• Title/Summary/Keyword: Posterior-only approach

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Surgical Treatment of Aortoiliac Arterial Occlusion: Report of 2 Cases (대동맥하단부-장골동맥의 급,만성 폐쇄성 동맥질환 2례)

  • 마중성
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.19-24
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    • 1972
  • The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

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Development of Auto Tracking System for Baseball Pitching (투구된 공의 실시간 위치 자동추적 시스템 개발)

  • Lee, Ki-Chung;Bae, Sung-Jae;Shin, In-Sik
    • Korean Journal of Applied Biomechanics
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    • v.17 no.1
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    • pp.81-90
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    • 2007
  • The effort identifying positioning information of the moving object in real time has been a issue not only in sport biomechanics but also other academic areas. In order to solve this issue, this study tried to track the movement of a pitched ball that might provide an easier prediction because of a clear focus and simple movement of the object. Machine learning has been leading the research of extracting information from continuous images such as object tracking. Though the rule-based methods in artificial intelligence prevailed for decades, it has evolved into the methods of statistical approach that finds the maximum a posterior location in the image. The development of machine learning, accompanied by the development of recording technology and computational power of computer, made it possible to extract the trajectory of pitched baseball from recorded images. We present a method of baseball tracking, based on object tracking methods in machine learning. We introduce three state-of-the-art researches regarding the object tracking and show how we can combine these researches to yield a novel engine that finds trajectory from continuous pitching images. The first research is about mean shift method which finds the mode of a supposed continuous distribution from a set of data. The second research is about the research that explains how we can find the mode and object region effectively when we are given the previous image's location of object and the region. The third is about the research of representing data into features that we can deal with. From those features, we can establish a distribution to generate a set of data for mean shift. In this paper, we combine three works to track baseball's location in the continuous image frames. From the information of locations from two sets of images, we can reconstruct the real 3-D trajectory of pitched ball. We show how this works in real pitching images.

A Case Report of an Immediate Frontal Sinus Reconstruction Using an Outer Table Calvarial Bone Graft in an En Bloc Manner (전두동 골절 환자에서 머리덮개뼈의 바깥판을 한판으로 이용한 즉시 전두동 재건술 1례)

  • Kim, Jong Do;Kim, Jeong Tae;Kim, Youn Hwan
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.33-36
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    • 2011
  • Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.

Microsatellite Markers for Non-Invasive Examination of Individual Identity, Genetic Variation, and Population Differentiation in Two Populations of Korean Long-Tailed Goral (Naemorhedus caudatus)

  • Kim, Baek-Jun
    • Proceedings of the National Institute of Ecology of the Republic of Korea
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    • v.3 no.4
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    • pp.191-198
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    • 2022
  • Natural habitats of the Korean long-tailed goral (Naemorhedus caudatus) have been fragmented by anthropogenic activities in South Korea in the last decades. Here, the individual identity, genetic variation, and population differentiation of the endangered species were examined via the multiple-tube approach using a non-invasive genotyping method. The average number of alleles was 3.16 alleles/locus for the total population. The Yanggu population (1.66) showed relatively lower average number of alleles than the Inje population (3.67). Of the total 19 alleles, only seven (36.8%) alleles were shared by the two populations. Using five polymorphic out of six loci, four and six different goral individuals from the captive Yanggu (n=24) and the wild Inje (n=28) population were identified, respectively. The allele distribution was not identical between the two populations (Fisher's exact test: P<0.01). A considerably low migration rate was detected between the two populations (no. of migrants after correction for size=0.294). Additionally, the F statistics results indicated significant population differentiation between them, however, quite low (FST=0.327, P<0.01). The posterior probabilities indicated that the two populations originated from a single panmictic population (P=0.959) and the assignment test results designated all individuals to both populations with nearly equal likelihood. These could be resulted from moderate population differentiation between the populations. No significant evidence supported recent population bottleneck in the total Korean goral population. This study could provide us with useful population genetic information for conservation and management of the endangered species.

The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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The retrospective study of survival rate of implants with maxillary sinus floor elevation (상악동 거상술을 동반한 상악구치부에 식립된 임플란트 생존율에 대한 후향적 연구)

  • Kim, Beom-Jin;Lee, Jae-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.108-118
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    • 2010
  • Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

Evaluation of Imaging Studies in Male Infants less than 3 Months after First Urinary Tract Infection (3개월 이하의 남아에서 첫 요로 감염 후 방사선학적 검사의 평가)

  • Jung Jong Su;Kwon Kyung Ho;Kim Jong Sik;Lee Young Ah;Kim Hyun Jung;Lee Gyun Woo
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.30-35
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    • 2001
  • Purpose : To evaluate tile frequency of urinary tract anomalies in male neonates less than 3 months old who presented with urinary tract infection(UTI) and to evaluate a appropriate imaging approach after first UTI. Materials and methods : During a period of 5 years from March 1994 to February 1999, 65 male infants less than 3months old(range: 4-92 days, mean: 43 days) with UTI were evaluated. Ultrasound(US) and Voiding cystourethrogram(VCUG) were done in 60 patients. Due to refusal and technological problem, 5 patients were missed. 99mTc-dimercaptosuccinic acid renal scan (99mTc-DMSA renal scan) was recommended to most patients but performed in 40 patients. Renal scan was performed at least 3 months later after urinary tract infection. Results : Urinary tract anomalies were found in 26 of 65 infants. Twenty-six had vesicoureteral reflux(VUR), two had both VUR and double ureter, two had both U and posterior urethral valve. In patients with VUR, eight had renal scar or renal atrophies. In case of renal scar or atrophy, grades of VUR were III or above. Conclusion : We suggest that US and VCUG should be routinely performed in infants(<3months)with first UTI. 99mTc-DMSA renal scan should be performed only when renal parenchymal damage was observed in US and VUR grade III or above in VCUG. (J. Korean Soc Pediatr Nephrol 5 : 30- 5, 2001)

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Anatomic Feasibility of Posterior Cervical Pedicle Screw Placement in Children : Computerized Tomographic Analysis of Children Under 10 Years Old

  • Lee, HoJin;Hong, Jae Taek;Kim, Il Sup;Kim, Moon Suk;Sung, Jae Hoon;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.475-481
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    • 2014
  • Objective : To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement. Methods : A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011. Results : For the C1 screw placement, entry point height (EPH) was the most restrictive factor (47.3% patients were larger than 3.5 mm). All C2 lamina had a height larger than 3.5 mm and 68.8% (51/74) of C2 lamina had a width thicker than 3.5 mm. For C2 pedicle width, 55.4% (41/74) of cases were larger than 3.5 mm, while 58.1% (43/74) of pedicle heights were larger than 3.5 mm. For pedicle width of subaxial spine, 75.7% (C3), 73% (C4), 82.4% (C5), 89.2% (C6), and 98.1% (C7, 1/54) were greater than 3.5 mm. Mean lamina width of subaxial cervical spine was 3.1 (C3), 2.7 (C4), 2.9 (C5), 3.8 (C6), and 4.0 mm (C7), respectively. Only 34.6% (127/370) of subaxial (C3-7) lamina thickness were greater than 3.5 mm. Mean length of lateral mass for the lateral mass screw placement was 9.28 (C3), 9.08 (C4), 8.81 (C5), 8.98 (C6), and 10.38 mm (C7). Conclusion : C1 lateral mass fixation could be limited by the morphometrics of lateral mass height. C2 translamina approach is preferable to C2 pedicle screw fixation. In subaxial spines, pedicle screw placement was preferable to trans-lamina screw placement, except at C7.

Burnt-out Metastatic Prostate Cancer

  • Shin, Dong Suk;Koo, Dong Hoe;Yoo, Suhyeon;Ju, Deok Yun;Jang, Cheol Min;Joo, Kwan Joong;Shin, Hyun Chul;Chae, Seoung Wan
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.116-119
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    • 2013
  • A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Full mouth rehabilitation with reorientation of occlusal plane using facial scan: a case report (교모 환자에서 안면 스캔을 활용하여 교합 평면을 재설정한 전악 보철 수복 증례)

  • Eun-Gyeong Kim;Sae-Eun Oh;Jee-Hwan Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.64-71
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    • 2024
  • The most critical aspect of full-arch prosthodontic treatment is evaluating whether the patient's vertical occlusal dimension is appropriate, and if necessary, restoring it through increasing vertical dimension. If the vertical occlusal dimension is too low, it can lead to reduced chewing efficiency, as well as not only aesthetic concerns but also potential issues like hyperactivity of muscles and posterior displacement of the mandible. This report is about the patient dissatisfied with pronunciation and aesthetics due to an inappropriate vertical occlusal dimension resulting from prior prosthetic interventions, underwent full-arch prosthodontic restoration treatment. Through the utilization of digital diagnostic apparatus, a comprehensive evaluation was undertaken for patient's vertical occlusal dimension, occlusal plane orientation, and the condition of prosthetic restorations. Through 3D facial scanning, the facial landmarks were discerned, and subsequently, the new occlusal plane was established. This provided the foundation for a digitally guided diagnostic wax-up. An elevation of 5 mm from the incisor was determined. Comprehensive dental rehabilitation was then executed for all remaining teeth, excluding the maxillary four incisors. The treatment protocol followed a systematic approach by initially creating implant-supported restorations on both sides of the dental arch to establish a stable occlusal contact. Subsequently, prosthetic restorations for the natural dentition were generated. Diagnostic and treatment planning were established through the utilization of facial scanning. This subsequently led to a reduction in treatment complexity and an expedited treatment timeline.