Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.5
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pp.391-399
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2004
Distraction osteogenesis has been thought to be promising technique for replacing bone graft in maxilla and mandible. The purpose of this study was to investigate the expression of osteonectin on distraction osteogenesis. Sixteen rabbits were used for this experiment. Osteotomy was performed between premolar and mental foramen. On the experimental group, distraction device was connected to the respective bone segments. On the control group, bone segments were fixed using plate and screws after osteotomy. Distraction was carried out at the rate of 0.7mm per day to obtain a 4.9mm elongation on the experimental group. After 3 days, 7 days, 14 days, and 28 days two rabbits of each group were sacrificed. The results obtained from this study were as follow : Experimental group was observed that the gaps between the distracted bone edges were occupied by new bone. Expression of Osteonectin were detected throughout the experiment in both groups and Expression of Osteonectin were markedly increased during distraction and consolidation period in experimental group than control group. From these results, it could be stated that distraction was shown to improve and accelerate bone formation and mechanical stress like distraction has considerable effects on osteonectin.
Objective : In order to develop a novel nerve guidance channel using porcine small intestinal submucosa (SIS) for nerve regeneration, we investigated the possibility of SIS, a tissue consisting of acellular collagen material without cellular immunogenicity, and containing many kinds of growth factors, as a natural material with a new bioactive functionality. Methods : Left sciatic nerves were cut 5 mm in length, in 14 Sprague-Dawley rats. Grafts between the cut nerve ends were performed with a silicone tube (Silicon group, n=7) and rolled porcine SIS (SIS group, n=7). All rats underwent a motor function test and an electromyography (EMG) study on 4 and 10 weeks after grafting. After last EMG studies, the grafts, including proximal and distal nerve segments, were retrieved for histological analysis. Results : Foot ulcers, due to hypesthesia, were fewer in SIS group than in Silicon group. The run time tests for motor function study were 2.67 seconds in Silicon group and 5.92 seconds in SIS group. Rats in SIS group showed a better EMG response for distal motor latency and amplitude than in Silicon group. Histologically, all grafts contained some axons and myelination. However, the number of axons and the degree of myelination were significantly higher in SIS group than Silicon group. Conclusion : These results show that the porcine SIS was an excellent option as a natural biomaterial for peripheral nerve regeneration since this material contains many kinds of nerve growth factors. Furthermore, it could be used as a biocompatible barrier covering neural tissue.
Objective : This study assessed the efficacy of anterior cervical discectomy and fusion (ACDF) with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. Methods : Patients with cervical degenerative disc disease from September 2004 to December 2009 were assessed retrospectively. A total of 42 patients received all ACDF at two-level cervical lesion. Twenty-two patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Clinical outcomes were assessed using Robinson's criteria and posterior neck pain, arm pain described by a 10 point-visual analog scale. Fusion rate, subsidence, kyphotic angle, instrument failure and the degenerative changes in adjacent segments were examined during each follow-up examination. Results : VAS was checked during each follow-up and Robinson's criteria were compared in both groups. Both groups showed no significant difference. Fusion rates were 90.9% (20/22) in ACDF with the cage alone group, 95% (19/20) in ACDF with the plate fixation group (p = 0.966). Subsidence rates of ACDF with cage alone were 31.81% (7/22) and ACDF with plate fixation were 30% (6/20) (p = 0.928). Local and regional kyphotic angle difference showed no significant difference. At the final follow-up, adjacent level disease developed in 4.54% (1/22) of ACDF with cage alone and 10% (2/20) of ACDF with plate fixation (p= 0.654). Conclusion : In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.
Kim, Ji Hoon;Lee, Chul Woo;Chun, Kwon Soo;Shin, Won Han;Bae, Hack-Gun;Chang, Jae Chil
Journal of Korean Neurosurgical Society
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v.52
no.4
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pp.384-390
/
2012
Objective : The objective of this study was to investigate the morphologic characteristics between the vertebral body and the regions of the cervical and thoracic spinal cords where each rootlets branch out. Methods : Sixteen adult cadavers (12 males and 4 females) with a mean age of 57.9 (range of 33 to 70 years old) were used in this study. The anatomical relationship between the exit points of the nerve roots from the posterior root entry zone at each spinal cord segment and their corresponding relevant vertebral bodies were also analyzed. Results : Vertical span of the posterior root entry zone between the upper and lower rootlet originating from each spinal segment ranged from 10-12 mm. The lengths of the rootlets from their point of origin at the spinal cord to their entrance into the intervertebral foramen were 5.9 mm at the third cervical nerve root and increased to 14.5 mm at the eighth cervical nerve root. At the lower segments of the nerve roots (T3 to T12), the posterior root entry zone of the relevant nerve roots had a corresponding anatomical relationship with the vertebral body that is two segments above. The posterior root entry zones of the sixth (94%) and seventh (81%) cervical nerve roots were located at a vertebral body a segment above from relevant segment. Conclusion : Through these investigations, a more accurate diagnosis, the establishment of a better therapeutic plan, and a decrease in surgical complications can be expected when pathologic lesions occur in the spinal cord or vertebral body.
Cantharidin is produced by blister beetles (Coleoptera: Meloidae) and smaller oedemerid beetles (Coleopetra: Oedemeridae) and is found in hemolymph and various tissues. The function of cantharidin in the courtship behaviour of meloids had never been fully established. Our studies show a correlation between density of cuticular pores and cantharidin titre of the scape and pedicel segments of male specimens of the East African species of Epicauta nyassensis (Haag-Rutenberg, 1880) (Coleoptera: Meloidae). Light microscopy of semi-thin cross sections of the male scape and pedicel indicates that there are many canal shaped structures that stretch from the antennal hemolymph to the antennomere surface. These structures may be tubules, which transport cantharidin circulating in the hemolymph to the surface, where the compound can be released via cuticular pore openings. Analyses of the head capsule and antennal segments of E. nyassensis females which had been copulated with males revealed low titre of cantharidin in the first two antennal segments. The density of the scape and pedicel pores of females was to some extent higher than the density of these pores on flagellum; however it was considerably lower than that of the males. Interestingly, no tubular cell or other transport structures were found in the cross sectioning of the female antennomeres or on the integument surface. During mating, male antennomeres, as well as cantharidin containing pores which are located on the $1^{st}\;and\;2^{nd}$ antennomeres, come into direct contact with the female antennae and may release cantharidin to their surface. Female E. nyassensis may be able to discriminate the opposite sex with abundant reserves of cantharidin prior to mating. This is another evidence that cantharidin function in close range sexual selection.
Objective : The authors retrospectively analyzed clinical and radiographic features of patients who developed symptomatic adjacent segment degeneration (ASD) that required re-operation. Methods : From 1995 to 2004, among 412 patients who underwent posterior lumbar fusion surgery, the authors experienced twenty-six patients who presented symptomatic ASD. Records of these patients were reviewed to collect clinical data at the first and second operations. Results : The patients were 9 males and 17 females whose mean age was $63.5{\pm}8.7$ years. Among 319 one segment and 102 multi-segment fusions, 16 and 10 patients presented ASD, respectively. Seventeen ASDs were noticed at the cephalad to fusion (65%), eight at the caudad (31%), and one at the cephalad and caudad, simultaneously (4%). All patients underwent decompression surgery. Nine patients underwent additional fusion surgeries to adjacent degenerated segments. In 17 patients who underwent only decompression surgery without fusion, the success rate was 82.4%. In fusion cases. the success rate was observed as 55.5%. There were no statistically significant factors to be related to development of ASD. However, in cases of multi-level fusion surgery, there was a tendency toward increasing ASD. Conclusion : Multi-segment fusion surgery could be associated with a development of ASD. In surgical treatment of symptomatic ASD, selective decompression without fusion may need to be considered as a primary procedure, which could reduce the potential risk of later occurrence of the other adjacent segment disease.
Heart Rate Variability (HRV) analysis is a convenient tool to assess Myocardial Ischemia (MI). The analysis methods of HRV can be divided into time domain and frequency domain analysis. This paper uses wavelet transform as frequency domain analysis in contrast to time domain analysis in short term HRV analysis. ST-T and normal episodes are collected from the European ST-T database and the MIT-BIH Normal Sinus Rhythm database, respectively. An episode can be divided into several segments, each of which is formed by 32 successive RR intervals. Eighteen HRV features are extracted from each segment by the time and frequency domain analysis. To diagnose MI, the Neural Network with Weighted Fuzzy Membership functions (NEWFM) is used with the extracted 18 features. The results show that the average accuracy from time and frequency domain features is 75.29% and 80.93%, respectively.
Purpose : To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. Materials and Methods : Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: $0.66{\times}0.66{\times}1.1$ or $1.2\;mm^3$), and CTA on 64-slice CT scanners (voxel dimension: $0.42{\times}0.42{\times}0.63\;mm^3$). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. Results: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n= 19) and intracranial (n = 15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity; specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1 % on CTA, with DSA as the standard of reference. Conclusion : Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.
Kim, Ju-Mi;WhangBo, Min;Kim, Joo-Young;Eum, Jong-Hyuk;Rhee, Ae-Ryon;Kim, Shin;Seo, Soo-Jeong
Journal of the korean academy of Pediatric Dentistry
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v.21
no.2
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pp.555-560
/
1994
Among the permanent teeth. the first permanent molars play the greatest role in occlusion and function. So, the congenital missing, abnormal reuption or abnormal formation of the first permanent molars in the course of arch development would inflict normal development of dental arches. Therefore, early detection of abnormal cases related to first permanent molars and understanding of current and predictable clinical problems are essential for proper occlusal guidance in children. With the aim of investigating the clinical patterns of delayed eruption of first permanent molars in children, panoramic tomograms of the childern in mixed and early permanent dentition were observed and analyzed. The results were as follows: 1. Among the delayed eruption of first permanent molars, on tooth or bilateral teeths were affected most frequently. Delayed eruption was more prevalent in maxilla than in mandible. 2. The formation of tardily erupted teeth were also delayed. 3. Delayed eruption was generally limited in first molars or molar segments. 4. Delayed eruption of first permanent molars is accompanied by abnormal position of tooth germs, for example, ectopic eruption, delayed dental age, delayed localized tooth formation and generalized congenital missing. 5. There was a tendency of delayed formation or congenital missing of second molars distal to tardily erupted 1st molars. And that was more marked in maxilla than in mandible. 6. There was reported that affected 1st molars show various size and shapes. Maxillary 1st molars showing delayed eruption showed a tendency of having 3 cusps. But, tardily erupted mandibular 1st molars showed no significant reduction in mesiodistal dimension, as reported. 7. In some cases, the delayed eruption of 1st permanent molars was associated with ectopic eruption, but their formation was not usually retarded. 8. In skeletal class III cases, there showed a tendency of mandibular 1st molars to erupt earlier than maxillary 1st molars with greater interval than in normal occlusion.
Authors investigated neuronal changes of local cellular metabolism in the cerebral lesions of Parkinsonian symptomatic side between before and after stereotactic neurosurgery by follow-up 1H magnetic resonance spectroscopy (MRS). Patients with Parkinson's disease (PD) (n = 15) and age-matched normal controls (n = 15) underwen MRS examinations using a stimulated echo acquisition mode (STEAM) pulse sequence that provided 2${\times}$2${\times}$2 ㎤ (8ml) volume of interest in the regions of substantia nigra, thalamus, and lentiform nucleus. Spectral parameters were 20 ms TE, 2000 ms TR, 128 averages,2500 Hz spectral width, and 2048 data points. Raw data were processed by the SAGE data analysis package (GE Medical Systems). Peak areas of N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho), inositols (Ins), and the sum (Glx) of glutamate and GABA were calculated by means of fitting the spectrum to a summation of Lorentzian curves using Marquardt algorithm. After blindly processed, we evaluated neuronal alterations of observable metabolite ratios between before and after stereotactic neurosurgery using Pearson product-moment analysis (SPSS, Ver. 6.0). A significant reduction of NAA/Cho ratio was observed in the cerebral lesion in substantia nigra of PD patient related to the symptomatic side after neurosurgery (P : 0.03). In thalamus, NAA/Cho ratio was also significantly decreased in the cerebral lesion including the electrode-surgical region (P : 0.03). A significant reduction of NAA/Cho ratio in lentiform nucleus was not oberved, but tended toward significant reduction after neurosurgery (P = 0.08). In particular, remarkable lactate signal was noted from the surgical thalamic lesions of 6 among 8 patients and internal segments of globus pallidus of 6 among 7 patients, respectively. Significant metabolic alterations of NAA/Cho ratio might reflect functional changes of neuropathological processes in the lesion of substantia nigra, thalamus, and lentiform nucleus, and could be a valuable finding fur evaluation of Parkinson's disease after neurosurgery. Increase of lactate signals, being remarkable in surgical lesions, could be consistent with a common consequence of neurosurgical necrosis. Thus, IH MRS could be a useful modality to evaluate the diagnostic and prognostic implications fur Parkinsons disease after functional neurosurgery.
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