• Journal of Oral Medicine and Pain
• /
• 제18권2호
• /
• pp.43-53
• /
• 1993

The aim of this study was to investigate the relationship between the presence or absence of anterior tooth contact and the changes in temporomandibular joint space. The study sample consisted of 32symptom-free dental students and 79 craniomandibular disorders patients with unilateral joint dysfunction. The two groups were categorized into control group or experimental group, respectively. Recordings of the number and distribution of occlusal contacts were made by T-Scan system. Transcranial radiographs were taken with using of accurad-100 head positioner. Measured items in transcranial radiographs were anterior, superior, posterior joint space and relative condylar position to deepest position of glenoid folla. According to the presence or absence of anterior tooth contact, each group was subdivided and compared with each other with respect to TM joint space. Data were processed and tested with SPSS/PC + package. The results of the study showed that the joint space in control group were wider than those of experimental group and the difference of the width of joint space was more remarkable in subjects with anterior contact between control group and experimental group. However, in same group whether the presence of anterior tooth contact could hardly affect the difference of the width of joint space. And anterior tooth contact in grouip are more frequent than in experimental group.

• Journal of Chest Surgery
• /
• 제50권6호
• /
• pp.448-452
• /
• 2017

Background: Proper monitoring of cerebral perfusion during carotid artery surgery is crucial for determining if a shunt is needed. We compared the safety and reliability of near-infrared spectroscopy (NIRS) w ith transcranial Doppler (TCD) for cerebral monitoring. Methods: This single-center, retrospective review was conducted on patients who underwent carotid endarterectomy (CEA) using selective shunt-based TCD or NIRS at Daegu Catholic University Medical Center from November 2009 to June 2016. Postoperative complications were the primary outcome, and the distribution of risk factors between the 2 groups was compared. Results: The medical records of 74 patients (45 TCD, 29 NIRS) were reviewed. The demographic characteristics were similar between the 2 groups. One TCD patient died within the 30-day postoperative period. Postoperative stroke (n=4, p=0.15) and neurologic complications (n=10, p=0.005) were only reported in the TCD group. Shunt usage was 44.4% and 10.3% in the TCD and NIRS groups, respectively (p=0.002). Conclusion: NIRS-based selective shunting during CEA seems to be safe and reliable for monitoring cerebral perfusion in terms of postoperative stroke and neurologic symptoms. It also reduces unnecessary shunt usage.

• Journal of Oral Medicine and Pain
• /
• 제23권1호
• /
• pp.45-55
• /
• 1998

The author assessed the sagittal relationships between glenoid fossa of the temporal bone and mandibular condyle from lateral transcranial views of 74 TMJ with disc displacement and 16 TMJ with normal disc-condyle complex by the magnetic resonance image findings. All the subjects were female and also in their 3rd decades. The disc displacement group was subdivided into anterior disc displacement with reduction (ADWR) group and anterior disc displacement without reduction (ADWOR) group. The anterior, superior, and posterior joint spaces as well as anterior/posterior (A/P) ratio of the space at the closed jaw position and vertical and horizontal components of the condyle position relative to the articular eminence at the open jaw position were measured from all the subjects and the data were compared among groups. The result were as follows : 1. The mean posterior joint space of ADWR group was smaller than ADWOR group, but there were no significant differences in anterior and superior joint spaces between two groups. 2. There showed a tendency of higher A/P ratio in ADWR group which meant the condyle of ADWR was likely to take posteriorly displaced position. 3. There were higher proportion of neutral condylar position in glenoid fossa in normal group, but higher proportion of posterior condylar position in ADWR group. 4. There were no significant differences in the degree of condyle-fossa concentricity among groups.

• 대한한방내과학회지
• /
• 제21권5호
• /
• pp.805-811
• /
• 2000

Objectives : To determine the effects on blood flow of vertebrobasal vascular system in cerebral infarction, Methods : We altered 33 normal patients and 12 patients who were diagnosed cerebral infarction on Rt. middle cerebral artery(MCA) region and 8 patients who were diagnosed cerebral infarction on Lt, MCA region, and measured the mean velocity, systolic to diastolic rate(SD rate), asymmetrical index(A/I) by TCD. Results : The mean velocity of posterior cerebral artery(PCA), vertebral artery was increased in same direction as infarcted site and the mean velocity of basal artery was more increased than control, and the SD rate of PCA, vertebral artery, basal artery was larger than control. The A/l of PCA, vertebral artery was revealed that mean velocity of vertebrobasal vascular system is increase the same direction as infarcted area. Conclusion : TCD examination within 7 days(acute stage) after stroke can help to predict the infarcted direction.

• Journal of Korean Neurosurgical Society
• /
• 제29권7호
• /
• pp.923-928
• /
• 2000

Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r＝-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.

• 대한한방내과학회지
• /
• 제31권3호
• /
• pp.612-619
• /
• 2010

Background : Low level laser therapy may be an effective method to protect tissue damage in acute stroke. Recently, series of clinical studies on the basis of animal experiments report efficacy and safety of laser therapy at early stages of acute stroke. Laser promotes mitochondrial ATP synthesis to reduce cell death by ischemic infarction. Objectives : To report possibility of non-invasive laser therapy for acute stroke by reviewing literature about its effectiveness, safety and mechanism. Methods : We searched papers using PubMed and 'Web of Knowledge' of Thomson ISI, using the keywords "Laser Therapy, Low-Level" and "Stroke". Limitations were last 10 years of publications and only in English. Search range includes RCTs, clinical reports, reviews and animal experiments. Papers not matched with inclusion criteria were excluded. Results : A total 223 studies were found, 203 excluded during title and extract screening. After scanning 20 papers the final 2 serial RCTs were selected and analyzed. They reported that transcranial laser therapy led in neuroprotective effect for acute stroke patents. Clinical evaluation factors showed favorable trend and initial safety. Conclusions : Non-invasive laser secured safety of clinical application. It may be a favorable choice for the acute stage of stroke.

• Journal of Korean Neurosurgical Society
• /
• 제57권1호
• /
• pp.54-57
• /
• 2015

A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx.

• Imaging Science in Dentistry
• /
• 제34권2호
• /
• pp.91-97
• /
• 2004

Purpose : This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. Materials and Methods: A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. Results: The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings: pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p < 0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Conclusion: Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

• 치과방사선
• /
• 제21권1호
• /
• pp.65-72
• /
• 1991

For the enhancement of a comprehension in temporomandibular joint radiographs, the author has compared and analysed the roentgenographic images of the temporomandibular joint of human dry skull which was taken by submentovertex projection, panoramic radiography, oblique lateral transcranial projection, corrected anterio-posterior tomogram and corrected lateral tomogram. The obtained results were as follows. 1. The submentovertex projection represented in detail the both poles and the posterior surface of the condylar head of the mandible. 2. The oblique lateral transcranial projection represented the articular space, the outer contour of the condylar head and the position of the condylar head within the mandibular fossa, but the relationship of the temporomandibular joint was not revealed accurate, because of the oblique direction of a central ray in taking radiographs. 3. The corrected antero-posterior tomogram was superior method in representation of roent- genographic images of the superior surface and the both poles of the condylar head and the corrected lateral tomogram was considered as the most accurate method among some radiographic techniques for the interpretation of articular space and condyle-fossa relationship. 4. It was possible to observe three-dimensionally the head of condyle with the combinated use of submentovertex projection, corrected antero-posterior tomogram and corrected lateral tomogram.

• 치과방사선
• /
• 제18권1호
• /
• pp.203-212
• /
• 1988

This study was designed to observe mandibular condyle shape and position in an asymptomatic popular ion. Using Accurad-200 head holder(Denar Corp.) for transcranial radiography of the temporo-mandibular joint region, transcranial radiographs were taken at the centric occlusion and 1 inch mouth opening in 73 males and females who were asymptomatic for TMJ disturbances, had no severe carious or missing teeth, and no history of prosthodontic or orthodontic treatments. Mandibular condyles were classified morphologically at the centric occlusion and evaluated in positional relationship with mandibular fossa and articular eminence at the centric occlusion and 1 inch mouth opening. The results were as follows: 1. In the morphologic classification of mandibular condyle, the convex shape was more prevalent in an asymptomatic population(90.4%), the locally concave shape and wedge shape were 5.5%, 4.1%. 2. At the centric occlusion, the means of joint space were 3.43nm superiorly, 2.17㎜ anteriorly, and 2.61㎜ posteriorly. 3. At the centric occlusion, the mandibular condyles were placed slightly anterior to the center of their fossa. 4. At the 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminence more than posterior to or below the top of the articular eminence.