• Title/Summary/Keyword: Lateral-superior

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Correction of Malunited Fracture of Zygoma Through Limited Incisions (제한적 접근을 통한 부정유합된 관골골절의 교정)

  • Kim, Yong-Ha;Kim, Sung-Ho;Seul, Jeung-Hyun;Lee, Kyung-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.1
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    • pp.22-31
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    • 1996
  • It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.

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Mini-open Rotator Cuff Repair Using Anterolateral Approach - Technical Note - (전외측 도달법을 이용한 소절개 회전근 개 봉합술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Lee, Kyung-Jae;Seo, Hyuk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.49-52
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    • 2010
  • Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

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LONGITUDINAL STUDY OF CRANIOFACIAL GROWTH BY LATERAL CEPHALOMETRIC ANALYSIS (정상교합 아동의 두개안면부 성장에 관한 종적 연구)

  • Yang, Kyu-Ho;Park, Chang-Hun;Son, Jung-Soo;Kim, Nak-Hyun;Choi, Nam-Ki;Kim, Seon-Mi;Kim, Ki-Baek;Shin, Hye-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.412-419
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    • 2009
  • The purpose of this study was to provide the reference data evaluating the treatment effect of orthopedic appliances. The skeletal and dental growth increments were measured in 24 normal mixed dentition children (boys: 14, girls: 10) by three serial lateral cephalograms: initial mean age: 9${\pm}$1.3 years, mean observation period: 13${\pm}$1.3 months. Cephalometric changes were analysed. The results were as follows: 1. In boys, the maxilla showed forward and downward growth pattern and the mandible showed forward growth pattern (p<0.05). In girls, the maxilla and mandible showed forward and downward growth pattern(p<0.05). 2. Horizontal growth of both maxilla and mandible in girls was superior to those in boys (A point; girls: 2.39mm, boys: 1.26mm, with p<0.05), whereas vertical growth of both maxilla and mandible in boys was similar to those in girls. 3. The change in tooth axis showed labioversion of upper incisor (p<0.01) and comparatively stable lower incisor position.

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Micro/Nanotribology and Its Applications

  • Bhushan, Bharat
    • Tribology and Lubricants
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    • v.11 no.5
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    • pp.128-135
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    • 1995
  • Atomic force microscopy/friction force microscopy (AFM/FFM) techniques are increasingly used for tribological studies of engineering surfaces at scales, ranging from atomic and molecular to microscales. These techniques have been used to study surface roughness, adhesion, friction, scratching/wear, indentation, detection of material transfer, and boundary lubrication and for nanofabrication/nanomachining purposes. Micro/nanotribological studies of single-crystal silicon, natural diamond, magnetic media (magnetic tapes and disks) and magnetic heads have been conducted. Commonly measured roughness parameters are found to be scale dependent, requiring the need of scale-independent fractal parameters to characterize surface roughness. Measurements of atomic-scale friction of a freshly-cleaved highly-oriented pyrolytic graphite exhibited the same periodicity as that of corresponding topography. However, the peaks in friction and those in corresponding topography were displaced relative to each other. Variations in atomic-scale friction and the observed displacement has been explained by the variations in interatomic forces in the normal and lateral directions. Local variation in microscale friction is found to correspond to the local slope suggesting that a ratchet mechanism is responsible for this variation. Directionality in the friction is observed on both micro- and macro scales which results from the surface preparation and anisotropy in surface roughness. Microscale friction is generally found to be smaller than the macrofriction as there is less ploughing contribution in microscale measurements. Microscale friction is load dependent and friction values increase with an increase in the normal load approaching to the macrofriction at contact stresses higher than the hardness of the softer material. Wear rate for single-crystal silicon is approximately constant for various loads and test durations. However, for magnetic disks with a multilayered thin-film structure, the wear of the diamond like carbon overcoat is catastrophic. Breakdown of thin films can be detected with AFM. Evolution of the wear has also been studied using AFM. Wear is found to be initiated at nono scratches. AFM has been modified to obtain load-displacement curves and for nanoindentation hardness measurements with depth of indentation as low as 1 mm. Scratching and indentation on nanoscales are the powerful ways to screen for adhesion and resistance to deformation of ultrathin fdms. Detection of material transfer on a nanoscale is possible with AFM. Boundary lubrication studies and measurement of lubricant-film thichness with a lateral resolution on a nanoscale have been conducted using AFM. Self-assembled monolyers and chemically-bonded lubricant films with a mobile fraction are superior in wear resistance. Finally, AFM has also shown to be useful for nanofabrication/nanomachining. Friction and wear on micro-and nanoscales have been found to be generally smaller compared to that at macroscales. Therefore, micro/nanotribological studies may help def'me the regimes for ultra-low friction and near zero wear.

Development of Tomographic SASW Method to Evaluate Two-Dimensional Variability of Shear Stiffness (지반 및 구조물의 이차원적 전단강성 평가를 위한 토모그래픽 SASW 기법의 개발)

  • 조성호
    • Journal of the Korean Geotechnical Society
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    • v.15 no.2
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    • pp.29-42
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    • 1999
  • The SASW (Spectral-Analysis-of-Surface-Waves) method, which evaluates the stiffness structure of the subsurface and structures nonintrusively and nondestructively, has been successfully used in the civil engineering applications. However, the SASW method assumes that the subsurface or structures consist of horizontal multi-layers, so that the method has some difficulty in continuously evaluating the integrity of a tunnel lining and a pavement system. This difficulty prevents the SASW method from being used to generate a tomographic image of stiffness for the subsurface or structures. Recently, the GPR technique which has the advantage of continuously evaluating integrity of the subsurface and structures has been popular. This advantage of GPR technique initiated the efforts to make the SASW method, which is superior to GPR and other nondestructive testing methods due to its capability of evaluating stiffness and modulus, be able to do continuous evaluation of stiffness structure, and the efforts finally lead to the development of \ulcornerTomographic SASW Technique.\ulcorner Tomographic SASW technique is a variation of the SASW method, and can generate a tomographic image of stiffness structure along the measurement line. The tomographic SASW technique was applied to the investigation of lateral variability of a sand box placed by the raining method for the purpose of verifying its effectiveness. Tomographic SASW measurements on the sand box revealed that the investigated sand box has different shear stiffness along the measurement line, which gave a clue of how to make a better raining device.

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Volumetric modulated arc therapy for carotid sparing in the management of early glottic cancer

  • Kim, Young Suk;Lee, Jaegi;Park, Jong In;Sung, Wonmo;Lee, Sol Min;Kim, Gwi Eon
    • Radiation Oncology Journal
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    • v.34 no.1
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    • pp.18-25
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    • 2016
  • Purpose: Radiotherapy of the neck is known to cause carotid artery stenosis. We compared the carotid artery dose received between volumetric modulated arc therapy (VMAT) and conventional fixed-field intensity-modulated radiotherapy (IMRT) plans in patients with early glottic cancer. Materials and Methods: Twenty-one early glottic cancer patients who previously underwent definitive radiotherapy were selected for this study. For each patient, double arc VMAT, 8-field IMRT, 3-dimensional conformal radiotherapy (3DCRT), and lateral parallel-opposed photon field radiotherapy (LPRT) plans were created. The 3DCRT plan was generated using lateral parallel-opposed photon fields plus an anterior photon field. VMAT and IMRT treatment plan optimization was performed under standardized conditions to obtain adequate target volume coverage and spare the carotid artery. Dose-volume specifications for the VMAT, IMRT, 3DCRT, and LPRT plans were calculated with radiotherapy planning system. Monitor units (MUs) and delivery time were measured to evaluate treatment efficiency. Results: Target volume coverage and homogeneity results were comparable between VMAT and IMRT; however, VMAT was superior to IMRT for carotid artery dose sparing. The mean dose to the carotid arteries in double arc VMAT was reduced by 6.8% compared to fixed-field IMRT (p < 0.001). The MUs for VMAT and IMRT were not significantly different (p = 0.089). VMAT allowed an approximately two-fold reduction in treatment delivery time in comparison to IMRT (3 to 5 minutes vs. 5 to 10 minutes). Conclusion: VMAT resulted in a lower carotid artery dose compared to conventional fixed-field IMRT, and maintained good target coverage in patients with early glottic cancer.

Correction of Spondylolisthesis by Lateral Lumbar Interbody Fusion Compared with Transforaminal Lumbar Interbody Fusion at L4-5

  • Ko, Myeong Jin;Park, Seung Won;Kim, Young Baeg
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.422-431
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    • 2019
  • Objective : In an aging society, the number of patients with symptomatic degenerative spondylolisthesis (DS) is increasing and there is an emerging need for fusion surgery. However, few studies have compared transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) for the treatment of patients with DS. The purpose of this study was to investigate the clinical and radiological outcomes between TLIF and LLIF in DS. Methods : We enrolled patients with symptomatic DS at L4-5 who underwent TLIF with open pedicle screw fixation (TLIF group, n=41) or minimally invasive LLIF with percutaneous pedicle screw fixation (LLIF group, n=39) and were followed-up for more than one year. Clinical (visual analog scale and Oswestry disability index) and radiological outcomes (spondylolisthesis rate, segmental sagittal angle [SSA], mean disc height [MDH], intervertebral foramen height [FH], cage subsidence, and fusion rate) were assessed. And we assessed the changes in radiological parameters between the postoperative and the last follow-up periods. Results : Preoperative radiological parameters were not significantly different between the two groups. LLIF was significantly superior to TLIF in immediate postoperative radiological results, including reduction of spondylolisthesis rate (3.8% and 7.2%), increase in MDH (13.9 mm and 10.3 mm) and FH (21.9 mm and 19.4 mm), and correction of SSA ($18.9^{\circ}$ and $15.6^{\circ}$) (p<0.01), and the changes were more stable from the postoperative period to the last follow-up (p<0.01). Cage subsidence was observed significantly less in LLIF (n=6) than TLIF (n=21). Fusion rate was not different between the two groups. The clinical outcomes did not differ significantly at any time point between the two groups. Complications were not statistically significant. However, TLIF showed chronic mechanical problems with screw loosening in four patients and LLIF showed temporary symptoms associated with the surgical approach, such as psoas and ileus muscle symptoms in three and two cases, respectively. Conclusion : LLIF was more effective than TLIF for spondylolisthesis reduction, likely due to the higher profile cage and ligamentotactic effect. In addition, LLIF showed mechanical stability of the reduction level by using a cage with a larger footprint. Therefore, LLIF should be considered a surgical option before TLIF for patients with unstable DS.

The Comparative Analysis Study and Usability Assessment of Fat Suppressed 3D T2* weighted Technique and Fat Suppressed 3D SPGR Technique when Examining MRI for Knee Joint Cartilage Assesment (슬관절 연골 평가를 위한 자기공명영상 검사 시 지방 신호 억제 3D T2* Weighted 기법과 지방 신호 억제 3D SPGR 기법의 비교 및 유용성 평가)

  • Kang, Sung-Jin
    • Journal of the Korean Magnetics Society
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    • v.26 no.6
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    • pp.219-225
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    • 2016
  • In this study, for assessment of degenerative knee joint cartilage disease we acquired images by fat suppressed 3D spoiled gradient recalled (SPGR) and fat suppressed 3D $T2^*$ weighted imaging techniques. To do a quantitative evaluation, the knee joint cartilage was divided into medial femoral cartilage (MFC), medial tibial cartilage (MTC), lateral femoral cartilage (LFC), lateral femoral cartilage (LFC) and patella cartilage (Pat) to measure their respective signal intensity values, signal-to-noise ratio, and contrast-to-noise ratio. As for the measured values, statistical significance between two techniques was verified by using Mann-Whitney U-Test. To do a qualitative evaluation, two radiologists have examined images by techniques after which image artifact, cartilage surface, tissue contrast, and depiction of lesion distinguishing were evaluated based on 4-point scaling (1: bad, 2: appropriate, 3: good, 4: excellent), and based on the result, statistical significance was verified by using Kappa-value Test. 3.0T MR system and HD T/R 8ch knee array coil were used to acquire images. As a result of a quantitative analysis, based on SNR values measured by using two imaging techniques, MFC, LFC, LTC, and Pat showed statistical significance (p < 0.05), but MTC did not (p > 0.05). As a result of verifying statistical significance for measured CNR value, MFC, LFC, and Pat showed statistical significance (p < 0.05), while MTC and LTC did not show statistical significance (p > 0.05). As a result of a qualitative analysis, by comparing mean values for evaluated image items, 3D $T2^*$ weighted Image has indicated a slightly higher value. As for conformance verification between the two observers by using Kappa-value test, all evaluated items have indicated statistically significant results (p < 0.05). 3D $T2^*$ weighted technique holds a clinical value equal to or superior to 3D SPGR technique with respect to evaluating images, such as distinguishing knee joint cartilages, comparing nearby tissues contrast, and distinguishing lesions.

Analysis of the Movement of Surgical Clips Implanted in Tumor Bed during Normal Breathing for Breast Cancer Patients (유방암 환자의 정상 호흡에서 종양에 삽입된 외과적 클립의 움직임 분석)

  • Lee, Re-Na;Chung, Eun-Ah;Suh, Hyun-Suk;Lee, Kyung-Ja;Lee, Ji-Hye
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.192-200
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    • 2006
  • [ $\underline{Purpose}$ ]: To evaluate the movement of surgical clips implanted in breast tumor bed during normal breathing. $\underline{Materials\;and\;Methods}$: Seven patients receiving breast post-operative radiotherapy were selected for this study. Each patient was simulated in a common treatment position. Fluoroscopic images were recorded every 0.033 s, 30 frames per 1 second, for 10 seconds in anterior to posterior (AP), lateral, and tangential direction except one patient's images which were recorded as a rate of 15 frames per second. The movement of surgical clips was recorded and measured, thereby calculated maximal displacement of each clip in AP, lateral, tangential, and superior to inferior (SI) direction. For the comparison, we also measured the movement of diaphragm in SI direction. $\underline{Results}$: From AP direction's images, average movement of surgical clips in lateral and SI direction was $0.8{\pm}0.5\;mm$ and $0.9{\pm}0.2\;mm$ and maximal movement was 1.9 mm and 1.2 mm. Surgical clips in lateral direction's images were averagely moved $1.3{\pm}0.7\;mm$ and $1.3{\pm}0.5\;mm$ in AP and SI direction with 2.6 mm and 2.6 mm maximal movement in each direction. In tangential direction's images, average movement of surgical clips and maximal movement was $1.2{\pm}0.5\;mm$ and 2.4 mm in tangential direction and $0.9{\pm}0.4\;mm$ and 1.7 mm in SI direction. Diaphragm was averagely moved $14.0{\pm}2.4\;mm$ and 18.8 mm maximally in SI direction. $\underline{Conclusion}$: The movement of clips caused by breathing was not as significant as the movement of diaphragm. And all surgical clip movements were within 3 mm in all directions. These results suggest that for breast radiotherapy, it may not necessary to use breath-holding technique or devices to control breath.

Is Male Professional Golfers' 10.94 m Putting Motion a Pendulum Motion? From a Point of View of the Location of the Center of Putter Head Rotation (퍼터헤드 회전중심점 위치 관점에서 본 남자프로골퍼의 10.94 m 퍼팅동작의 진자운동 여부)

  • Park, Young-Hoon;Youm, Chang-Hong;Seo, Kuk-Woong
    • Korean Journal of Applied Biomechanics
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    • v.17 no.2
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    • pp.217-226
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    • 2007
  • Putting score counts about 43 % of the golf score. The dominant idea of the putting motion to amateur golfers as well as to many professional golfers is a pendulum-like motion. If a golfer's putting stroke motion is a pendulum-like motion, the putting motion should be straight-back-and-through, the same backswing, downswing, and follow through length and period, and a swing with a fixed hinge joint. If the putting motions of the human are different from the pendulum motion, there could be confusion in understanding and teaching golf putting. The purpose of this study was to examine the center of rotation(COR) of the putter head to reveal whether professional golfers really putt like a pendulum. Thirteen male professional golfers were recruited for the study. Each golfers executed 10.94 m putts six times on an artificial grass mat. Putter head position data were collected through a 60 Hz three-dimensional motion analysis system and low pass filtered with cut-off frequency of 6 Hz. COR of the putter head was mathematically acquired. Each golfer's last five putting motions were considered. The results show that the COR of the putter head was neither fixed nor located inside of the golfer. The medio-lateral directional component of the COR of the putter head fluctuated in the range of 10 cm during downswing and follow through. The anterior-posterior directional component of the COR of the putter head was fixed from the beginning of the downswing through impact. Just after impact, however, it moved to the target up to 60 cm. The superior-inferior directional component of COR of the putter head moved in a superior direction with the beginning of the downswing and showed peak height just prior to impact. During the follow through, it moved back in an inferior direction. The height-normalized peak value of the COR of the putter head was $1.4{\pm}0.3$ height. Technically speaking, male professional golfers' 10.94 m putting motion is not a pendulum-like motion. The dominating idea of a pendulum-like motion in putting might come from the image of the flawless, smooth motion of a pendulum.