• Journal of Korean Neurosurgical Society
• /
• 제46권4호
• /
• pp.355-359
• /
• 2009

Objective : The definition of empty sella syndrome is 'an anatomical entity in which the pituitary fossa is partially or completely filled with cerebrospinal fluid, while the pituitary gland is compressed against the posterior rim of the fossa'. Reports of this entities relating to the brain tumors not situated in the pituitary fossa, have rarely been reported. Methods : In order to analyze the incidence and relationship of empty sella in patients having brain tumors, the authors reviewed preoperative magnetic resonance imaging (MRI) of 72 patients with brain tumor regardless of pathology except the pituitary tumors. The patients were operated in single institute by one surgeon. There were 25 males and 47 females and mean patient age was 53 years old (range from 5 years to 84 years). Tumor volume was ranged from 2 cc to 238 cc. Results : The overall incidence of empty sella was positive in 57/72 cases (79.2%). Sorted by the pathology, empty sella was highest in meningioma (88.9%, p=0.042). The empty sella was correlated with patient's increasing age (p=0.003) and increasing tumor volume (p=0.016). Conclusion : Careful review of brain MRI with periodic follow up is necessary for the detection of secondary empty sella in patients with brain tumors. In patients with confirmed empty sella, follow up is mandatory for the management of hypopituitarism, cerebrospinal fluid (CSF) rhinorrhea, visual disturbance and increased intracranial pressure.

• Imaging Science in Dentistry
• /
• 제38권1호
• /
• pp.23-27
• /
• 2008

Purpose: The aim of this study was to evaluate the change in the position of the mandibular condyle within articular fossa by a CBCT after wearing complete denture (CD). Materials and Methods: CBCT of 34 temporomandibular joints were taken from 9 male and 8 female patients with CB $Mercuray^{TM}$ (Hitachi, Japan) before and after wearing a CD for rehabilitation. Position of mandibular condyle within articular fossa at centric occlusion was evaluated with $Vimplant2.0^{TM}$ (CyberMed, Korea) on the central parasagittal view and curved panoramic coronal view of the condylar head. A statistical evaluation was done with SPSS. Results: The range of anteroposterior positional rate (AP) of condylar head within articular fossa was -16-5 and -10-12 respectively on the right and left sides. Before wearing CD, the AP rate showed discrepancy between right and left sides (p<0.05). After wearing CD, both condyles showed a tendency to decrease in posterior condylar position (right side; p<0.05). The average discrepancy between right and left side in mediolateral positional rate (MD) was 15.5 and 4.5 respectively before and after wearing CD. The improvement was observed in mediolateral relationship of both condylar heads after wearing CD (p< 0.01). Before wearing CD, the average horizontal angle of long axis of condylar head was $79.6{\pm}2.7^{\circ}\;and\;80.1{\pm}5.7^{\circ}$ respectively on the right and left sides. After wearing CD, both condyles were rotated in the same direction in average on axial plane. Conclusion: We observed with CBCT the significant clinical evidence in case of positional change of mandibular condyle after wearing complete denture.

• Imaging Science in Dentistry
• /
• 제43권4호
• /
• pp.273-281
• /
• 2013

Purpose: This study was performed to evaluate the general anatomy and morphology of the nasopalatine canal using cone-beam computed tomography (CBCT) and to determine the human anatomic variability of the nasopalatine canal in relation to age and gender. Materials and Methods: The study included 100 subjects aged between 20 and 86 years who were divided into the following 3 groups: 1) 20-34 years old; 2) 35-49 years old; 3) ${\geq}50$ years old. The subjects were equally distributed between the genders. CBCT was performed using a standard exposure and patient positioning protocol. The data of the CBCT images were sliced in three dimensions. Image planes on the three axes (X, Y, and Z) were sequentially analyzed for the location, morphology and dimensions of the nasopalatine canal by two independent observers. The correlation of age and gender with all the variables was evaluated. Results: The present study did not reveal statistically significant differences in the number of openings at the nasal fossa; diameter of the nasal fossa openings; diameter of the incisive fossa; shape, curvature, and angulation of the canal as viewed in the sagittal sections; antero-posterior dimensions and length of the canal in the sagittal sections; or the level of division of the canal in the coronal plane by age. However, males and females showed significant differences in the length of the canal in the sagittal sections and level of the division of the canal in the coronal plane. Conclusion: The present study highlighted important variability observed in the anatomy and morphology of the nasopalatine canal.

• 구강회복응용과학지
• /
• 제18권4호
• /
• pp.321-329
• /
• 2002

Bending moments results from offset overloading of dental implant, which may cause stress concentrations to exceed the physiological capacity of cortical bone and lead to various kinds of mechanical failures. The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different angulated placement of dental implant in mandibular posterior missing areas. The three kinds of finite element model, were designed according to 3 main configurations: Model 1(parallel typed placement of 2 fixtures), Model 2(15. distal angulated placement of one fixture on second molar area), Model 3(15. mesial angulated placement of one fixture on second molar area). The cemented crowns for mandibular first and second molars were made on the two fixtures (4mm 11.5). Three-dimensional finite element models by two fixtures were constructed with the components of the implant and surrounding bone. A 200N vertical static load were applied to the center of central fossa and the point 2mm apart from the center of central fossa on each model. The preprocessing, solving and postprocessing procedures were done by using FEM analysis software NISA/DISPLAY IV Version 10.0((Engineering Mechanics Research Corporation, USA). Von Mises stresses were evaluated and compared in the supporting bone, fixtures, and abutment. The results were as following : (1) Under the point loading at the central fossa, the direction of angulated fixture affected the stress pattern of implants. (2) Under the offset loading, the position of loading affected more on the stress concentration of implants compare to the angulated direction of implants. The results had a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the placement angulation of implant fixture is placed toward mesial or distal direction. In designing of the occlusal scheme for angulated placement, placing the occlusal contacts axially during chewing appears to have advantages in a biomechanical viewpoint.

• Clinics in Shoulder and Elbow
• /
• 제1권2호
• /
• pp.242-249
• /
• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• 대한치과교정학회지
• /
• 제16권1호
• /
• pp.85-106
• /
• 1986

The purpose of this investigation was to know the means of the T.M.J. space and to compare spational differences in centric relation and centric occlusion by the T.M.J. Tomogram and to study the correlation between the articular eminence slope and the lingual surface slope of the maxillary central incisor by the Cephalogram in near normal occlusion subjects. These results could give contribution for the diagnosis of orthodontic treatment and T.M.J. dysfunction and the assessment of orthopedic treatment and orthognathic surgery. 44 young adults (28 men and 16 women, 21 to 27 years of age) were selected from the Dental students in Yonsei Univ. Criteria for selection was normal occlusion, no clinical signs and T.M.J. dysfunction, no history of orthodontic treatment, and no missing tooth. After submental vertex view analysis. each subject was given the T.M.J. Tomogram in centric relation and centric occlusion and the Cephalogram was given with Quint Sectograph. All data was recorded and statistically processed with the CYBER computer system. Results were analyzed: the following findings and conclusions were derived. 1. The mean value for the combined right and left anterior joint space was 2.549mm, the posterior space was 2.260mm, and superior space was 3.31mm in centric relation. The anterior space was 2.316mm, posterior space was 2.474mm, and superior space was 3.435mm in centric occlusion. 2. In the centric relation position, both condyles were placed more posterioly and superioly in their fossae than in the centric occlusion position by the spatial difference. 3. In the centric occlusion position, both condyles were more symmetrically placed in their fossae with equal anterior-posterioly rather than in the centric relation position. 4. The mean articular eminence angle was $48.19^{\circ}$ and the mean fossa height was 7.911mm. A strong positive correlation between the articular eminence angle and fossa height in T.M.J. Tomogram was found. 5. In Cephalometric analysis, there was a strong positive correlation between the articular eminence slope and the lingual surface slope of the upper central incisor to the FH plane, occlusal plane, and S-N plane. 6. There was moderate positive correlation between the S-E measurements and the fossa height, articular eminence angle, and DcGn < F-H.

• 치과방사선
• /
• 제22권2호
• /
• pp.351-364
• /
• 1992

Internal derangement of the temporomandibular joint can be defined an abnormal relationships of the meniscus relative to the mandibular condyle, articuar fossa and eminence. This may cause variable mandibular dysfunctions and pain. For diagnosis, arthrography, computed tomography and magnetic resonance imaging are used. In this study, the author reviewed 98 TMJs of 88 patients who were diagnosed as internal derangement througth inferior joint space arthrography at the department of Oral & Maxillofacial Radiology, Dental Hospita, Dankook university through 1986 to 1992. 98 TMJs consisting of 30 disc displcement with reduction, 48 disc displcement without reduction and 20 perforation were studied about clinical and radiological findings. The results were as follows: 1. Internal derangement was found most frequently in the 2nd 3rd decades and the average age of perforation was higher than that of disc displcement with higher than that of disc displcement with reduction. The sexual predilection was 2 times hiher in females. 2. The most frequent chief complaints were TMJ sound in disc displcement with reduction, pain and limitation of mouth opening in disc displcement without reduction and pain in perforation. The duration of the chief complaints was longer in disc displcement with reduction with than in preforation and disc displcement without reduction. 3. Reciprocal click was the most frequently TMJ sound in disc displcement with reduction. History of joint sound in disc displcement without reduction an crepitus in perforation was the most frequent one. 4. The average maximum opening was 45.4㎜ in disc displcement with reduction, 31.4㎜ in disc displcement without reduction and 33.8㎜ in perforation. 5. In the centric occlusion, posterior condylar position was the most frequent in disc displcement with reduction. posterior and concentric condylar position was frequent in disc displcement without reduction, concentric and anterior condylar position in perforation. At 1 inch opening, the same position to articular eminence was most frequently found in disc displcement with reduction, posterior position in disc disp1cement without reduction, posterior and nterior position in perforation was frequently found. 6. Bony changes, especially sclerosis and flattening, was most frequently found in perforation.

• Journal of Oral Medicine and Pain
• /
• 제16권1호
• /
• pp.33-72
• /
• 1991

The purpose of this study was to investigate the stress distribution and the displacement in the temporomandibular joints following the teeth loss patterns. The three dimensional finite element method was used for a mathematical model. The finite element model was composed of 1,632 elements and 2,411 nodes in the mandible with articular disc and mandibular fossa of the temporal bone. The masseter, the temporal and the internal pterygoid muscle forces were applied at each insertion site, bisecting point of gonion and antegonion, tip of the coronoid process, and gonion at the ration of 2:2:1 respectively. The directions of muscles force were obtained from frontal and lateral cephalometric tracings using bony landmarks of the skull. The results were as follows : 1. In control model, the minimum principal stresses were concentrated on the region of anterosuperior part of the condyle head and articular disc, and maximum principal stresses on the anterior part of the condyle head and posterolateral part of the articular disc. 2. In case of unilateral teeth loss, the greater principal stress appeared at the teeth loss side and the principal stresses increased at the teeth loss side as the number of the posterior teeth loss went up. 3. In case of bilateral teeth loss, the principal stresses were greater than those of the control model and as the number of the posterior teeth loss increased, the grater principal stresses on the temporomandibular joints appeared at the both side. 4. When the posterior teeth existed bilateral, the principal stress patterns were similar to those of the control model. 5. The displacement ws directed mainly upward and backward in the upper part of the temporomandibular joints and upward and forward in the largest part of the condyle head. The displacement increased as the number of the posterior teeth loss went up.

• 척추신경추나의학회지
• /
• 제5권2호
• /
• pp.151-158
• /
• 2010

Objective : SLAP is rupture of biceps brachii muscle tendon and it's origin, posterior side of superior labral to anterior glenoid fossa. Snapping and Pain, instability are its typical symptoms. SLAP is physical damage so surgeons use arthroscopy. In point of surgeons view, a conservative medicine is not effective for lesion of labrum. So In this article, we report a result of conservative treatment for the amatuer baseball player diagnosis with type 2 superior labral anterior posterior lesion. Methods : In this case, patient played amatuer baseball for 2 years, had diagnosis with type 2 Superior labral anterior posterior lesion by MRI after right shoulder Injury. OS recommened arthroscopy surgery. But he receive conservative Korean medicin treatment in Korean medicine hospital, including Atx, BV, herbal acupunture and rehabilitation excersise. Results : After 6 months, in the end of continuous conservative treatment and rehabilitation excersise, patient can play baseball normally, and felt a little pain. But In physical examination, he still has a some abnormal signs. Conclusion : A Conservative treatment for an amatuer baseball player diagnosis with SLAP type 2 was effective in restore of fuctional activities, but usefulness of this treatment needs more study.

• Imaging Science in Dentistry
• /
• 제46권2호
• /
• pp.127-131
• /
• 2016

Purpose: This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). Materials and Methods: In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. Results: The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. Conclusion: The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.