, alcoholic liver disease and connective tissue disease can be risk factors. The 44-year old woman with a sudden dry cough, blood tinged sputum, and exertional dyspnea visited the Korea University Hospital. Petechiae on her anterior chest wall was found. Chest X-ray and CT showed patchy opacities and multifocal ground-glass opacities in both lung fields. An open lung biopsy demonstrated diffuse pulmonary hemorrhage and intravascular macrovesicular fat bubbles. After conservative management, her symptoms and radiologic findings were significantly improved. A case of fat embolism syndrome without any known risk factors is reported.
Purpose: The purpose of this study was to assess the 2-year follow-up results of patients with a trimalleolar fracture, who had undergone an anterior incision cannulated screw fixation of the posterior malleolar fragment, which had more than 25% of articular involvement or had no cortical continuity with the distal tibia. Materials and Methods: Among 28 patients with a trimalleolar fracture who had undergone fixation of the posterior malleolar fragment between February 2005 and February 2010, 14 patients, who underwent an anterior incision cannulated screw fixation of posterior malleolar fragment and were followed-up for more than 2 years, were selected. The postoperative clinical and radiological findings immediately and at the 1- and 2-year follow-up were compared. The clinical findings were evaluated as American Orthopaedic Foot and Ankle Society (AOFAS) score. The radiological assessment was evaluated as the maintenance of reduction, period to bone union, and the presence of nonunion, malunion, and complications. Results: The clinical outcome by mean AOFAS score revealed 83.0 points in the group with preoperative displacement below 2 mm and 80.7 points in the group with preoperative displacement above 2 mm postoperatively. The mean AOFAS score was 91.7 and 93.1 points in the group with preoperative displacement below 2 mm on 1- and 2-year follow-up, respectively, and 89.8 and 91.7 points in group with the preoperative displacement above 2 mm on 1- and 2-year follow-up, respectively. After a 2-year follow-up among 14 cases selected for this study, 13 cases showed an excellent reduction state and only 1 case (7.1%) showed a displacement of more than 2 mm. No complication were encountered in the group with preoperative displacement below 2 mm. On the other hand, among 8 patients in the group with preoperative displacement above 2 mm, there were 3 with limitations of the range of motion of the ankle joint (37.5%) and 1 post-traumatic arthritis (12.5%) at the 2-year follow-up. Conclusion: Anterior incision cannulated screw fixation of the posterior malleolar fragment could be a valuable method for the treatment of trimalleolar fractures that provides satisfactory results.
A 9-month-old female Korean short hair cat weighing 2.2 kg presented for evaluation of a two-week history of obstipation. The owner reported that the cat sustained pelvic fractures 4 months previous to the onset of fecal tenesmus. On physical examination, fecal tenesmus was observed and restriction of the movement of the right coxofemoral joint was evident. Rectal palpation revealed narrowing of the pelvic canal with a hard bony protuberance at the bilateral acetabulum and pubic bones. Radiographs revealed a distended colon with feces and narrowing of the pelvic canal with abnormal structure of the pelvic bone. Conservative management consisting of stool softeners and a warm water enema was instituted; however, there was no improvement in obstipation. Partial iliac, ischial, pubic, and acetabular ostectomies were performed. Postoperative radiographs and rectal palpation revealed the enlarged pelvic canal. Stool softeners (5 ml orally twice daily) was administered following surgery for 14 days and then tapered down to 2.5 ml for 14 days. A warm water enema was performed twice postoperatively. At examination 14 days postoperatively, no problems with defecation and gait were reported. There was no evidence of obstipation and lameness of the left pelvic limb 5 months postoperatively.
The bodyguard is continuously training basic physical training and security art martial to protect the privacy of security target, prepare and deal with external contingencies and threats. Currently, university students majoring in security are required to take a judo class, one of their security art martial, which can use a technology to catch, crush and repress opponent. Therefore, this study identified the effects of systematic training on body composition, Performance fitness, growth hormones, and IGF-1 among male university students through a 10-week judo training program so that it was committed to providing objective data to enhance the value of judo as a security art martial and as a result, we have a conclusion as follows: After 10 weeks of judo training, muscle mass increased significantly, and body fat rate and BMI decreased significantly. The muscular strength and power of Performance fitness were shown to increase significantly, and growth hormones were shown to increase significantly. In total, the above results showed that for judo training university students, overall body composition improved positively, the muscular strength and power of active physical fitness improved, and growth hormones increased. Thus, the increase in muscle strength and growth hormones through judo training will encourage fat breakdown due to the development of the body's muscles and increase bone density in the spine, thereby reducing the risk of fractures and preventing injury to the trainees who are performing a security art martial. It will also greatly help your health by preventing obesity, cardiovascular and metabolic diseases, which eventually will enhance your bodyguard function and prolong your life as a bodyguard.
Osteoporosis is a disease that increases the risk of fractures by inducing a decrease in bone strength by the changes in hormones and a decrease in minerals. Recent reports have indicated that the long-term administration of Adefovir dipivoxil (ADV), which is used as a treatment for the hepatitis virus and AIDS, may have osteoporotic side effects. On the other hand, there are few studies on the cytopathic correlation of these causes. In this study, the biological relevance of ADV was evaluated using osteoblast hFOB1.19 and vascular endothelial cell HUVEC. First, the cells were treated with ADV at different concentrations, and DAPI and crystal violet staining were performed for morphological analysis of each cell and nucleus. A CCK-8 assay, real-time PCR, alkaline phosphatase (ALP) staining, and activity was performed to evaluate the drug effects on cell proliferation, gene expression, and osteoblast differentiation. As a result, ADV induced cell hypertrophy in hFOB1.19 cells and HUVEC cells. Furthermore, ADV not only inhibited cell proliferation and TGF-${\beta}$ expression but was also involved in osteoblast differentiation. Overall, these results provide basic data to help better understand the mechanism of ADV-induced osteoporosis and its clinical implications.
Objectives : A root of Dipsacus asperoides C. Y. Cheng et T. M. Ai (D. asperoides) has been traditionally used as a medicinal resource in several Asian countries, including Korean and traditional Chinese medicine that has been traditionally used for treating several medical conditions including pain, arthritis, and bone fractures in Korea. In the present study, we investigated potential subacute toxicities of D. asperoides extract. Methods : C57BL/6 mice (male, 7weeks) were randomly divided into 4 groups of 5 mice. Except for the control group, the mice were orally administrated D. asperoides extract at doses of 50, 150, or 450 mg/kg/day for 2 weeks. At the end of the treatment period, all mice were euthanized, and the following parameters were examined: mortality, body weight, clinical signs, gross findings, hematology, serum biochemistry, organ weight, and histopathology. Results : There were no abnormalities in mortality, clinical signs, body weight, gross findings, or organ weight after repeated administration of D. asperoides extract for 2 weeks, compared with the control group. In addition, there were no significant changes in hematological, serum biochemical, and histopathological parameters between the control group and D. asperoides extract administrated groups with doses of up to 450 mg/kg/day. Conclusion : In this study, D. asperoides extract showed no significant toxicities at a dose of up to 450 mg/kg/day in mice. Although we could not confirm the toxic dose of D. asperoides extract, it can be considered safe for further pharmacological use.
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