• Title/Summary/Keyword: Insertion 4p

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Accurate Placement of Parieto-occipital Ventricular Catheter Using CT Parameters (CT 지표를 이용한 두정-후두부 뇌실 도관의 정확한 삽입)

  • Min, Hyung-Sik;Song, Jun-Hyeok
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.886-890
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    • 2000
  • Objective : placement of ventricular catheter is important to achieve long-term patency of the shunt system. We describe a method of calculating the insertion site, trajectory, and the length of the ventricular catheter using CT parameters in shunt surgery. Patients and Methods : These can be rapidly obtained using a caliper from a scout cut and two axial scans at lateral ventricular and upper 3rd ventricular level. To compare this technique with traditional one, we analyzed 40 consecutive patients who underwent shunt surgery. Results : Of 20 patients undergoing ventriculoperitoneal shunt insertion using this technique, none had poor location of the proximal catheter. In the counterpart, 9 patients had poor location(p=0.001). The number of patients who required revision surgery were also lower in the group using this technique, but it was not statistically significant (4 versus 2, p=0.422). Mean follow-up period was shorter in this technique group. Conclusion : This technique provides an accurate placement of the proximal catheter without special instrument or additional expenses.

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Risk factors for persistent otitis media with effusion in children: a case-control study

  • Lee, Ju Yeon;Kim, Se-Hyung;Song, Chan Il;Kim, Young Ree;Kim, Yoon-Joo;Choi, Jae Hong
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.70-75
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    • 2018
  • Background: Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion. Methods: Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group. Results: A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at <1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively. Conclusion: Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

Insertion/Deletion Polymorphism of the Angiotensin Converting Enzyme Gene in Coronary Artery Disease in Southern Turkey

  • Acarturk, Esmeray;Attila, Gulen;Bozkurt, Abdi;Akpinar, Onur;Matyar, Selcuk;Seydaoglu, Gulsah
    • BMB Reports
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    • v.38 no.4
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    • pp.486-490
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    • 2005
  • Genetic factors are important in the pathogenesis of coronary artery disease (CAD). Angiotensin converting enzyme (ACE) gene insertion(I)/deletion(D) polymorphism is one of the genetic factor found to be related with CAD. We investigated the association between I/D polymorphism of the ACE gene and the presence of CAD. Threehundred and seven patients (187 males and 120 females, aged between 35-80, mean $54.3{\pm}9.8$ years) who underwent diagnostic coronary angiography were included in the study. ACE I/D polymorphism was detected by polymerase chain reaction. Of the 307, 176 had CAD. The most frequently observed genotype in all subjects was ID (47.9 %). However, in patients with CAD the frequency of II genotype was lower whereas DD genotype was higher compared to the controls (p < 0.05). The number of D allele carrying subjects were also higher (p < 0.05) in CAD patients. The logistic regression analysis indicated that the ACE D allele is an independent risk factor (odds ratio = 1.48, 95% CI = 1.01-2.18, p < 0.05). In conclusion, the I/D polymorphism of ACE gene (carrying D allele) is an independent risk factor for CAD in the studied Turkish population.

BONE DENSITY AND HISTOMORPHOMETRY ASSESSMENT OF DENTAL IMPLANT USING COMPUTERIZED TOMOGRAPHY (컴퓨터 영상을 이용한 임플란트 식립부위의 골밀도와 조직학적 연구)

  • Son, Jang-Ho;Choi, Byung-Hwan;Park, Soo-Won;Cho, Yeong-Cheol;Sung, Iel-Yong;Lee, Ji-Ho;Byun, Ki-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.136-142
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    • 2009
  • Bone density in the recipient implant site seems to be an important factor for long term success of endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify suitable implant sites, thereby improving the success rate of the procedure. Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively with computerized tomography and histologically measured bone density by bone biopsy. Patients and methods; Twenty seven patients were selected. All the patients were in good health, with no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery 2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and insertion torque values were recorded. Results; The highest histomorphometric values was found in the posterior mandible $32.3{\pm}3.8$, followed by $29.9{\pm}2.6$ for the posterior maxilla, $29.4{\pm}2.6$ for the anterior maxilla, $28.6{\pm}2.3$ for the anterior mandible(p=0.214). The hounsfield unit was $989.2{\pm}258.1$ in the posterior mandible, $845.0{\pm}241.5$ in the anterior maxilla, $744.5{\pm}92.6$ in the anterior mandible, $697.3{\pm}136.9$ in the posterior maxilla(p=0.045). This results may suggest that there are strong correlation between the histomorphometric values and hounsfield unit(r=0.760, p<0.05). The RF measurements were $81.9{\pm}2.4$ ISQ in the posterior mandible, $79.0{\pm}1.4$ ISQ in the anterior mandible, $78.3{\pm}4.6$ ISQ in the posterior maxilla, $76.5{\pm}5.0$ ISQ in the anterior maxilla(p=0.048). The insertion torque values was $43.2{\pm}4.2\;Ncm$ in the posterior mandible, $42.0{\pm}0.0\;Ncm$ in the anterior mandible, $41.3{\pm}4.1\;Ncm$ in the posterior maxilla, $40.8{\pm}3.8\;Ncm$ in the anterior maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield unit and the insertion torque values(r=0.494, p<0.05), the histomorphometric values and the insertion torque values(r=0.689, p<0.05). But there was no correlation between histomorphometric values and ISQ. There was no statistical significance in age and gender effect on parameters. Conclusions; There was significant correlations between bone density and implant stability parameters. The bone density measurements using preoperative CT may help clinicians to predict primary stability before implant insertion, which is associated with implant survival rates.

Evaluation of pain experienced by orthodontic patients following elastomeric separator insertion: A cross-sectional study

  • Hareem Sultan;Hana Pervez;Sidra Maqsood;Wajeeh Syed Zeeshan
    • The korean journal of orthodontics
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    • v.53 no.5
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    • pp.298-306
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    • 2023
  • Objective: Pain following the insertion of separators and archwires varies with age, sex, race, ethnicity, threshold, and health status. This study aimed to evaluate the characteristics of pain in orthodontic patients after the insertion of elastomeric separators, its effects on daily life, and its association with age and sex in a population not previously studied in this regard. Methods: A cross-sectional study of 130 patients undergoing orthodontic treatment included collecting data on demographics, pain experienced following the placement of separators, time of onset, duration, characteristics, change in dietary pattern or chewing side, intake of analgesics, and severity of pain on the Wong Baker's scale. The results are reported as counts and percentages. Associations between sex and age were evaluated using Pearson's chi-square test. Results: Among the 130 patients, 56.2% were 9-20 years old, 63.8% experienced pain following the insertion of separators, 22.9% had their first episode of pain at 4 hours, 56.6% experienced intermittent pain, and 37.3% experienced discomfort; 18.1% males and 81.9% females experienced pain following the insertion of separators. Pearson's chi-square test showed a significant association between pain and sex (P = 0.04). Most patients (37.3%) reported "hurts little more" for pain intensity on Wong Baker's scale and 21.7% reported all four quadrants as sites of pain. Conclusions: The pain experienced after separator insertion was associated with sex and age. Females experienced more pain than males and patients between the age range of 21 and 36 years suffered more pain during mastication than between 9 and 20 years old.

The Effect of Repetitive Insertion and Pullout of Spinal Screws on Pullout Resistance : A Biomechanical Study (척추 수술에 사용되는 나사못의 반복 삽입과 인출이 인장항력에 미치는 영향 : 생체 역학적 연구)

  • Bak, Koang Hum;Ferrara, Lisa;Kim, Kwang Jin;Kim, Jae Min;Kim, Choong Hyun;Benzel, Edward C.
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.131-136
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    • 2001
  • Object : The clinical uses of screws are increasing with broader applications in spinal disorders. When screws are inserted repeatedly to achieve optimal position, tips of screw pitch may become damaged during insertion even though there are significant differences in the moduli of elasticity between bone and titanium. The effect of repeated screw insertion on pullout resistance was investigated. Methods : Three different titanium screws(cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw) were inserted into the synthetic cancellous material and then extracted axially at a rate of 2.4mm/min using Instron(Model TT-D, Canton, MA). Each set of screws was inserted and pulled out three times. There were six screws in each group. The insertional torque was measured with a torque wrench during insertion. Pullout strength was recorded with a digital oscilloscope. Results : The mean pullout force measurements for the cortical lateral mass screws($185.66N{\pm}42.60$, $167.10N{\pm}27.01$ and $162.52 N{\pm}23.83$ for first, second and third pullout respectively : p=0.03) and the cervical vertebral body screws($386.0N{\pm}24.1$, $360.2N{\pm}17.5$ and $330.9N{\pm}16.7$ : p=0.0024) showed consecutive decrease in pullout resistance after each pullout, whereas the cancellous lateral mass screws did not($194.00N{\pm}36.47$, $219.24N{\pm}26.58$ and 199.49N(36.63 : p=0.24). The SEM after insertion and pullout three times showed a blunting in the tip of the screw pitch and a smearing of the screw surface. Conclusions : Repetitive screw insertion and pullout resulted in the decrease of pullout resistance in certain screws possibly caused by blunting the screw tip. This means screw tips suffer deformations during either repeated insertion or pullout. Thus, the screws that have been inserted should not be used for the final construct.

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The Suggestion of MF BIA Analyzer Method to Reflect the Resistance in the Extracelluar and Intracelluar Fluid at Acupoint & the Evaluation of Reflection Rate on the Tissue under Skin (MF-BIA Analyzer를 이용한 경혈의 세포 내액과 외액에 의한 저항성분 추정 방법 제시 및 반영률 평가)

  • Kim, Soo-Byeong;Lee, Na-Ra;Kim, Won-Ky;Lee, Yong-Heum
    • Korean Journal of Acupuncture
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    • v.29 no.4
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    • pp.563-572
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    • 2012
  • Objectives : The aim of this study was to suggest a new method to estimate the resistance by acupoint compositions by using the multi-frequency bioelectrical impedance analysis(MF-BIA) of 5 kHz, 50 kHz and 200 kHz within 2 cm of acupoints as a local segment. Moreover, we try to confirm the relation to between measured resistance at skin surface and measured resistance by various manual acupuncture needle insertion depth. Methods : Ten male subjects participated in this study. We measured the resistance at left/right ST36 at skin surface and various manual acupuncture needle insertion depth(skin, 5 mm, 10 mm, 15 mm, 20 mm, 25 mm and 30 mm). Results : It was also observed that the all measured resistances were the highest at 5 kHz and the lowest at 200 kHz. There were significant differences at 5 kHz, 50 kHz and 200 kHz between measured resistance at skin surface and measured resistance by various manual acupuncture needle insertion depth(p<0.05). There was no significant difference in the left and right identical acupoints under the identical condition(p>0.05). Conclusions : We conclude that the measured resistance at skin surface has limitation as to reflect the information of tissue. However, the measured resistance at each frequency was changed as similar pattern by different insertion depth. Hence, we confirmed the possibility of assumption on information of tissue which was expected to locate an acupoint.

Hip Resurfacing Arthroplasty after Failure of Tantalum Rod Insertion in Patients with Osteonecrosis of the Femoral Head

  • Yoon Je Cho;Kee Hyung Rhyu;Young Soo Chun;Hyun Gon Gwak
    • Hip & pelvis
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    • v.34 no.4
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    • pp.219-226
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    • 2022
  • Purpose: The purpose of this study was to examine the clinical outcomes and efficacy of hip resurfacing arthroplasty (HRA) in patients with osteonecrosis of the femoral head after the failure of porous tantalum rod insertion without rod removal. Materials and Methods: Conversion to hip resurfacing arthroplasty was performed in 10 patients (11 hips) with a mean period of 14.9 months after the primary surgery. The mean follow-up period was 73.7 months. Analysis of pre and postoperative range of motion (ROM), University of California at Los Angeles (UCLA) activity score, modified Harris hip score, and visual analog scale (VAS) pain score was performed. Radiographic analysis of component loosening and osteolysis was performed. Results: The postoperative ROM showed significant improvement (P<0.05), excluding flexion contracture. The modified Harris hip score showed improvement from 65.82 to 96.18, the UCLA score showed improvement from 4.18 to 8.00, and the VAS pain score was reduced from 6.09 to 1.80. All scores showed statistically significant improvement (P<0.05). No component loosening or osteolysis was detected by radiographic analysis. Conclusion: Satisfactory results were obtained from conversion hip resurfacing arthroplasty after failure of porous tantalum rod insertion without rod removal. The findings of this study demonstrate the advantages of HRA, including no risk of trochanteric fracture and no bone loss around the tantalum rod. In addition, the remaining porous tantalum rod provided mechanical support, which reduced the potential risk of femoral neck fracture or loosening. This technique can be regarded as a favorable treatment option.

REMOVAL TORQUE AND BONE FORMATION OF ORTHODONTIC MINISCREW IMPLANT (교정용 미니스크류 임플랜트의 제거회전력 및 골형성에 관한 연굴)

  • Yun, Young-Kuk;Ryu, Jae-Jun;Suh, Kyu-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.4
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    • pp.492-505
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    • 2007
  • Statement of problem: An orthodontic miniscrew implant has been used as a skeletal anchorage for orthodontic treatment. However, any relation among the influence of the cortical bone, morphologic differences of orthodontic miniscrew implants and new bone formation hasn't been made clear yet. Purpose: The purpose of this study was to evaluate whether the orthodontic miniscrew implant could work as an intraoral skeletal anchorage immediately and stably for orthodontic treatment after insertion of it. Material and methods: Two types of orthodontic miniscrew implants were used in this experiment; tapered type and straight type. One hundred and sixty eight orthodontic miniscrew implants were inserted into the tibiae of 21 rabbits and sacrificed on 3, 7, 11, 14, 21 and 28days later after insertion of them to study removal torque values and histologic and histomorphometric analyses. Results: The results were as follows. 1. The removal torque values of the tapered type were higher than those of the straight type in all groups(p<0.05). 2. There wasn't any distinguishing differences between the tapered type and the straight type about the new bone formation percentage. 3. The removal torque values for both the tapered type and the straight type were gradually decreased at early stages of the test but started to increase at the 7 days group of the straight type and the 11 days group of the tapered type. 4. New bone formation percentage was increased gradually for both the tapered and the straight types as time passed(p<0.05). 5. It was found that the tapered type showed lower values in the cortical bone about both the maximum equilibratory stress distribution and the maximum principal stress distribution than the straight type in linear finite elements analysis. Conclusion: According to the research, the removal torque values were decreased at 7 days group of the tapered type and 11 days group of the straight type after the insertion of the orthodontic miniscrew implants in tibiae of rabbits. Considering the human bone activity, it is better to apply the orthodontic force $3{\sim}4$ weeks later than to apply it immediately after the insertion of orthodontic miniscrew implants. Considering that general orthodontic force is about $250{\sim}500$ grams, the tapered type can be worked as a stable skeletal anchor age in an orthodontic treatment even if the orthodontic force is applied on it immediately after the insertion of it.

The validation of Periotest values for the evaluation of orthodontic mini-implants' stability (즉시 부하 교정용 미니임플랜트의 안정성 평가를 위한 Periotest$^{(R)}$의 유효성)

  • Cha, Jung-Yul;Yu, Hyung-Seog;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.40 no.3
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    • pp.167-175
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    • 2010
  • Objective: The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants' stability. Methods: Sixty orthodontic mini-implants (7.0 mm $\times$ $\emptyset1.45$ mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning. Results: The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p < 0.05). The PTV values ranged from -3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (-0.51), bone density (-0.48), cortical bone thickness (-0.42) (p < 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (-0.66) (p < 0.01) in the mandible. Conclusions: These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible.