• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.309-316
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• 2000

Objective :The transoral approach allows direct view of the ventral craniovertebral junction and provides useful management of the various lesions of this area. We present a step by step guide to the performance of the transoral excision of the odontoid process in the cadaveric model. Methods : Ten cadaver heads were used in fixed or unfixed state. We describe the relevant surgical anatomy in the cadaveric dissection and surgical technique of transoral transpharyngeal odontoidectomy. Results : The surgical procedure of transoral odontoidectomy was categorized by six steps；soft palate, posterior pharyngeal wall, muscular structures, osseous structures, odontoid process and ligaments, cruciate ligament and dura. Conclusion : With anatomical knowledge of these regions neurosurgeons can deal with wide variety of lesions in the ventral craniovertebral junction.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.185-195
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• 2018

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

• Journal of the Korean Society of Radiology
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• v.15 no.3
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• pp.321-327
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• 2021

Wrist PA-grip view is used to diagnose triangular fibrocartilage complex (TFCC) tear because it can easily diagnose damage to the surrounding wrist ligaments. However, despite advances in radiology equipment, distortion of images due to geometric elements still has many limitations. In this paper, we propose a method that can minimize the distortions of images by analyzing the distortions occurring in the wrist PA-grip view. A source of image distance (SID) were set at 130 cm and 150 cm for comparison with 110 cm. Depending on the SID, the phantom of wrist was moved at 0, 2, 4, 6, 8, and 10 cm in the X-axis and Y-axis directions, respectively. For quantitative evaluation, the difference of distance between the radius and ulna was measured in picture archiving and communication system (PACS) system. As a qualitative evaluation, survey was conducted among 20 radiologic technologists who examined the Wrist PA-grip view. The Kruskal Wallis test was performed to compare the distortion according to the phantom movement in the X-axis and Y-axis directions based on the SID, and the Tukey test was performed as a post-test. In the quantitative evaluation results, the measured values obtained in the X-axis was not significantly different in all groups (p>0.05). The measured values obtained in the Y-axis was significantly different in the most groups (p<0.05). Therefore, to reduce distortion while maintaining image quality, we recommend what examine the SID at 150 cm than 110 cm.

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.311-327
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• 1998

The purpose of this study was to evaluate the effects of Transforming Growth Factor-${\beta}$ (TGF-${\beta}$) on the viability of human periodontal ligament cells, in-vitro and on the experimental tooth movement in rat, in-vivo. Human periodontal ligaments were cultured from the first premolar tooth extracted for the purpose of the orthodontic treatment. 0.1, 1, 5 and 10ng/m1 of TGF-${\beta}$ was given to the cultured wells, respectively and the viability was evaluated by MTT assay. Twenty Sprague-Dawley rats were divided into 5 experimental groups(4 rats in each) where 100g of force was applied from helical spring across the maxillary incisors. TGF-${\beta}$ was injected via Hamilton syringe into the periodontal ligament at the mesial and the distal surface of a maxillary incisor of 2 rats in each experimental group. Phosphate buffer saline(PBS) was injected in 2 other rats as controls. Experimental groups were sacrificed at 1, 3, 7, 14 and 28 days after force application, respectively. The obtained tissues were evaluated histologically. The obtained results were as follows: 1. The viability of periodontal ligament cells in 0.1ng/ml of TGF-${\beta}$ was not significantly different from that of control at 1-, 2- and 3-day of cultivation. 2. The viability of periodontal ligament cells was significantly increased at 3-day in 1ng/ml or 5ng/ml of TGF-${\beta}$, and at 2-,3-day in 10ng/ml of of TGF-${\beta}$. 3. The zone of hyalinization in periodontal ligament in pressure side was smaller in TGF-${\beta}$ injection group than that in control group at 3-day after the application of experimental force in rat. But no difference was seen after 7-day. 4. Osteoclastic activity and capillary prolieferation in pressure side were greater in TGF-${\beta}$ injection group than that in control group at 3-day to 7-day. 5. Osteoblastic activity and new bone fomation in tension side were greater in TGF-${\beta}$ injection group than that in control group at 3-day to 14-day.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.213-230
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• 2008

The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.

• Journal of Periodontal and Implant Science
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• v.26 no.2
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• pp.469-490
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• 1996

The initial events required for periodontal regeneration is the attachment, spreading, and proliferation of appropriated cells at the healing sites. These have been reported that minocycline stimulates the attachment of periodontal ligament cells, and also $TGF-{\beta}1$ enhances the proliferation of periodontal ligament cells. The purpose of the present study was to evaluate the effects of $TGF-{\beta}1$ on the cellular activity of minocycline treated human periodontal ligament cells. Periodontal ligament cells were obtained from the explants of healthy periodontal ligaments of extracted 3rd molars or premolar teeth extracted from the patients for orthodontic treatment. The cells were cultured in minimal essential medium(${\alpha}-MEM$) supplemented with 10.000units/ml penicillin, $10,000{\mu}g/ml$ streptomycin and 10% FBS(fetal bovine serum) at $37^{\circ}C$ in a humidified atmosphere of 5% carbon dioxide and the 5th to the 8th passages of the cells were used. To evaluate the effect of minocycline on cell attachment, the cells were seeded at a cell density of $1.5{\times}10^4$ cells/well in 24-well culture plates and treated with $20{\mu}g/ml$ and $100{\mu}g/ml$ of minocycline for 1.5 h. After trypsinization, the cells were counted with hemocytometer and were taken photographs for observation of cellular morphology. To evaluate the effect of $TGF-{\beta}1$ on minocycline-pretreated periodontal ligament cells, the cells were seeded at a cell density of $1{\times}10^4$ cells/ well in 24-well culture plates and treated with $20{\mu}g/ml$ and $100{\mu}g/ml$ of minocycline for 1.5 h. After incubation, 1 and 10ng/ml of $rh-TGF-{\beta}1$ were also added to the each well and incubated for 1 and 2 days, respectively. Then, MTT assay, DNA synthesis($^3H-thymidine\;assay$), and protein and collagen assay(3H-proline assay) were carried out. In the MIT assay, after 200ul MTT solutionlconeentration of 5mg/ml) were added to the each well of the 24-well plates and incubated for 3 hours, and 200 ul DMSO were added so as to dissolve insoluble blue formazan crystals which was formed in incubated period. Then it read plates on a ELISA reader. For mitogenic assay, 1 uCi/ml $^3H-thymidine$ was added to each well for the final 2 hours of the incubation periods. After labeling, the wells were washed 3 times with ice cold PBS and 4 times with 5% TCA to remove unincorporated label and precipitate the cellular DNA. DNA, with the incorporated $^3H-thymidine$, was solubilized with 500 ul of 0.1% NaOH/0.1% SDS. A 250 ul aliquot was removed from each well and placed in a scintillation vial with 4ml of scintillation cocktail. Using an liguid scintillation counter, counts per minute(CPM) were determined for each samples. 3 uCi/ml $^3H-proline$ was added to each well for the final 4 hours of the incubation periods and total protein and percent collagen synthesis were carried out. The results indicate that minocycline treated group with $100{\mu}g/ml$ concentration for 1.5 hours significantly increased than that of control in cell attachment, and cell process is also evident compared with that of control in cell morphology, and the cellular activity and DNA synthesis rate of cells treated minocycline and $TGF-{\beta}1$ significantly increased than that of control values, but were below to values of the $TGF-{\beta}1$ only treated group in MIT assay and $^3H-thymidine\;assay$, and the total protein synthesis of minocycline and $TGF-{\beta}1$ treated group also significantly increased than that of control values, but the percent collagen synthesis of tested group significantly decreased to compared with control. On the above the findings, the tested group of minocycline and $TGF-{\beta}1$ did not increase the effect on the cell activity than $TGF-{\beta}1$ only tested group and the tested group of minocycline inhibited cell activity. This results indicate that minocycline was effective on cell attachment in early stage, but it is harmful to cell activity, that inhibitory effect of minocycline was compensated with stimulatory effect of $TGF-{\beta}1$.

• The korean journal of orthodontics
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• v.41 no.5
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• pp.324-336
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• 2011

Objective: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. Methods: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. Results: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. Conclusions: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.31-36
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• 2002

Purpose : ACL (anterior cruciate ligament) reconstruction using achilles allograft was done for whom ACL injured person in recreational sports activity. The purpose of this study was to evaluate the clinical results and return to their sports activity in these patients. Materials and Methods : ACL injured 56 amateur athletes who had experienced sports 3 times a week more than 5 years, reconstructed with Achilles allograft, and it was analyzed subjective and objective parameter, Tegner scoring, Telos stress arthrometer, Lysholm Knee Scoring System and modified Feagin scoring system. The average age was 25 years old (range: 18$\~$49), the average follow up period was 15 months (range: 12$\~$19). Morbid sports were football (29 cases), basket ball (14 cases), badminton (5 cases), tennis (3 cases), squash (2 cases) and otherwise (3 cases). Result : The mean Lysholm Knee Scoring System was improved to 88.2 from 60. Telos arthrometer in anterior stress test revealed 2.3 mm improved from 7.1 mm. The modified Feagin scoring system showed 50 cases (89$\%$) with excellent and good results. We had obtained 12 cases (21$\%$) of Tegner score VI, 32 cases (57$\%$) of score V, 20 cases (35%$\%$ of score IV, 3 (5.3$\%$) cases of score III. Conclusions : Reconstruction of anterior cruciate ligaments can restore stability sufficient to allow sports activity in ACL injured patients, but it’s difficult to achieve 'normal' sports activity. So we will have to solve the reasons of this dissatisfaction at furthermore.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.154-158
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• 2000

Purpose : The purpose of this study is to demonstrate changes in the orientation ortho glenohumeral ligaments(GHL) in different degrees of abduction and rotation of the normal healthy individuals. Materials and Methods : Saline Magnetic Resonance(MR) arthrography of nine consecutive shoulders of normal healthy adults were checked. At that time, MR images were obtained in three different positions of abduction and external rotation($0^{\circ}C\;and\;0^{\circ},\;45^{\circ}C\;and\;25^{\circ}C,\;90^{\circ}$ and maximum, respectively). From a series of consecutive MRI, three-dimensional images were reconstructed after detecting the location of the middle glenohumeral ligament(MGHL) and the inferior glenohumeral ligament(IGHL) using workstation computer. Results : The shape of the MGHL was taken in double curved, and straight, and finally curved again in three different positions of the shoulder in sequence. On the other hand, the shape of the IGHL was obliquely positioned, and curvilinear, and finally straight and extended at lower part of the anterior surface of the humeral head. Conclusions : At $45^{\circ}$ of abduction and $25^{\circ}$ of external rotation, and at $90^{\circ}$ of abduction and maximal external rotation of the shoulder, the MGHL and the IGHL had the role of the most important static stabilizer of the glenohumeral joint repectively.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.159-165
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• 2000

Purpose : Endoscopic carpal tunnel release technique was developed and has being used to decrease postoperative morbidity and complications. The purpose of this study was to evaluate the clinical results and clinical usefulness of endoscopic carpal tunnel release using single portal technique. Methods and Materials : 18 carpal tunnel syndrome patients who were diagnosed by means of clinical symptoms, physical examination, and electrodiagnostic study had endoscopic carpal tunnel release using single portal technique with about 1 cm oblique wrist incision on 30 hands. And then they were followed-up and reviewed in the same way. Late results of operation were analysed by grading system according to patient's own assessments of relief of symptoms at the final fellow-up. The follow-up period ranged 6 to 13 months from surgery. Results : There were postoperative improvements with respect to clinical symptoms, physical examination, and electrodiagnostic study. 23 of 30 hands$(76.7\%)$ had complete resolution of symptoms. 27 hands$(90\%)$ were able to return to normal activities and work within 6 weeks, and 30 hands$(100\%)$ returned within 8 weeks. In grip strength study, 29 hands$(96.6\%)$ regained preoperative strength in 6 months. 12 of 22 hands$(55\%)$ had improvement with respect to thenar atrophy within 6 months. Late results were as follows . 23 hands$(76.7\%)$ was graded as excellent, 6 hands$(20\%)$ graded as good and 1 hand$(3.3\%)$ graded as fair, and there was no poor result. Conclusion : We think that endoscopic carpal tunnel release with single portal technique is technically safe and simple, if the surgeon takes step to stay within the safety zone based on local anatomy and selects an appropriate patient and that endoscopic carpal tunnel release does have advantages over open release. We agree that the surgeon must be prepared to perform an open technique, if technical difficulties arise, difficulty in introducing the device into the carpal tunnel is encountered, or the transverse fibers of the transverse carpal ligaments are not clearly seen.