• Title/Summary/Keyword: Proximal surface

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Multi-dimentional Correction of the Scarf Osteotomy for the Treatment of Hallux Valgus (무지 외반증에 시행한 Scarf 절골술의 3차원적 변형 교정력에 관한 연구)

  • Moon, Gi-Hyuk;Ahn, Gil-Yeong;Yun, Ho-Hyun;Lee, Yeong-Hyun;Lee, Jung-Ick;Nam, Il-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.23-27
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    • 2007
  • Purpose: Scarf osteotomy can provide the simultaneous correction of the hallux valgus angle (HVA), 1-2 intermetatarsal angle ($IMA_{1-2}$), DMAA and the plantar displacement of the fragment. The study was conducted to understand the multi-dimensional correction of the hallux valgus. Materials and Methods: Fourty eight patients who had undergone Scarf osteotomy with hallux valgus at more than $30^{\circ}$ of HVA and more than $15^{\circ}$ of $IMA_{1-2}$ were studied. Before an osteotomy, a reference K-wire was inserted to the 1st metatarsal head. After the osteotomy, the plantar fragment was moved laterally and the proximal end of the fragment was forced beyond the distal end which resulted in an internal rotation of the head fragment to correct the DMAA. Results: The HVA improved an average of $33.3^{\circ}$ to $7.7^{\circ}$ with the IMA1-2 respectively from $15.4^{\circ}$ to $6.5^{\circ}$. The DMAA improved an average of $19.5^{\circ}$ ($5.2-30.9^{\circ}$) to $4.5^{\circ}$ ($0.4-13.8^{\circ}$). By checking the angle, which was at an average of $25^{\circ}$ between the plantar surface of the foot and the osteotomy plane, the average distance of 1.9 mm (1.18-3.1 mm) of plantar displacement was measured using the value of sine (sin 25 = 0.422). Conclusions: It is possible to correct the HVA, IMA1-2 and DMAA simultaneously with one osteotomy making the lateral shift, the internal rotation and the plantar displacement of the plantar head fragment as desired. Despite the technicality and difficulty of the Scarf osteotomy, once familiarized through myriad procedures, all disadvantages are outweighed by the success and satisfaction of both patient and surgeon.

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Stress Analysis on the Splinted Conditions of the Two Implant Crowns with the Different Vertical Bone Level (치조골 높이가 다른 2개 임플란트 금관의 고정연결 조건에 따른 응력분석)

  • Jeon, Chang-Sik;Jeong, Sin-Young;Kang, Dong-Wan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.21 no.2
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    • pp.169-182
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    • 2005
  • The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.

Comparison of Muscle Activity During a Push-up on a Suspension Sling and a Fixed Support (슬링(sling)과 고정된 지지면에서의 팔굽혀펴기 동작 시 근 활성도 비교)

  • Oh, Jae-Seop;Park, Jun-Sang;Kim, Suhn-Yeop;Kwon, Oh-Yun
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.29-40
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    • 2003
  • The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.

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Foot Reconstruction by Reverse Island Medial Plantar Flap Based on the Lateral Plantar Vessel

  • Moon, Min-Cheol;Oh, Suk-Joon;Cha, Jeong-Ho;Kim, Yoo-Jeong;Koh, Sung-Hoon
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.137-142
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    • 2010
  • Purpose: Tumor ablation and traumatic intractable ulceration of the plantar surface of the foot results in skin and soft tissue defects of the weight-bearing sole. Simple skin grafting is not sufficient for reconstruction of the weight-bearing areas. Instead, the island medial plantar flap (instep flap) and distally-based island medial plantar flap was used for proper reconstruction of the weight bearing area. However, there are some disadvantages. In particular, an island medial plantar flap has a short pedicle limiting the mobility of the flap and the distally-based island medial plantar flap is based on a very small vessel. We investigated whether good results could be obtained using a reverse island medial plantar flap based on the lateral plantar vessel as a solution to the above limitations. Methods: Three patients with malignant melanoma were cared for in our tertiary hospital. The tumors involved the lateral forefoot, the postero-lateral heel, and the medial forefoot area. We designed and harvested the flap from the medial plantar area, dissected the lateral and medial plantar artery and vena comitans, and clamped and cut the vessel 1 cm proximal to the branch from the posterior tibial artery and vena comitans. The medial plantar nerve fascicles of these flaps anastomosed to the sural nerve, the 5th interdigital nerve, and the 1st interdigital nerve of each lesion. The donor sites were covered with skin grafting. Results: The mean age of the 3 subjects was 64.7 years (range, 57 - 70 years). Histologically, all cases were lentiginous malignant melanomas. The average size of the lesion was $5.3\;cm^2$. The average size of the flap was $33.1\;cm^2$. The flap color and circulation were intact during the early postoperative period. There was no evidence of flap necrosis, hematomas or infection. All patients had a normal gait after the surgery. Sensory return progressively improved. Conclusion: Use of an island medial plantar flap based on the lateral plantar vessel to the variable weight-bearing sole is a simple but useful procedure for the reconstruction of any difficult lesion of the weight-bearing sole.

Holocene Glaciomarine Sedimentation and Its Paleoclimatic Implication on the Svalbard Fjord in the Arctic Sea (북극해 스발바드 군도 피오르드에서 일어난 홀로세의 빙해양 퇴적작용과 고기후적 의미)

  • Yoon, Ho-Il;Kim, Yea-Dong;Yoo, Kyu-Cheul;Lee, Jae-Il;Nam, Seung-Il
    • Ocean and Polar Research
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    • v.28 no.1
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    • pp.1-12
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    • 2006
  • Analyses of sedimentological and geochemical parameters from two radiocarbon-dated sediment cores (JM98-845-PC and JM98-818-PC) retrieved from the central part of Isfjorden, Svalbard, in the Arctic Sea, reveal detailed paleoclimatic and paleoceanographic histories over the last 15,000 radiocarbon years. The overconsolidated diamicton at the base of core JM98-845-PC is supposed to be a basal till deposited beneath pounding glacier that had advanced during the LGM (Last Glacial Maximum). Deglaciation of the fjord commenced after the glacial maximum, marked by the deposition of interlaminated sand and mud in the ice-proximal zone by subglacial meltwater discharge, and prevailed between 13,700 and 10,800 yr B.P. with enriched-terrigenous organic materials. A return to colder conditions occurred at around 10,800 yr B.P. with a drop in TOC content, which is probably coincident with the Younger Dryas event in the North Atlantic region. At this time, an abrupt decrease of TOC content as well as an increase in C/N ratio suggests enhanced terrigenous input due to the glacial readvance. A climatic optimum is recognized between 8,395 and 2,442 yr B.P., coinciding with 'a mid-Holocene climatic optimum' in Northern Hemisphere sites (e.g., the Laurentide Ice sheet). During this time, as the sea ice receded from the fjord, enhanced primary productivity occurred in open marine conditions, resulting in the deposition of organic-enriched pebbly mud with evidence of TOC maxima and C/N ratio minima in sediments. Fast ice also disappeared from the coast, providing the maximum of IRD (ice-rafted debris) input. Around 2,442 yr B.p. (the onset of Neoglacial), pebbly mud, characterized by a decrease in TOC content, reflects the formation of more extensive sea ice and fast ice, which might cause decreased primary productivity in the surface water, as evidenced by a decrease in TOC content. Our results provide evidence of climatic change on the Svalbard fjords that helps to refine the existence and timing of late Pleistocene and Holocene millennial-scale climatic events in the Northern Hemisphere.

Expression of TRPV1 and iNOS in the Dorsal Root Ganglion Exposed by Autologous Nucleus Pulposus in the Rat

  • Kim, Su-Jeong;Seo, Jeong-Min;Cho, Yun-Woo;Park, Hea-Woon;Lee, Joon-Ha;Hwang, Se-Jin;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.71-77
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    • 2010
  • Purpose: To determine whether upregulation of inducible nitric oxide synthase (iNOS) transcription and translation is related to radicular pain in a model of lumbar disc herniation. Also, to investigate the temporal changes of mRNA expression of iNOS and the identity of iNOS and transient receptor potential vanilloid (TRPV) 1 channel expression cells in dorsal root ganglion (DRG) of a model of lumbar disc herniation. Methods: A lumbar disc herniated rat model was developed by implantation of the autologous nucleus pulposus, harvested from the coccygeal vertebra of each tail, on the left L5 nerve root just proximal to the DRG. Rats were tested for mechanical allodynia of the plantar surface of both hind paws 2 days before surgery and 1, 5, 10, 20 and 30 days postoperatively. Reverse transcription polymerase chain reaction (RT-PCR) was used to follow iNOS mRNA expression. To stain iNOS and TRPV1 in DRG, an immunohistochemical study was done 10 days after surgery. Results: A significant drop in mechanical withdrawal threshold on the ipsilateral and contralateral hind paws was observed 1 day after surgery and was prolonged to 30 days in rats with lumbar disc herniation. The expression of mRNA for iNOS peaked at postoperative day 10 on both sides of the DRG. iNOS-positive sensory neurons in the DRG varied in size from large to small diameter cells. A majority of small and intermediate sensory neurons were TRPV1-positive cells. Double immunofluorescence staining for TRPV1 and iNOS revealed that most intermediate TRPV1-positive sensory neurons co-localized with iNOS-positive neurons. Conclusion: Nucleus pulposus-induced mechanical allodynia can be generated without mechanical compression. This pain is related to temporal changes in expression of iNOS mRNA in the DRG. Co-localization of TRPV1 and iNOS in intermediate neurons of the DRG is correlated with pain modality and intensity.

Ultrastructure of Spermatozoa in the Catfish, Silurus asotus (메기, Silurus asotus 정자의 미세구조)

  • Kwon, Ae-Sook;Kim, Kgu-Hwan;Lee, Young-Hwan
    • Development and Reproduction
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    • v.2 no.1
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    • pp.75-80
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    • 1998
  • 메기 정자는 그 길이가 약 62.5 \mu m이며 구형의 핵, 짧은 중편 및 꼬리를 ㄱ진 일반적인 메기류 정자의 미세구조적 특징을 나타내었다. 정자는 대부분의 경골어류의 정자에서와 같이 첨체를 가지고 있지 않았으며 염색질은 완전치 농축되어 있었다. 핵와(nuclear fossa)는 약 0.6 \mu m 함입되어 있었고 그 속에 기부 중심립과 말단 중심립의 일부가 포함되어 있었다. 두 중심립은 140 \circ C의 각도로 배열되어 있었으며 말단 중심립에서 9개의 부수체가 언형질막을 향하여 배열되어 있었다. 미토콘드리아는 중편 세포질에서 2층 또는 3층으로 배열되어 있었으며 핵의 후반부와 꼬리의 기부를 둘러싸고 있었다. 꼬리는 축사만으로 구성되어 있었으며 lateral fins는 관찰되지 않았다. 메기 정자의 가장 큰 구조적 특징은 중편 세포질에 구성되어 있는 관구조(tubular structure)이었다. 대부분의 경골어류의 정자는 중편 세포질에 미토콘드리아만을 포함하고 있으나, 메기 정자에서는 중편 세포질의 전반부에 미토콘드리아가 포함되어 있고, 후반부에는 소관이 모여 망상구조를 형성하는 관구조가 잘 발달되어 있었다. 이와 같은 관구조는 현재까지 Characiformes의 정자 이외의 다른 경골어류에서는 보고된 바 없으며 이러한 구조는Characiformes과 메기류의 계통학적 관계를 연구하는데 매우 중요한 형질로 여겨진다. ^u The spermatozoa of Silurus asotus are appoximately 62.5 \mu m in length and relatively simple cells composed of spherical head, a short midpiece and a tail as in most Siluriformes. The ultrastructure of the spermatozoa of S. asotus is characterized by the following features. The nucleus measuring about 1.5 \mu m in length is depressed with a deep nuclear fossa of about 0.6 \mu m in length, two fifth of the nuclear diameter. The fossa contains the proximal centriole and the half of the distal centriole. Two centrioles form an angle of approximately 140 \circ to each other. the nine satellite rays radiate from the outer surface of the distal centriole. the mitochondrea surround the basal nucleus and the axoneme, and are arranged in two or three layers in the postnuclear cytoplasm. The lateral fins are lost in the sperm tail. The most significant feature is manifested in the midpiece. The midpece comprises two parts, the mitochondria and the tubular structure unlike other teleost fishes containing only the mitochondria. The tubular structure was reported only in the spermatozoa of Citharinus belonging to the characiformes of teleost fishes. Thus it is considered to be a good characteristics for the study of phylogenetic link between Siluriformes and Characiformes.

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Regional Difference in Distribution of Glycoconjugates in Mouse Epididymis (생쥐 부정소 부위별 당쇄 분포의 차이)

  • 계명찬
    • Development and Reproduction
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    • v.5 no.2
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    • pp.167-173
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    • 2001
  • To characterize the difference in glycoconjugates of mouse epididymis, lectin labeling of the tissue section was conducted using Ulex europaeus agglutinin I(UEA I), succinylated wheat germ agglutinin(sWGA), and Griffonia simplicifolia lectin-I(GSL-I). UEA I which binds to outer $\alpha$-L-fucose residue that is a terminal sugar of the side chain branched from oligosaccharide chain gave the labeling in the proximal caput epithelia exclusively. Lumen was commonly labeled in all of the organ. It suggested that the glycoconjugates bearing outer $\alpha$ -L-fucose residue were largely expressed in the initial segments ot epididymis and subjected to secretion. GSL-I which binds to terminal $\alpha$ -D-galactosyl residue of glycoconjugates gave the labeling in the cytoplasm of clear cells and basal cells, and cilia in corpus and cauda regions but not in the caput region. There was no vast difference in labeling pattern by sWGA which binds to N-acetyl-glucosamine residue among the epididymal regions. Clear cells in corpus and cauda epithelia showed more intense labeling by sWGA compared to principal cells, suggesting the functional specialization of this type of cells. The labeling intensities of luminal content by UEA I and sWGA decreased in cauda region compared to corpus region suggesting the presence of enzymatic activities responsible for processing the $\alpha$-L-fucose and N-acetyl-glucosamine residues from secreted glycoconjugates. In summary, the difference in glycoconjugates bearing the $\alpha$-L-fucose, $\alpha$-D-galactose, and N-acetyl-glucosamine residues according to the type of epithelial cells and epididymal segments suggests functional specialization and different roles of each segment in the processing of sperm surface antigens during the epididymal transit.

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Fracture strength of zirconia ceramic crowns according to tooth position (치아 부위에 따른 지르코니아 도재관의 파절강도)

  • Lee, In-Seob;Kim, Jeong-Mi;Dong, Jin-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.2
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    • pp.94-100
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    • 2010
  • Purpose: The purpose of this study was to compare the fracture strength of the zirconia ceramic crowns according to tooth position. Material and methods: After 10 metal dies were made for each group, the zirconia ceramic crowns were fabricated using CAD/CAM system ($Lava^{TM}$ All-Ceramic System) and each crown was cemented on each metal die with resin cement (Rely $X^{TM}$ Unicem). The cemented zirconia ceramic crowns mounted on the testing jig were inclined with 30 degrees to the long axis of the tooth and the universal testing machine was used to measure the fracture strength. Results: 1. The fracture strength of the zirconia ceramic crown in the lower 1st molar (2963 N) had the highest and that in the lower central incisor (1035 N) had the lowest. 2. The fracture strength of zirconia ceramic crown was higher than that of the IPS Empress crowns in all tooth position. 3. The fracture mode of the crowns was similar. Most of fracture lines began at the loading area and extended through proximal surface perpendicular to the long axis of the crowns. 4. There were no significant differences on the fracture strength of the zirconia ceramic crowns according to tooth position except in premolar group. Conclusion: Within the limitations of this study, the results suggested that strength of zirconia ceramic crown is satisfactory for clinical use.

ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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