This study was performed for the purpose of investigating the relation between width of temporomandibular joint space and craniofacial morphology in patients with CMDs. The subjects utilized here were aged from 16 to 63 years old and 19 male and 46 female. For the study, each patient was taken radiographs by Transcranial and Lateral Cephalographic projection and the films were traced with routine method. The measured items were anterior, superior, posterior joint space and relative condylar position to the deepest part of glenoid fossa in Transcranial film and items related vertical and/or horizontal growth in Cephalogram. The data were processed with SPSS/PC+ package for statistical analysis. The obtained results were as follows : 1. Anterior joint space in affected side were wider than that of unaffected side, but for superior and posterior joint space, the value of unaffected side were more than those of affected side. 2. Superior or posterior joint space of affected side were significantly correlated with items related vertical growth, such as ramus height, Jarabak ratio, FMA. From this, the following cold be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed growth pattern of counter clockwise. 3. Superior or posterior joint space of affected side were significantly correlated with items related horizontal growth, such as SNPo, NAPo, APDI and ANB. From this the following could be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed anterior displacement of mandible. 4. It would be proposed that the diagnositic value of superior and posterior joint space of affected side in transcranial radiograph was excellent.
The Internal derangement of temporomandibular joint disc was evaluated by using magnetic resonance imaging and arthrogram in 5 patients having reciprocal clicking or locking and in 5 normal subjects. Parasagittal multisections on both closed and open mouth were serially obtained by using a 1.5 Tesla MR system and surface coil with CSMEMP, MPGR. MR images obtained were analized by correlating with images of arthrograms. The obtained results were as follows: 1. Displaced meniscus was clearly delineated as dark structure on MR images other than on arthrograms of closed mouth view of patient having clicking or locking. 2. The deltoid white images of synovial fluid were identified in the glenoid fossa and on the posterior surface of condyle on open mouth view and partly depicted on closed mouth view, of parasagittal sections by MPGR. 3. The greyish image of joint fluid was identified on the posterior surface of condyle on the open mouth view of parasagittal sections by CSMEMP. 4. The structural relationship among condyle, meniscus, and fluid showed the variety of images on each parasagitta1 view.
The authors had observed a rare case of osteopetrosis from 8 years old male who had complained nasal obstruction at, Department of Dental Radiology, Kyung Hee University. In the serial roentgenograms the following results were revealed. 1. This osteopetrosis was considered to be malignant rather than benign. 2. In the skull, the greatest degree of radiopacity was found in the base. The pituitary fossa appeared to be small and posterior clinoid process revealed clubbing and thickening. 3. In the frontal and nasal bones were slightly enlarged with marked radiopacity and paranasal sinuses were obscured. 4. The maxilla was markedly affected and bony trabeculae were seen to be coarse and thickened but mandibular posterior segment slightly. 5. There were long retardation of the tooth eruption and physiologic resorption of the deciduous teeth, and tooth root revealed stunted and dwarfed appearance in the both jaws. 6. In this case, the thickened alveolar lamina dura was indistinguishable.
Kim, Eui-Hyun;Park, Yong-Sook;Chang, Jong-Hee;Chang, Jin-Woo;Park, Yong-Gou
Journal of Korean Neurosurgical Society
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제38권3호
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pp.184-189
/
2005
Objective : Hemangioblastomas are highly vascular and benign neoplasm of the central nervous system[CNS]. They can often be found as multiple lesions, as is commonly observed in von Hippel-Lindau[VHL] disease. The aim of this study is to determine the proper management for multiple hemangioblastomas. Methods : Since 1990, 78cases of hemangioblastoma have been encountered. Among these, 9cases were multiple hemangioblastomas that were treated with surgical resection with or without radiosurgery. The medical, radiological, surgical and histological records were reviewed retrospectively and analyzed statistically. Results : Nine patients presented with multiple hemangioblastomas and were diagnosed as VHL disease. The mean follow-up duration was 75.7months [$6.6{\sim}159.2months$] after the first surgical treatment. Three patients were treated with surgical resection alone and six patients were treated by both surgical resection and radiosurgery. Twenty-one surgical procedures [13 surgical resections and 8 radiosurgery] were performed. One patient required ventriculoperitoneal shunt and a posterior fossa decompressive craniectomy because of post-radiation brain swelling. Another patient refused additional treatment for the newly developed lesions after the successful treatment of initial lesions. The other patient who presented with numerous lesions in the whole brain and spine underwent cranio-spinal irradiation. Remaining patients showed good results. Conclusion : The surgical outcomes for the patients with a single lesion of the CNS hemangioblastoma are favorable. However. the treatment of multiple hemangioblastoma is more difficult, and should be treated by surgical resection and radiosurgery with careful consideration.
Objective : Chiari II malformation (CM II) is still the main cause of severe morbidity and mortality in children with open neural tube defects (ONTDs). The goal of this study was to validate a CM II model in late-stage chick embryos with surgically induced ONTDs. Methods : To make the chick embryo model of ONTD, their neural tubes were opened for a length of 5-6 somites at the thoracic level in Hamburger and Hamilton stage 18 chick embryos (n=150). They were reincubated in ovo up to a total age of 17-21 days. A total of 19 embryos survived and were assigned to either the postoperative day (POD) 14-15 group (n=6) or the POD 17-18 group (n=13). Magnetic resonance imaging (MRI) and histopathologic findings of embryo heads with spinal ONTDs were compared with age-matched normal chick embryos. Results : The chick embryos with ONTDs demonstrated definite and constant structural changes, such as downward displacement of the cerebellum to just above the foramen magnum and narrow and small cerebrospinal fluid spaces in the crowded small posterior fossa. These morphologic features were more prominent in the POD 17-18 group than in the POD 14-15 group. Conclusion : This is the first description of CM II with spinal ONTD in a late-stage chick embryo model with MRI and histopathological analysis. The morphological changes of the posterior fossa in this study mimic those of CM II associated with spinal ONTD in humans. This model will facilitate investigation of the pathogenesis of CM II.
Two hundreds of female aged 19 years old and up were recruited to evaluate the postural changes and bilateral variation of asymmetry over age. To find out the differences among the age group, subjects were classified into 5 groups, early young age(19-29), late young age(30-39), early middle age(40-49), late middle age(50-59), and old age(60-). 35 body measurements were taken by the 3-D body scanner which allowed us to take measurements which cannot be measured using traditional methods, including the shape of a cross section, slice area surface are, and volume. Bilateral variations were observed as a function of age; Depth of scapular point level, scapular point to center back, and blade angle. Postural change of anterior cervical angle, upper anterior thoracic angle, upper posterior thoracic angle, posterior cervical angle, and center back/center front ratio were also exhibited. In each measurements, subjects were classified into normal, and abnormal group. Percentiles of abnormal in shoulder line angle, blade angle, neck point $\∼$ acromial point $\∼$ scapular point, posterior cervical angle, and upper posterior thoracic angle were increased over age group. The upper body of lateral view was classified into 3 types of posture based on the previous research; straight, erect(leaning back), and stooped(bent forward). The percentiles of subjects who have straight postures were decreased as a function of age, but those of stooped postures were increased. Subjects who have erect postures did not so. The stooped posture group shows the big cervical fossa angle, anterior cervical angle, posterior cervical angle, upper posterior thoracic angle, and the small upper anterior thoracic angle comparing to the straight and erect posture group. These results could be apply for clothing construction reflecting the changes in back, shoulder, neck, and the bilateral asymmetry according to the target age group.
Kim, Sung-Ho;Yeo, Dong-Kyu;Shim, Jae-Joon;Yoon, Seok-Mann;Chang, Jae-Chil;Bae, Hack-Gun
Journal of Korean Neurosurgical Society
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제57권5호
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pp.350-358
/
2015
Objective : To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA). Methods : A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope. Results : The anterior and middle segments of the ATPAs arose at mean intervals of $1.75{\pm}1.62$ mm and $5.86{\pm}2.05$ mm from the internal carotid artery (ICA), and the interval between these segments was a mean of $3.17{\pm}1.64$ mm. The posterior segment arose at a mean interval of $2.43{\pm}1.46$ mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of $3.45{\pm}1.39$ mm. The mean numbers of perforators were $2.66{\pm}1.19$, $3.03{\pm}1.84$, and $1.67{\pm}0.98$ in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases. Conclusion : Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa.
Posterior shoulder muscle tightness is frequently observed in shoulder impingement syndrome because tightness in the posterior portion of the shoulder muscles can cause anterior and superior translation of the humeral head in relation to the glenoid fossa. The purpose of this study was to determine the immediate effects of soft tissue massage on acromiohumeral distance (AHD), anterior translation of the humeral head, and glenohumeral (GH) range of motion (ROM) in subjects with posterior shoulder muscle tightness. Twenty-seven subjects with greater than $10^{\circ}$ difference in the range of GH horizontal adduction between right and left sides were recruited. The range of GH horizontal adduction and internal rotation were measured by a digital inclinometer. The AHD and anterior translation of the humeral head were measured using ultrasonography. A paired t-test was used to compare AHD, anterior translation of the humeral head, and the range of GH horizontal adduction and internal rotation before and after soft tissue massage. The results showed that AHD increased significantly (p<.05) and the anterior translation of humeral head decreased slightly, but not significantly (p=.40) after the soft tissue massage. Furthermore, the ROM of horizontal adduction and internal rotation in the GH joint increased significantly after the soft tissue massage (p<.05). These findings indicate that soft tissue massage on posterior shoulder muscle tightness is an effective method to increase AHD and ROM in the horizontal adduction and internal rotation of the GH joint.
Purpose : Disc and condylar position were observed on MRIs of temporomandibular joint disorder patients and condylar position agreement between MRI and tranascranal radiography was evaluated. Materials and Methods MRI and transcranial radiographs of both TM joints from 67 patients with temporemandibular disorder were used. On MRI, the position and shape of disc and condylar position as anterior, middle, posterior was evaluated at medial, center, and lateral views. On transcranial radiographs, condylar position was evaluated using the shortest distance from condyle to fossa in anterior, superior, and posterior directions. Results. 1. On MRI, 96 joints (71.6%) of 134 had anterior disc dispalcement with reduction and 38 joints (28.4%) without reduction. 2. Fourteen (14.6%) of 96 reducible joints showed anterior condylar position, 19 (19.8%) showed central position, 63 joints (65.6%) showed posterior position. Two joints (5.3%) of 38 non-reducible joints showed anterior condylar position, while 9 (23.7%) showed central position, and 27 (71.1%)-posterior position. 3. In 85 joints (63.4%) of 134, the transcranial condylar position agreed with that of the central MRI view, 10 joints (7.5%) with that of medial, 16 joints (11.9%) with that of lateral, and 23 joints (17.2%) disagreed with that of MRI. Conclusion : On MRT, most oi the reducible and non-reducible joints showed posterior condylar position. Transcranial radiographs taken with machine designed for TMJ had better agreement of condylar position with that of MRI. Extremely narrow joint spaces or very posterior condylar positions observed on transcranial radiographs had a little more than fifty percent agreement with those of MRIs.
It is very important to arrange the artificial teeth correctly in bucco-lingual (labio- lingual) relation in reconstrcting dentition. Although many anatomic landmarks and techniques have been reported over the years, they are based on westerns. So this study was performd to examine the horizontal relations of mandibular teeth in Korean dentulous adults. 200 volunteers(mean age 22.9) who had natural dentition were selected. The impressions were taken with irreversible hydrocolloid impression material and mandibular study models were fabricated using class I dental stone. Then they were measured with 3-dimensional measuring device specially designed for this study. The results were as follows ; It is better to consider the lingual cusps of the lower posterior teeth as a guide than the linguoaxial surfaces of the lower posterior teeth, arranging the lower posterior teeth buccally to the line which starts from the mesial aspect of the lower canine and continue backward to the lingual aspect of the retromolar pad. It is better to arrange the fossae of the lower posterior teeth buccally to the line which starts from the cusp tip of the lower canine and continue backward to the top of the retromolar pad. The positions of the lower posterior teeth in the denture-bearing area ; considering the fossa as a guide, the 2nd premolar was positioned in center. considering the buccal cusp as a guide, the 1st molar and the 2nd molar were positioned in center. the distance ratio(d/a) was incresed constantly from the lower canine to the 2nd molar d ; the distance between the buccal vestibule(the lowest point) and the buccal cusp tips of the lower posterior teeth. a ; the distance between the buccal vestibule(the lowest point) and the lingual vestibule(the lowest point). The lower canine was positioned lingually($0.11{\pm}0.13$) than the labial vestibule, and the central incisor and the lateral incisor were positioned almost in the imaginary perpendicular plane of the labial vestibule(the lowest point).
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