• Title/Summary/Keyword: Lateral-superior

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Activation of Vestibular Neurons Projecting to Autonomic Brain Stem Nuclei Following Acute Hypotension in Rats

  • Choi, Myoung-Ae;Wang, Won-Ki;Choi, Dong-Ok;Kim, Min-Sun;Park, Byung-Rim
    • The Korean Journal of Physiology and Pharmacology
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    • v.8 no.3
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    • pp.133-140
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    • 2004
  • The purpose of the present study was to elucidate the possible involvement of the medial vestibular nucleus (MVN) and inferior vestibular nucleus (IVN) following acute hypotension in the vestibuloautonomic reflex through vestibulosolitary or vestibuloventrolateral projections. Acute hypotension-induced cFos expression was assessed in combination with retrograde cholera toxin B subunit (CTb) tract tracing. After injection of CTb into the solitary region, CTb-labeled neurons were located prominently around the lateral borders of the caudal MVN and medial border of the IVN. The superior vestibular nucleus also had a scattered distribution of CTb-labeled neurons. After injection of CTb toxin into the unilateral VLM, the distributions of CTb-labeled neurons in the MVN and IVN were similar to that observed after injection into the solitary region, although there were fewer CTb-labeled neurons. In the caudal MVN, about 38% and 13% of CTb-labeled neurons were double-labeled for cFos after injection of CTb into the solitary region and the VLM, respectively. In the IVN, 14% and 7% of CTb-labeled neurons were double-labeled for cFos after injection of CTb into the solitary region and the VLM, respectively. Therefore, the present study suggests that acute arterial hypotension may result in activation of vestibulosolitary pathways that mediate behavioral and visceral reflexes, and vestibuloventrolateral medullary pathways that indirectly mediate vestibulosympathetic responses.

3-D Finite Element Analysis of Acetabular Reconstruction of THR (인공고관절 전치환술에 있어서 비구 재건 술에 관한 3차원 유한요소해석)

  • Ryu, J.C.;Mun, M.S.;Kim, G.S.;Yoo, M.C.
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.11
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    • pp.34-38
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    • 1995
  • Using a 3-D finite element method (FEM), the biomechanical characteristics of a threaded truncated acetabular component and a porous coated hemispherical acetabular component were studied. The Von-Mises stress/strain patterns in the acetabulum reconstructed with these two different types of cementless acetabular cups were investigated. The geometry and dimensions of human hemi-pelvis used in the present shape modeling for finite element analysis were scanned with a 3-D laser scanner(TDS-9000, Cyberware, USA). The scanned data was numerically handled with a shape modelling software 'Pro-Engineer'. Using 19836, 16853 tetrahedral elements, respectively, the stress and displacement field of the acetabulum reconstructed with the two different types of the acetabular components were computed. While the hemi-sphere component was found to show a relatively similar stress/strain patterns to those in the normal hip, the results with the threaded cup showed a considerably different patterns from those in the normal condition. Several regions in cancellous bone near the threads and the edge of the truncated cup was found to be overstressed, especially in the superior-lateral part of the acetabulum. It was postulated that the excessive reaming-out of subchondral bone layer when the truncated cup was used can cause the presence of these overstressed regions of cancellous bone. This theoretical prediction for the implanted acetabulum appeared to consistent with the pathological observation of proximal/medial migration of the threaded truncated acetabular prostheses in the previous publications.

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Free Hand Insertion Technique of S2 Sacral Alar-Iliac Screws for Spino-Pelvic Fixation : Technical Note, Acadaveric Study

  • Park, Jong-Hwa;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.578-581
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    • 2015
  • A rigid spino-pelvic fixation to anchor long constructs is crucial to maintain the stability of long fusion in spinal deformity surgery. Besides obtaining immediate stability and proper biomechanical strength of constructs, the S2 alar-iliac (S2AI) screws have some more advantages. Four Korean fresh-frozen human cadavers were procured. Free hand S2AI screw placement is performed using anatomic landmarks. The starting point of the S2AI screw is located at the midpoint between the S1 and S2 foramen and 2 mm medial to the lateral sacral crest. Gearshift was advanced from the desired starting point toward the sacro-iliac joint directing approximately $20^{\circ}$ angulation caudally in sagittal plane and $30^{\circ}$ angulation horizontally in the coronal plane connecting the posterior superior iliac spine (PSIS). We made a S2AI screw trajectory through the cancellous channel using the gearshift. We measured caudal angle in the sagittal plane and horizontal angle in the coronal plane. A total of eight S2AI screws were inserted in four cadavers. All screws inserted into the iliac crest were evaluated by C-arm and naked eye examination by two spine surgeons. Among 8 S2AI screws, all screws were accurately placed (100%). The average caudal angle in the sagittal plane was $17.3{\pm}5.4^{\circ}$. The average horizontal angle in the coronal plane connecting the PSIS was $32.0{\pm}1.8^{\circ}$. The placement of S2AI screws using the free hand technique without any radiographic guidance appears to an acceptable method of insertion without more radiation or time consuming.

A study on the Cochlear View in Multichannel Cochlear Implantees (인공와우 이식술 환자의 Cochlear View 촬영에 관한 연구)

  • Kweon, Dae-Cheol;Kim, Jeong-Hee;Kim, Seong-Lyong;Kim, Hae-Seong;Lee, Yong-Woo
    • Journal of radiological science and technology
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    • v.22 no.2
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    • pp.27-32
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    • 1999
  • Cochlear implant poses a contraindication to the magnetic resonance imaging(MRI) process, because MRI generates artifacts, inducing an electrical current and causing device magnetization. CT is relatively expensive and the metal electrodes scatter the image. Post-implantation radiological studies using anterior-posterior transorbital, submental-vertex and lateral views, the intracochlear electrodes are not well displayed. Therefore, the authors developed a special view, which we call the cochlear view. The patient is sitting in front of a vertical device. Then the midsagittal plane is adjusted to form an angle of $15^{\circ},\;30^{\circ}$, and $45^{\circ}$ with the film. The flexion of the neck is adjusted to make the infraorbitomeatal line(IOML) is parallel with the transverse axis of the film. The central ray is directed to exit from the skull at point which is 3.0 cm anterior and 2.0 cm superior to the EAM(external auditory meatus). Results have shown that single radiography of the cochlear view provides sufficient information to demonstrate the position of the electrodes array and the depth of insertion in cochlear. Radiography of the cochlear view in angle of $45^{\circ}$ is an excellent image. The cochlear view gives the greatest amount of medical information with the least radiation and lowest medical cost. It can be widely used in all cochlear implant clinics.

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Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study

  • Park, Jung Jin;Park, Young-Chel;Lee, Kee-Joon;Cha, Jung-Yul;Tahk, Ji Hyun;Choi, Yoon Jeong
    • The korean journal of orthodontics
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    • v.47 no.2
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    • pp.77-86
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    • 2017
  • Objective: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). Methods: This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. Results: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of $1.1^{\circ}-2.9^{\circ}$. Conclusions: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.

Comparison of Immediate Effects of Pain, Range of Motion and Treatment Satisfaction on Difference of Applying Joint Mobilization Levels in Patients With Acute Mechanical Neck Pain (급성 기계적 경부통 환자들의 관절가동술 적용 위치에 따른 통증과 가동범위와 치료 만족도의 즉각적인 효과 비교)

  • Lee, Nam-yong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.50-60
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    • 2015
  • The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.

Lattice Shear Reinforcement for Slab-Column Connection Subjected to Unbalanced Moment (불균형모멘트를 받는 슬래브-기둥 접합부를 위한 래티스 전단 보강)

  • Park, Hong-Gun;Kim, You-Ni;Song, Jin-Kyu;Kim, Sun-Kyu;Lee, Chul-Woo
    • Journal of the Korea Concrete Institute
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    • v.19 no.3
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    • pp.301-312
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    • 2007
  • A slab-column connection is susceptible to brittle punching shear failure, which may result in the necessity of shear reinforcement. In the present study, to investigate the earthquake resistance of newly developed lattice shear reinforcement, experimental study was performed for interior slab-column connections subjected to cyclic loading. For comparison, specimens with existing shear reinforcement method such as stud rail, shear band and stirrup were also tested. The test result showed that the structural capacity of the lattice shear reinforcement was superior to those of the existing methods and was greater than the code-specified strength. On the other hand, the existing methods did not significantly improve the shear strength of the specimens. The shear strengths of the existing methods were much less than the code-specified shear strength.

Surgical implications of anatomical variation in anterolateral thigh flaps for the reconstruction of oral and maxillofacial soft tissue defects: focus on perforators and pedicles

  • Kim, Ji-Wan;Kim, Dong-Young;Ahn, Kang-Min;Lee, Jee-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.265-270
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    • 2016
  • Objectives: To gain information on anatomical variation in anterolateral thigh (ALT) flaps in a series of clinical cases, with special focus on perforators and pedicles, for potential use in reconstruction of oral and maxillofacial soft tissue defects. Materials and Methods: Eight patients who underwent microvascular reconstructive surgery with ALT free flaps after ablative surgery for oral cancer were included. The number of perforators included in cutaneous flaps, location of perforators (septocutaneous or musculocutaneous), and the course of vascular pedicles were intraoperatively investigated. Results: Four cases with a single perforator and four cases with multiple perforators were included in the ALT flap designed along the line from anterior superior iliac spine to patella. Three cases had perforators running the septum between the vastus lateralis and rectus femoris muscle (septocutaneous type), and five cases had perforators running in the vastus lateralis muscle (musculocutaneous type). Regarding the course of vascular pedicles, five cases were derived from the descending branch of the lateral circumflex femoral artery (type I), and three cases were from the transverse branch (type II). Conclusion: Anatomical variation affecting the distribution of perforators and the course of pedicles might prevent use of an ALT free flap in various reconstruction cases. However, these issues can be overcome with an understanding of anatomical variation and meticulous surgical dissection. ALT free flaps are considered reliable options for reconstruction of soft tissue defects of the oral and maxillofacial area.

Microvascular Anastomosis with Non-penetrating Vascular Clips in Head and Neck Free Flap Surgery (두경부 유리피판 수술에 있어서의 비천공성 혈관 클립을 이용한 미세혈관 문합술)

  • Chang, Hak;Minn, Kyung-Won;Kim, Woo-Ram;Shin, Hyun-Woo;Koh, Kyung-Suck
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.57-62
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    • 2005
  • Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

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A Case of Penetrating Facial Wound by a Grinder (분쇄기에 의한 얼굴 관통창 1 례)

  • Kang, Jin-ah;Kim, Kang Ho;Paik, Jin Hui;Hong, Dae Young;Kim, Ji Hye;Lee, Kyoung Mi;Kim, Jun Sig;Han, Seung Baik
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.89-92
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    • 2006
  • Penetrating facial wounds are uncommon and are usually life threatening because of the possibility of brain damage. There are three possible pathways for penetrating the cranium through the orbit: via the orbital roof, via the superior orbital fissure, or between the optic canal and lateral wall of the orbit. Brain injuries resulting from the penetrating wounds show extensive parenchymal damage, hemorrhage, and brain edema. Transorbital penetrating wounds can lead to diverse lesions of the optical apparatus, including the eye globe, the optical nerve, and the chiasm. Moreover, intracerebral structures may be hurt, and bleeding and infection may occur. Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of a penetrating facial wound. An 87-year-old man was admitted to the emergency department with a grinder impacted into the medial aspect of the right eye. On presentation, the man was fully conscious with a Glasgow Coma Scale score of 15 and complained of a visual disturbance of the right eye. Computed tomography demonstrated a right orbital medial and inferior wall fracture, a frontal bone fracture, and a contusional hemorrhage in frontal lobe of the brain. A craniotomy with hematoma removal and repair of the orbital floor was done. He showed no neurological deficits except right visual loss. This appears to be the first report of a man with a penetrating facial wound caused by a grinder, who presented with a potentially disastrous craniocerebral injury that did not lead to any serious neurological seguelae.