• Title/Summary/Keyword: Lateral deviation

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Infrared Thermal Imaging in Patients with Medial Collateral Ligament Injury of the Knee - A Retrospective Study

  • Yang, HyunJung;Park, HaeIn;Lim, Chungsan;Park, SangKyun;Lee, KwangHo
    • Journal of Pharmacopuncture
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    • v.17 no.4
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    • pp.50-54
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    • 2014
  • Objectives: Digital infrared thermographic imaging (DITI) has been used widely for various inflammatory diseases, circulatory diseases, skin diseases, musculoskeletal diseases and cancers. In cases of ligament injury, obviously the temperature of the damaged area increases due to local inflammation; however, whether the temperature also increases due to DITI has not been determined. The purpose of the present study was to identify whether or not the changes of temperature in patient's with medial collateral ligament injury were really due to infrared thermography and to determine the applicability of DITI for assessing ligament injuries. Methods: Twenty patient's who underwent DITI for a medial collateral ligament injury from September 2012 to June 2014 were included in the current study. The thermographic images from the patient's knees were divided to cover seven sub-areas: the middle of the patella, and the inferomedial, the inferolateral, the superomedial, the superolateral, the medial, and the lateral regions of patella. The temperatures of the seven regions were measured, and the temperature differences between affected and unaffected regions were analyzed by using the Wilcoxon signed rank test. Results: The 20 patient's were composed of 14 women (70%) and 6 men (30%), with a mean age of $62.15{\pm}15.71$ (mean${\pm}$standard deviation (SD)) years. The temperature of the affected side, which included the middle of the patella, and the inferomedial, the superomedial, the superolateral, and the medial regions, showed a significant increase compared to that of the unaffected side (P < 0.05). The inferolateral and the lateral regions showed no significant changes. Conclusion: Our study results suggest that DITI can show temperature changes if a patient has a ligament injury and that it can be applied in the evaluation of a medial collateral ligament injury.

A Study on Clinical Crown Angulation and Inclination of Females in the Twenties with Normal Occlusion (20대 여성 정상교합자에서 임상치관의 순·설측 경사도와 근·원심 경사도에 관한 연구)

  • Cho, Hong-Kyu
    • Journal of Technologic Dentistry
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    • v.35 no.4
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    • pp.415-424
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    • 2013
  • Purpose: This study is to present a standard value for clinical crown angulation and inclination required in laboratory process and see if the value can be used for actual laboratory process. Methods: In order to find out a standard value for clinical crown angulation and inclination, this study made a study model of normal occlusion of 21 females in twenties. The clinical crown angulation and inclination of both six-maxillary and six-mandibular anterior teeth are measured by Set-up Model Checker. From the measured value above, the mean and standard deviation of the twelve teeth are obtained, and then the mean of the teeth between right and left side is calculated. Results: Each clinical crown angulation of maxillary central incisor, lateral incisor, and canine is like this; $1.0^{\circ}{\pm}1.3^{\circ}$, $3.0^{\circ}{\pm}1.3^{\circ}$, and $5.0^{\circ}{\pm}1.4^{\circ}$. In case of mandibular, each degree is like this; $0.6^{\circ}{\pm}1.1^{\circ}$, $1.5^{\circ}{\pm}1.1^{\circ}$, and $4.1^{\circ}{\pm}1.1^{\circ}$. Each clinical crown inclination of maxillary central incisor, lateral incisor, and canine is like this; $6.1^{\circ}{\pm}1.8^{\circ}$, $4.5^{\circ}{\pm}1.9^{\circ}$, and $-6.2^{\circ}{\pm}1.4^{\circ}$. In case of mandibular, each degree is like this; $0.3^{\circ}{\pm}1.5^{\circ}$, $0.3^{\circ}{\pm}1.8^{\circ}$, and $-7.5^{\circ}{\pm}1.8^{\circ}$. Conclusion: As the result, the mean value for clinical crown angulation and inclination can be referred to actual laboratory process. However, the mean value is different from those of the precedent study and an unsatisfied one for adopting the standard value.

Investigation of the efficacy and safety of ultrasound-standardized autologous blood injection as treatment for lateral epicondylitis

  • Braaksma, Christel;Otte, Jill;Wessel, Ronald N.;Wolterbeek, Nienke
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.57-64
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    • 2022
  • Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

Differential Subsampling with Cartesian Ordering Contrast-Enhanced Magnetic Resonance Angiography for the Preoperative Assessment of Anterolateral Thigh Flap

  • Yunfeng Shen;Xiucun Li;Chao Zhang;Hai Zhong;Weiqiang Dou
    • Korean Journal of Radiology
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    • v.23 no.8
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    • pp.803-810
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    • 2022
  • Objective: To investigate the clinical application of differential subsampling with Cartesian ordering (DISCO) contrast-enhanced (CE) magnetic resonance angiography for anterolateral thigh (ALT) flap transplantation, using operative findings as a reference. Materials and Methods: Thirty patients (21 males and nine females; mean age ± standard deviation, 45.5 ± 15.6 years) who were scheduled to undergo reconstruction with ALT flaps between June 2020 and June 2021 were included in the prospective study. Before ALT flap transplantation, patients were scanned using CE-DISCO imaging. All acquired DISCO images of the 60 lower limbs (both sides from each patient) were analyzed using maximum intensity projection and volume rendering methods. Two experienced radiologists were employed to examine the patterns of the lateral circumflex femoral artery (LCFA), its branches, and perforators and their skin termini, which were compared with the operative findings. Results: Using CE-DISCO, the patterns of the LCFA and its branches were clearly identified in all patients. Four different origins of the LCFA were found among the 60 blood vessels: type I (44/60, 73.3%), type II (6/60, 10.0%), type III (8/60, 13.3%), and type IV (2/60, 3.3%). Owing to a lack of perforators entering the skin, two patients did not undergo ALT flap transplantation. For the remaining 28 patients, the ALT flaps in 26 patients were successfully operated without flap reselection during the operation, while the remaining two patients underwent other surgical procedures due to the thin diameter of the perforator or injury of the perforator during the operation. The success rate of flap transplantation was 92.8% (26/28). All transplanted flaps exhibited good blood supply and achieved primary healing without infection or delayed healing. Conclusion: CE-DISCO imaging can be an effective method for preoperative perforator imaging before ALT flap transplantation.

Evaluation of Target Position's Accuracy in 2D-3D Matching using Rando Phantom (인체팬톰을 이용한 2D-3D 정합시 타켓위치의 정확성 평가)

  • Jang, Eun-Sung;Kang, Soo-Man;Lee, Chul-Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.33-39
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    • 2009
  • Purpose: The aim of this study is to compare patient's body posture and its position at the time of simulation with one at the treatment room using On-board Imaging (OBI) and CT (CBCT). The detected offsets are compared with position errors of Rando Phantom that are practically applied. After that, Rando Phantom's position is selected by moving couch based on detected deviations. In addition, the errors between real measured values of Rando Phantom position and theoretical ones is compared. And we will evaluate target position's accuracy of KV X-ray imaging's 2D and CBCT's 3D one. Materials and Methods: Using the Rando Phantom (Alderson Research Laboratories Inc. Stanford. CT, USA) which simulated human body's internal structure, we will set up Rando Phantom on the treatment couch after implementing simulation and RTP according to the same ways as the real radioactive treatment. We tested Rando Phantom that are assumed to have accurate position with different 3 methods. We measured setup errors on the axis of X, Y and Z, and got mean standard deviation errors by repeating tests 10 times on each tests. Results: The difference between mean detection error and standard deviation are as follows; lateral 0.4+/-0.3 mm, longitudinal 0.6+/-0.5 mm, vertical 0.4+/-0.2 mm which all within 0~10 mm. The couch shift variable after positioning that are comparable to residual errors are 0.3+/-0.1, 0.5+/-0.1, and 0.3+/-0.1 mm. The mean detection errors by longitudinal shift between 20~40 mm are 0.4+/-0.3 in lateral, 0.6+/-0.5 in longitudinal, 0.5+/-0.3 in vertical direction. The detection errors are all within range of 0.3~0.5 mm. Residual errors are within 0.2~0.5 mm. Each values are mean values based on 3 tests. Conclusion: Phantom is based on treatment couch shift and error within the average 5mm can be gained by the diminution detected by image registration based on OBI and CBCT. Therefore, the selection of target position which depends on OBI and CBCT could be considered as useful.

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Prosthetic rehabilitation of partially edentulous patient after hemimandiblectomy: Case report (하악골 부분절제술 시행한 부분 무치악 환자에서 보철 수복 증례)

  • Lee, Dong-Hun;Yoo, Dong-Soo;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.39-45
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    • 2015
  • Loss of continuity of the mandible destroys the balance and symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the resected side. Apart from deviation, other dysfunctions include difficulty in swallowing, speech, mandibular movements, mastication, and respiration are accompanied. In general, surgical reconstruction is considered first then proceeds to the prosthetic restorations. However, patients with systemic disease such as BRONJ (Bisphosphonate related osteonecrosis of the Jaw), surgical reconstruction may be limited. Thus, the prosthetic restoration remains as the only resort. Numerous prosthetic methods are employed to minimize deviation and to improve masticatory efficiency, function and esthetics. If a removable partial denture is the selected treatment modality, maximum stability of the partial denture base may be accomplished with a functional impression procedure by means of eliminating lateral and horizontal forces caused by the functional movements of the lips, cheeks and tongue. Also, Twin occlusion is used to obtain a favorable occlusal relationship and check support for esthetics. The purpose of this case report is to demonstrate how neutral zone impression technique and twin occlusion scheme were applied to restore a hemi-mandiblectomy patient with BRONJ syndrome to achieve satisfactory results in functional and esthetic aspects.

Adolescent Idiopathic Scoliosis Treated by Posterior Spinal Segmental Instrumented Fusion : When Is Fusion to L3 Stable?

  • Hyun, Seung-Jae;Lenke, Lawrence G.;Kim, Yongjung;Bridwell, Keith H.;Cerpa, Meghan;Blanke, Kathy M.
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.776-783
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    • 2021
  • Objective : The purpose of this study was to identify risk factors for distal adding on (AO) or distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) treated by posterior spinal fusion (PSF) to L3 with a minimum 2-year follow-up. Methods : AIS patients undergoing PSF to L3 by two senior surgeons from 2000-2010 were analyzed. Distal AO and DJK were deemed poor radiographic results and defined as >3 cm of deviation from L3 to the center sacral vertical line (CSVL), or >10° angle at L3-4 on the posterior anterior- or lateral X-ray at ultimate follow-up. New stable vertebra (SV) and neutral vertebra (NV) scores were defined for this study. The total stability (TS) score was the sum of the SV and NV scores. Results : Ten of 76 patients (13.1%) were included in the poor radiographic outcome group. The other 66 patients were included in the good radiographic outcome group. Lower Risser grade, more SV-3 (CSVL doesn't touch the lowest instrumented vertebra [LIV]) on standing and side bending films, lesser NV and TS score, rigid L3-4 disc, more rotation and deviation of L3 were identified risk factors for AO or DJK. Age, number of fused vertebrae, curve correction, preoperative coronal/sagittal L3-4 disc angle did not differ significantly between the two groups. Multiple logistic regression results indicated that preoperative Risser grade 0, 1 (odds ratio [OR], 1.8), SV-3 at L3 in standing and side benders (OR, 2.1 and 2.8, respectively), TS score -5, -6 at L3 (OR, 4.4), rigid disc at L3-4 (OR, 3.1), LIV rotation >15° (OR, 2.9), and LIV deviation >2 cm from CSVL (OR, 2.2) were independent predictive factors. Although there was significant improvement of the of Scoliosis Research Society-22 average scores only in the good radiographic outcome group, there was no significant difference in the scores between the groups. Conclusion : The prevalence of AO or DJK at ultimate follow-up for AIS with LIV at L3 was 13.1%. To prevent AO or DJK following fusion to L3, we recommend that the CSVL touch L3 in both standing and side bending, TS score is -4 or less, the L3/4 disc is flexible, L3 is neutral (<15°) and ≤2 cm from the midline and the patient is ≥ Risser 2.

Three-dimensional CT image study on the correction of gonial angle width enlarged on frontal cephalogram (정모두부방사선사진에서 하악골 우각부 영상확대 및 이의 보정에 관한 3차원 CT영상 연구)

  • Hwang, Hyeon-Shik;Eun, Chun-Sun;Hwang, Chung Hyon;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.35 no.4 s.111
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    • pp.251-261
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    • 2005
  • Enlargement is an inherent property of X-rays which occurs when straight hues diverse from small a focal spot. The purpose of the present study was to evaluate the validity of the correction of gonial angle width enlarged on frontal cephalogram, using frontal and lateral cephalograms taken orthogonally from each other. In 40 adult individuals, frontal and lateral cephalograms were taken at a $90^{\circ}$ angle using the Head Posture Aligner. The angle width was measured on the frontal cephalogram and subsequently. the corrected angle width was calculated using the magnification rate of two cephalograms. Measured and corrected angle widths were compared with the measurement from the 3D CT image. The measurement or the frontal cephalogram showed a 9.10mm of enlargement on average ranging from 7.92 to 11.31mm. Corrected angle width measurement showed a 0.14mm difference with the 3D CT image measurement, which was not statistically significant. The results of the study indicate that actual au91e width can be approached through calculation using frontal and lateral cephalograms taken orthogonally with the help of the Head Posture Aligner The study also showed that the magnitude of correction error did not show a significant correlation with the amount of menton deviation, and it suggests that the present correction method is valid even in individuals with severe facial asymmetry.

Comparison Study on CNR and SNR of Thoracic Spine Lateral Radiography (흉추 측면검사 영상의 CNR과 SNR 측정의 비교 연구)

  • Kim, Ki-Won;Min, Jung-Whan;Lyu, Kwang-Yeul;Kim, Jung-Min;Jeong, Hoi-Woun;Lee, Joo-Ah;Jung, Jae-Hong;Sung, Dong-Chan;Park, Soon-Cheol
    • Journal of radiological science and technology
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    • v.36 no.4
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    • pp.273-280
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    • 2013
  • This study was proven for the T-spine breathing technique in lateral projection, using computer radiography (CR), charge coupled device (CCD), indirect digital radiography (IDR) and direct digital radiography (DDR). All images were evaluated and compared with CNR and SNR measured with the mean pixels and the standard deviation as setting ROI of spinous process, pedicle, vertebral body, intervertebral foramen and intervertebral disk using Image J. In experiment results of 4 type detectors, T-spine breathing technique was indicated as excellent in ROI of spinous process, pedicle, vertebral body, intervertebral foramen and intervertebral disk. As T-spine breathing technique indicated excellent images compared to the existing T-spine lateral radiography, this method would be useful for elderly patients who have difficulty in deep exhalation. This study was indicated the application possibility of T-spine breathing technique by presenting contrast to noise ratio (CNR) and signal to noise ratio (SNR) with quantitative value in 4 type detectors.

Correction of mandibular ramus height with frontal and lateral ramal inclinations in cephalograms and its effects on diagnostic accuracy of asymmetry (2차원 방사선 규격사진에서 하악골 상행지 고경의 보정분석에 관한 3차원 CT 영상 연구)

  • Hwang, Hyeon-Shik;Kim, Hyung-Min;Lee, Ki-Heon;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.37 no.5
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    • pp.319-330
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    • 2007
  • Defining right and left side differences in mandibular ramus height is one of the key elements in the diagnosis of facial asymmetry. The purpose of the present study was to evaluate the effect of correction of ramus height with frontal and lateral ramal inclinations (FRI and LRI) in 2-dimensional cephalograms and observe how this affects the diagnostic accuracy of asymmetry. Methods: Frontal and lateral cephalograms were obtained in 40 individuals with chin deviation. FRI and LRI were measured on each side and ramus height measurement was corrected with these inclinations using Pythagorean's theorem. The results of diagnosis before and after correction on cephalograms were compared with the results in 3D CT images. Results: Both FRI and LRI showed greater values in the contralateral side than in the chin-deviated side and these contributed to an increase in the right and left side ramus height differences. After comparison of diagnostic results before and after correction on cephalograms with the results on 3D CT images, the sensitivity increased significantly (from 74 to 94 %) whereas the specificity decreased (from 44 to 22 %). Overall accuracy increased from 68 to 78 % with the correction using FRI and LRI. Conclusions: The results of the present study indicate that correction of ramus height with FRI and LRI is useful for an accurate diagnosis of facial asymmetry on frontal cephalograms.