• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.2-20
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• 2020

MRI is a valuable imaging technique for the evaluation of intraarticular diseases. Accurate interpretation of joint MRI necessitates sound knowledge of anatomy. In the field of joint anatomy, in addition to the discovery of new structures, previously reported joint components of unexplained function are also detected. In this review, joint anatomy researched actively over the last decade is discussed. Joint components including the rotator cable and the superior capsule of the shoulder, posterolateral corner and the anterolateral ligament complex of the knee, and the distal tibiofibular syndesmosis of the ankle joint are introduced and correlated with their MRI features.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.75-80
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• 2023

The prevalence of aneurysm formation in adults with Moyamoya disease (MMD) is higher than that in the general population. The treatment strategy is often individualized based on the patient's disease characteristics. A 22-year-old man was diagnosed with MMD after presenting a small thalamic intracerebral and subarachnoid hemorrhage in the quadrigeminal cistern. Cerebral angiography revealed a small aneurysm (2.42 mm) in the left anterior choroidal artery. Since the hemodynamics in the left hemisphere was compromised, an indirect bypass surgery was performed. The patient's condition deteriorated postoperatively because of poor perfusion of the internal carotid artery, and massive hydration was required. During neurocritical care, the aneurysm increased in size (5.33 mm). An observation strategy was adopted because of the distal aneurysmal location and the high risk involved. Subsequently, the patient recovered, and newly developed collateral flow appeared from the external carotid artery. Additionally, a dramatic size reduction of the aneurysm (1.51 mm) was noticed. Our case suggests that MMD-related dissecting aneurysms on a distal cerebral artery, which present a high risk of embolization, could be managed by indirectly reducing the hemodynamic burden. Massive hydration in such cases should be avoided or balanced to avoid the risk of rapid growth and aneurysm rupture.

• The Journal of Advanced Prosthodontics
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• v.7 no.3
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• pp.240-248
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• 2015

PURPOSE. To explore whether there is matching relation between the length and the tilting angle of terminal implants in the All-on-Four protocol by studying the effects of different implant configurations on stress distributions of implant, bone, and framework. MATERIALS AND METHODS. Four implants were employed to support a full-arch fixed prosthesis and five three-dimensional finite element models were established with CT images, based on the length (S and L) and distal tilt angle ($0^{\circ}$, $30^{\circ}$ and $45^{\circ}$) of terminal implants for an edentulous mandible, which named: Tilt0-S, Tilt30-S, Tilt30-L, Tilt45-S and Tilt45-L. An oblique 240 N was loaded at second molar. The von Mises Stresses were analyzed. The implants were consecutively named #1 to #4 from the loading point. RESULTS. 1) Tilt0-S had the greatest stress on the implants, with the other groups exhibiting variable reductions; the four implants of Tilt45-L demonstrated the greatest reduction in stress. 2) Tilt0-S had the greatest stress at bone around #1 implant neck, and Tilt45-L exhibited the least stress, which was a 36.3% reduction compared to Tilt0-S. 3) The greatest stress in the framework was found on the cantilevers distal to #1 implant. Tilt45-S exhibited the least stress. CONCLUSION. Matching different length and tilting angle of the terminal implants led to variable stress reductions on implants, bone and the superstructure. By optimizing implant configuration, the reduction of stress on implants and surrounding bone could be maximized. Under the present condition, Tilt45-L was the preferred configuration. Further clinical testings are required.

• Korean Journal of Applied Biomechanics
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• v.31 no.1
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• pp.16-23
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• 2021

Objective: The purpose of the study was to compare the acceleration and shock attenuation (SA) of the runners with/without low back pain (LBG vs. NLBG) while running at 2.5 m/s, 3.0 m/s, 3.5 m/s and 4.0 m/s. Method: 15 adults without low back pain (age: 23.13±3.46 years, body weight: 70.13±8.94 kg, height: 176.79±3.68 cm, NLBG) and 7 adults with low back pain (age: 27.14±5.81 years, body weight: 73.10±10.74 kg, height: 176.41±3.13 cm, LBG) participated in this study. LBG was recruited through the VAS pain rating scale. All participants ran on an instrumented treadmill (Bertec, USA). Results: The LBG shows statistically greater vertical acceleration at the distal tibia during running at 3.5 m/s and 4.0 m/s and greater shock attenuation from the distal tibia to the head during running at 3.5 m/s compared with the NLBG during running (p<.05). As the speed increased, there was a statistically significant increase in vertical/resultant acceleration and shock attenuation for both groups. Conclusion: The findings indicated that the runners with low back pain (LBG) experience greater impact and shock attenuation compared with non-low back pain group (NLBG) during fast running. However, it is still inconclusive whether high impact on the lower extremity during running is the main cause of low back pain in the population. Thus, it is suggested that the study on low back pain should observe the characteristics of impact during running with individuals' low back pain experience and clinical symptoms.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.306-313
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• 2007

Objective : In permanent distal middle cerebral artery occlusion [pdMCAO] model of rats, the temporal order of subcellular translocation is not fully understood yet. We studied translocation sequence of cytochrome c and apoptosis inducing factor [AIF] after pdMCAO and patterns of expression. Methods : Twenty-one male rats - with ten minutes, 1, 4, 8, 24 and 48 hours of pdMCAO groups - were enrolled. At core and penumbra area of each cerebral cortex, Western blotting of cytochrome c and AIF were performed using cytosolic fractions and then compared with sham specimens. With 48 hours group, the expression of cytochrome c and AIF was examined with immunofluorescent staining. Results : Compared to sham, the cytosolic translocation of cytochrome c significantly increased at all time points [p<0.05]. As early as 10 min after onset of ischemia, it was increased significantly [p<0.01]. The cytosolic translocation of AIF showed gradual increase with the passage of time and significantly increased 8 hours after [p<0.05]. As late as 24 hours and 48 hours after onset of ischemia, there were increased most significantly [p<0.01]. At penumbra, both proteins failed to show significant increase at all time points. At 48 hours after ischemia, colocalization of cytochrome c and AIF were confirmed. Conclusion : Cytosolic translocation of cytochrome c peaks much earlier than that of AIF in pdMCAO model of rat. Caspase dependent apoptosis activates soon after ischemia and later, it can be reinforced by gradually increasing AIF in ischemic core.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.173-177
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• 2014

Purpose: The purpose of this study is to evaluate the characteristics of hallux valgus with severe hallux valgus angle (HVA) and moderate intermetatarsal angle (IMA) after proximal chevron osteotomy. Materials and Methods: Between January 2008 and December 2010, 41 patients (48 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic severe hallux valgus deformity ($HVA{\geq}40^{\circ}$). Patients were divided into two groups, group M (IMA< $18^{\circ}$) and group S ($IMA{\geq}18^{\circ}$). Mean age of patients was 55.7 years (34~70 years) in group M and 60.0 years (44~78 years) in group S. Mean duration of follow-up was 20.4 months (12~41 months) in group M and 18.5 months (12~35 months) in group S. Radiographic parameters, including HVA, IMA, sesamoid position, metatarsus adductus angle (MAA), and distal metatarsal articular angle (DMAA), were compared between groups. Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Recurrence rate at the last follow-up was compared between group M and group S. Results: Preoperative HVA and grade of sesamoid position did not differ between the groups. However, immediate postoperative HVA and grade of sesamoid position were significantly larger in group M. Preoperative MAA and DMAA were significantly larger in group M. No significant difference in AOFAS score and VAS was observed between the groups at the last follow-up. Ten of the 27 feet (37.0%) in group M and two of the 21 feet (9.5%) in group S showed hallux valgus recurrence at the last follow-up. Group M showed a significantly higher recurrence rate than group S. Conclusion: Recurrence rate for severe hallux valgus with moderate IMA is higher than that of severe hallux valgus with severe IMA.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.99-105
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• 2010

Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.17-22
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• 1999

Over 60 cases were enlisted, but only 31 cases among 24 patients were eligible with a minimum follow-up of 1 year and complete medical documents with imaging data. There were 18 boys and 6 girls, and 7 patients had bilateral lesions. The age of the patients ranged from 2 to 20 years(mean:10.5 years). At their first visit, most lesions had a highly characteristic location and radiographic appearance of radiolucent lesion(s) ranging from 1 to 3cm, except for one case of 5.5 cm in the posteromedial comer of distal femoral metaphysis. The margins were generally well-defined, although some were ill-defined. After reviewing our cases from the viewpoint of clinical course and radiographic patterns, we divided these lesions into two types. Type I is the osteolytic lesion excavated into the posteromedial aspect of the distal femur without cortical defect; and type II is the buldged out lesion of the femur with cortical irregularity into the surrounding soft tissues. Both types have distinctive clinical courses. Type I lesions were easy to make a definite diagnosis with plain radiographs alone, but in type II, it was sometimes very difficult to differentiate it from malignant tumors or chronic localized osteomyelitis. For this lesion, Gd-enhanced MRI was the most effective method for differential diagnosis. In this study, biopsy was not necessary to confirm the diagnosis. Clinical symptoms of type I were very minor or even absent. Many of them were accidentally found after minor trauma around the knee joint. Clinical symptoms disappeared far earlier than radiographical lesions. No treatment such as restriction of activity or drugs was necessary. For type II, the clinical symptoms were more accentuated and lasted longer, and it was necessary to restrict the activity for a certain period in many cases. However, all were self-limited.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.129-132
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• 2009

Purpose: We evaluated the result of operative treatment of the hallux valgus in male patients. Materails and Methods: Total 11 cases (10 patients) of the hallux valgus deformity that treated with operation were evaluated. Following Mann's radiological classification system, there was 1 cases of mild, 8 cases of moderate, and 2 cases of severe. Preoperative, postoperative, postoperative 3 months and postoperative 6 months follow up standing radiographs were used as radiologic evaluation. And we evaluated radiological outcomes by hallux valgus angle (HVA), first-second intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA) and clinical outcomes by hallux-metatarsophalangeal scale of American Orthopaedic Foot and Ankle Society (AOFAS) score. Result: Radiologically, the mean preoperative HVA $37^{\circ}$ and IMA $13.7^{\circ}$ were improved postoperatively as HVA $11.9^{\circ}$ and IMA $4.7^{\circ}$, and the mean preoperative DMMA $29.4^{\circ}$ and PPAA $8.6$ were improved postoperatively DMMA $13.9^{\circ}$ and PPAA $7^{\circ}$. But, postoperative 6 months follow up HVA, IMA, DMMA and PPAA was increased at $14.2^{\circ}$, $6.3^{\circ}$, $16.1^{\circ}$ and $8.3^{\circ}$. Average AOFAS score were improved from 61.2 points to 75.2 points. Conclusion: In our study, operative treatment of hallux valgus in male patients with proximal metatarsal osteotomy and distal soft tissue procedure showed good results but it was necessary to pay attention to increase aspect of follow up radiologic measurements.

• Journal of Plant Biotechnology
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• v.32 no.2
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• pp.135-138
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• 2005

Embryogenic callus was obtained from cotyledonary explants of Codonopsis lanceloata on Murashige & Skoog's medium supplemented with 1 mg/L 2,4-D. Suspension cultures of the embryogenic calli were grown on a shaker at 100 strokes/min, and then the calli were subcultured for 2 weeks in 2,4-D-free medium to produce somatic embryo. In somatic embryos at the globular stage, cotyledon initials began to differentiate themselves in the near distal end of the procambial strand. Dicotyledons, tricotyledon, tetracotyledon and fused cotyledon were differentiated from the distal ends of two, three, four and circular procambial strands, respectively. Nearly circular procambial strand in lower hypocotyls were independently differentiated into two, three, four procambial tissues at cotyledonary node and cotyledons to form somatic embryos with dicotyledon, tricotyledon, tetracotyledon. If the distal subepidermal cells of globular embryo exclusively became cotyledon initials, the torpedo or cotyledonary embryo was characterized by somatic embryos with fused cotyledon.