• Title/Summary/Keyword: Lateral-inferior

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CHARACTERISTICS OF CRANIOFACIAL STRUCTURES IN SEVERE ADULT CLASS III MALOCCLUSION (심한 골격성 III급 부정교합을 가진 성인 두개안면골격의 특성)

  • Park, Chang-Jin;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.219-229
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    • 1998
  • The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control sampler consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows : 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.

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Correlation between the Seoul Neuropsychological Screening Battery of the Parkinson's Disease Patient with Mild Cognitive Impairment and Change of the Cerebral Ventricle Volume in the Brain MRI (경도인지장애를 동반한 파킨슨병 환자의 서울신경심리검사와 뇌 자기공명영상에서 뇌실 체적 변화에 대한 상관관계)

  • Lee, Hyunyong;Kim, Hyeonjin;Im, Inchul;Lee, Jaeseung
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.231-240
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    • 2014
  • The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.

Evaluation of the Positional Uncertainty of a Liver Tumor using 4-Dimensional Computed Tomography and Gated Orthogonal Kilovolt Setup Images (사차원전산화단층촬영과 호흡연동 직각 Kilovolt 준비 영상을 이용한 간 종양의 움직임 분석)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Park, Hee-Chul;Ahn, Jong-Ho;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jin-Sung;Han, Young-Yih;Lim, Do-Hoon;Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.155-165
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    • 2010
  • Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

A study on the perimandibular tissues before and after orthodontic treatment with orthognathic surgery in mandandibular prognathic patients (하악골 전돌자의 악교정 수술을 동반한 교정치료 전후 하악골 주위조직의 변화에 관한 연구)

  • Yang, Byung-Ho;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.261-272
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    • 2000
  • Severe skeletal anteroposterior and vertical discrepancy is difficult to obtain satisfactory result by only orthodontic treatment, and much anteroposterior movement and treatment stability require orthodontic treatment with orthognathic surgery. The treatment goal of mandibular prognathic patients is to promote the function of stomatognathic system including mastication and phonetics, to improve the esthetics of facial profile and to maintain stability. Positional changes of hyoid bone, pharynx and tongue were seen with mandibular movement after orthognathic surgery. This study was performed to observe the changes of perimandibular tissues of orthodontic patients with skeletal mandibular prognathism who treated with orthodontic treatment, and the changes of hyoid bone, pharyx and tongue by relapse or recurrance after before and after orthognathic surgery and retention. The 22 patients who had mandibular prognathism were selected. They treated with orthodontic treatment with sagittal split ramus osteotomy as orthognathic surgery. And lateral cephalometric radiographs were taken 3 times : pre-surgery (T1), immediate post-surgery (T2) and 2 years alter retention (T3). The results were as follows : 1. The hyoid bone returned back after clockwise rotation to maxilla and occlusal plane during retention (P<0.01). 2. The hyoid bone moved posterior-inferiorly by mandibular surgery and returned back anterior-superior after retention. (P<0.01) 3. The changes of pharyngeal depth showed a little decrease at upper area in post- surgery, but it was not a significant difference generally through before, after and retention. 4. In relating to tongue base, the angle of tongue base was decreased and the dorsal area of tongue base moved to inferior-posterior direction and to superior direction again after retention (P<0.01). 5. Related to the thickness of upper and lower lip, the thickness of upper lip decreased after surgery, and the soft tissues below lower lip increased after surgery and decreased after retention.

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Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer (조기유방암환자의 이차원치료계획과 삼차원치료계획의 방사선조사범위의 차이)

  • Jo, Sun-Mi;Chun, Mi-Son;Kim, Mi-Hwa;Oh, Young-Taek;Kang, Seung-Hee;Noh, O-Kyu
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.177-183
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    • 2010
  • Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

The effect of CR-CO discrepancy on cephalometric measurements in Class III malocclusion patients (골격성 III급 부정교합자에서 중심위 변위가 두부 방사선 계측치에 미치는 영향)

  • Park, Yang-Soo;Kim, Jong-Chul;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.26 no.3
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    • pp.255-265
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    • 1996
  • The purpose of this study was to investigate if there were a significant difference between cephalometric measurements of mandibular position derived from a centric occlusion tracing compared to those of a converted centric relation tracing in the Class III malocclusion. The sample consisted of 25 Class III malocclusion and 25 normal occlusion persons who had no orthodontic treatment. The records included an lateral cephalometrics in centric occlusion, centric relation and centric occlusion bite registration and diagnostic casts mounted on the SAM II articulator in CR. The amount of CR-CO discrepancy of condyle was recorded using a MPI(Mandibular Position Indicator, MPI $200^{(R)}$, Great Lakes Orthodontics, USA). The conversion of the CO cephalogram to CR using the MPI readings was performed on the Conversion work sheet. Measures of mandibular position were chosen for the purpose of this study. The comparison of the difference between CO and CR cephalometric measurements in the normal occlusion and Class III malocclusion group were studied. The results were as follows: 1. In the features of CR-CO discrepancy of the condyle, the condyle was displaced posterior and inferior when the teeth were in centric occlusion. The horizontal component(${\Delta}X$) in Class HI malocclusion group was greater than the vertical component(${\Delta}Z$) and also greater than the horizontal component(${\Delta}X$) in normal occlusion group. There was no statistically significant correlation between MPI measurements and the groups of normal occlusion and Class III malocclusion group. 2. In the comparison of the cephalometric measurements in each group, Normal occlusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity and ODI. Class HI malocclusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity, ODI, SNB, APDI, L1-FP and it had more significance than the normal occlusion group. 3. The Value of cephalometric measurements was significantly different between CO and CR but there were no differences between the groups of normal occlusion and Class III malocclusion. The results of this study suggest that if the discrepancies are greater than the amount of normal displacement from clinically captured centric relation, centric relation should be considered as the starting point for proper diagnosis and treatment planning.

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Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery (골격성 III급 부정교합자에서 전진이부성헝술을 동반한 하악 후퇴술 후 연조직 외형의 변화)

  • Kim, Keun-Ryoung;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.38 no.2
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    • pp.104-120
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    • 2008
  • Purpose: The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty. Methods: This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery. Results: Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group. Conclusions: The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.

Functional Brain Mapping Using $H_2^{15}O$ Positron Emission Tomography ( II ): Mapping of Human Working Memory ($H_2^{15}O$ 양전자단층촬영술을 이용한 뇌기능 지도 작성(II): 작업 기억의 지도 작성)

  • Lee, Jae-Sung;Lee, Dong-Soo;Lee, Sang-Kun;Nam, Hyun-Woo;Kim, Seok-Ki;Park, Kwang-Suk;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.238-249
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    • 1998
  • Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.

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Flexural Test of H-Shape Members Fabricated of High-Strength Steel with Considering Local Buckling (국부좌굴을 고려한 고강도 조립 H형강 부재의 휨성능 실험)

  • Lee, Cheol-Ho;Han, Kyu-Hong;Park, Chang-Hee;Kim, Jin-Ho;Lee, Seung-Eun;Ha, Tae-Hyu
    • Journal of Korean Society of Steel Construction
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    • v.23 no.4
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    • pp.417-428
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    • 2011
  • Depending on the plastic deformation capacity required, structural steel design under the current codes can be classified into three categories: elastic, plastic, and seismic design. Most of the current steel codes explicitly forbid the use of a steel material with a yield strength higher than 450 MPa in the plastic design because of the concerns about its low plastic deformation capacity as well as the lack of test data on local and lateral torsional buckling behavior. In this study, flexural tests on full-scale H-shape members built with SM490A (ordinary steel or benchmark material) and HSB800 (high-strength steel) were carried out. The primary objective was to investigate the appropriateness of extrapolating the local buckling criterion of the current codes, which was originally developed for normal-strength steel, to the case of high-strength steel. All the SM490A specimens performed consistently with the current code criteria and exhibited sufficient strength and ductility. The performance of the HSB800 specimens was also very satisfactory from the strength perspective; even the specimens with a noncompact and slender flange developed the plastic moment capacity. The HSB800 specimens, however, showed an inferior plastic rotation capacity due to the premature tensile fracture of the beam bottom flange beneath the vertical stiffener at the loading point. The plastic rotation capacity that was achieved was less than 3 (or the minimum level required for a plastic design). Although the test results in this study indicate that the extrapolation of the current flange local-buckling criterion to the case of high-strength steel is conservative from the elastic design perspective, further testing together with an associated analytical study is required to identify the causes of the tensile fracture and to establish a flange slenderness criterion that is more appropriate for high-strength steel.

Evaluation of Myocardial Oxygen Consumption with $^{11}C$-Acetate and 3D PET/CT: By Applying Recirculation Correction Method and Modified One-Compartmental Tracer Kinetic Modeling ($^{11}C$-Acetate와 3차원 PET/CT를 이용한 심근의 산소 소모량 평가: 재순환 교정법 및 수정 단일구획 추적자 동적 모델 적용)

  • Chun, In-Kook;Hwang, Kyung-Hoon;Lee, Sang-Yoon;Kim, Jin-Su;Lee, Jae-Sung;Shin, Hee-Won;Lee, Min-Kyung;Yoon, Min-Ki;Choe, Won-Sick
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.275-284
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    • 2008
  • Purpose: We intended to evaluate myocardial oxygen consumption ($MVO_2)$ by applying recirculation correction and modified one-compartment model to have a reference range of $MVO_2$ in normal young population and to reveal the effect of recirculation on time-activity curve (TAC). Materials and Methods: In nine normal male volunteers with mean age of $26.3{\pm}4.0$, $MVO_2$ was estimated with 925 MBq (25mCi) of $^{11}C$-Acetate (Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Korea) and PET/CT (Biograph 6, Siemens Medical Solution, Germany). Analysis software such as $MATLAB^{(R)}$ v7.1 (Mathworks, Inc., United States), $Excel^{(R)}$ 2007 (Microsoft, United States), and $SPSS^{(R)}$ v12.0 (Apache Software Foundation, United States) were used. Twenty three frames were of $12{\times}10$, $5{\times}60$, $3{\times}120$, $2{\times}300's$ duration, respectively. The modified one-compartmental model and the recirculation correction method were applied. Statistical analysis was performed by using Test of Normality, ANOVA and Post-Hoc (Scheffe's) analysis, and p-value less than 0.05 was considered as significant. Results: The normal reference ranges of $MVO_2$ were presented as $3.18-4.64\;{\times}\;10^{-4}\;ml/g/sec$, $1.91-3.94\;{\times}\;10^{-4}\;ml/g/sec$, $4.31-6.40\;{\times}\;10^{-4}\;ml/g/sec$, $2.84-4.53\;{\times}\;10^{-4}\;ml/g/sec$ and $3.42-5.00\;{\times}\;10^{-4}\;ml/g/sec$ in the septum, the inferior wall, the lateral wall, the anterior wall and the entire wall, respectively. In addition, it was noted that the dual exponentiality of the clearance curve is due to the recirculation effect and that the characteristic of the curve is essentially mono-exponential. Conclusion: $^{11}C$-Acetate is a radiotracer worthwhile to assess $MVO_2$. Re-circulated $^{11}C$ can influence TAC of $^{11}C$ in myocadia and so the recirculation correction must be considered when measuring $MVO_2$.