Objective : In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels. Methods : Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan. Results : The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were $6.9{\pm}1.34\;mm$, $8.23{\pm}1.18\;mm$, $30.93{\pm}4.65\;mm$, $26.42{\pm}7.91$ degrees, $25.9{\pm}4.83$ degrees, and $10.6{\pm}3.39$ degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group. Conclusion : C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.
Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.
Background: The hamstring muscles in the lower extremity are highly important for knee joint stability and can be classified into medial and lateral hamstrings according to the anatomical position, which have some different functions. To measure the strength of the individual hamstring muscles, manual muscle testing is clinically performed by dividing rotation postures into internal and external postures. However, this has no sufficient scientific background. Objects: This study aimed to test the difference that the tibial rotation would cause in the muscle activity of the medial and lateral hamstrings. Methods: The muscle activities of the biceps femoris, semitendinosus, and semimembranosus were measured in a total of three different postures (neutral position and internal and external rotations) with 3 replications. During the maximal isometric contraction, resistance was constantly provided by the string attached to the strap, not by manual resistance of the examiner. Before and after electromyography measurements, the participants underwent hamstring flexibility measurement using the active knee extension test in the supine position on the treatment table. Results: The semitendinosus had a 12.56% reduction in muscle activity in external rotation as compared with that in neutral position. The biceps femoris and semimembranosus showed reduced muscle activities in both external and internal rotations as compared with those in neutral position. Only the women showed significant decreases in the comparison between pre and post-active knee extension. Conclusion: Only the semitendinosus muscle was consistent with the anatomical speculation. However, the reduction in the muscle activity of the semitendinosus as compared with that in neutral position was only 12.56%, the clinical value of which may be difficult to justify.
Kwon, Jieun;Kim, Yeun Ho;Yeom, Tae Sung;Oh, Joo Han
Clinics in Shoulder and Elbow
/
v.18
no.1
/
pp.36-42
/
2015
Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.
Habib, Syed Rashid;Asiri, Waleed;Hefne, Mohammed Jameel
The Journal of Advanced Prosthodontics
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v.6
no.6
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pp.444-450
/
2014
PURPOSE. To compare the accuracy of marginal and internal adaptation of zirconia (Zr) copings fabricated on anatomic (A), semi-anatomic (SA) and non-anatomic (NA) occlusal surface preparations. MATERIALS AND METHODS. 45 extracted bicuspid teeth were prepared for receiving zirconia crowns, with different occlusal preparation designs A=15, SA=15 & NA=15. The Zr copings were fabricated by using CAD4DENT, CAD/CAM. The copings were adjusted, cemented and were cross sectioned centrally from buccal cusp tip to lingual cusp tip into mesial and distal halves. The copings were examined under electron microscope at ${\times}200$ magnification and the measurements were recorded at 9 predetermined areas in micrometers. RESULTS. Overall mean gap values for the three groups was found to be $155.93{\pm}33.98{\mu}m$ with Anatomical Occlusal preparation design having the least gap value of $139.23{\pm}30.85{\mu}m$ showing the best adaptation among the groups. Post Hoc Tukey's test showed a statistically significant difference (P=.007) between the means of gap for A & NA preparation designs. Measurements recorded at 9 predetermined points showed variations for the three groups. CONCLUSION. Anatomical occlusal preparation designs resulted in better marginal and internal adaptation of Zr copings. There is a considerable variation between the measured marginal and internal gap values for the Zr copings fabricated by the (CAD4DENT-CAD/CAM). This variation may be associated with the lack of standardization of the preparation of teeth, computerized designing of the coping for each tooth, cement used, uniform pressure application during the cementation of the copings, sectioning of the copings and the microscopic measurements.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.15
no.1
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pp.75-83
/
1985
Bitewing and periapical radiographic techniques are used in clinical and epidemiological studies to assess crestal alveolar bone levels. The purpose of the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. Bitewing and periapical radiographs were available from posterior quadrants of 120 subjects. The distance from cemento-enamel junction to the alveolar crest (CEJ -CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows; 1. In maxilla, a significant t ratio with a P value of 0.05 or less was reached for 78% and in mandible reached for 39%. 2. Pearson correlations were calculated 32 surfaces (89%) had values below 0.70 and so, data obtained by these techniques can not be used interchangeably on an individual or group basis. 3. In situations where the periapical measure was greater than the bitewing, it ranged up to 20.7% greater with a mean 9.8%. Where the bitewing was greater than periapical, it ranged up to 51. 9% greater, with a mean 18.2%. 4. The percentage difference was greater in maxillary posterior areas than in mandibular molar, premolar areas. A lower prevalence of significant differences was attributed to relatively more simple root and favorable radiographic conditions in mandibular molar and premolar areas. 5. The anatomical limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 6. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used.
Purpose: To analyze the maxillary sinus anatomy over edentulous ridges in the bilateral posterior maxillary area in Taiwanese patients using cone-beam computed tomography (CBCT). Methods: In total, 101 anatomical sites from 61 patients, including 32 premolar and 69 molar regions, were analyzed using CBCT. Measurements were made of the width and height of edentulous ridges, the thickness of the lateral wall of the maxillary sinus, and the presence of a sinus septum and the posterior superior alveolar artery (PSAA). A statistical analysis of the measurements was performed, and correlations among the measurements were assessed. Results: The average ridge width was $10.26{\pm}3.16mm$, with a significantly greater ridge width in the second molar region than in the premolar region. The mean residual ridge height was $8.55{\pm}4.09mm$, and ridge height showed an opposite trend from ridge width for the premolar and molar regions. A sinus septum was present at 5.9% of the sites, and the PSAA was observed in 24.5%. The average thickness of the lateral wall of the maxillary sinus was $2.08{\pm}0.94mm$, with no significant difference between the tooth position and lateral wall thickness. Conclusions: This study presents the anatomical features of the maxillary sinus, which should be considered in sinus lift procedures for implant placement, in the Taiwanese population. The use of CBCT is recommended to avoid intraoperative complications.
Peng-Bo Zhu;Yeon-Dong Kim;Ha Yeong Jeong;Miyoung Yang;Hyung-Sun Won
The Korean Journal of Pain
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v.36
no.4
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pp.465-472
/
2023
Background: Percutaneous radiofrequency thermocoagulation (RFTC) has been widely utilized in the management of trigeminal neuralgia. Despite using image guidance, accurate needle positioning into the target area still remains a critical element for achieving a successful outcome. This study was performed to precisely clarify the anatomical information required to ensure that the electrode tip is placed on the sensory component of the mandibular nerve (MN) at the foramen ovale (FO) level. Methods: The study used 50 hemi-half heads from 26 South Korean adult cadavers. Results: The cross-sectioned anterior and posterior divisions of the MN at the FO level could be distinguished based on an irregular boundary and color difference. The anterior division was clearly brighter than the posterior one. The anterior division of the MN at the FO level was located at the whole anterior (38.0%), anteromedial (6.0%), anterior center (8.0%), and anterolateral (22.0%) parts. The posterior division was often located at the whole posterior or posterolateral parts of the MN at the FO level. The anterior divisions covered the whole MN except for the medial half of the posterolateral part in the overwrapped images of the cross-sectional areas of the MN at the FO level. The cross-sectional areas of the anterior divisions were similar in males and females, whereas those of the posterior divisions were significantly larger in males (P = 0.004). Conclusions: The obtained anatomical information is expected to help physicians reduce unwanted side effects after percutaneous RFTC within the FO for the MN.
Anterior talofibular ligament (ATFL) injuries are the most common cause of ankle sprains. To ensure anatomically accurate surgery and ultrasound imaging of the ATFL, anatomical knowledge of the bony landmarks around the ATFL attachment to the distal fibula is required. The purpose of the present study was to anatomically investigate the ATFL attachment to the fibula with respect to bone morphology and attachment structures. First, we analyzed 36 feet using micro-computed tomography. After excluding 9 feet for deformities, the remaining 27 feet were used for chemically debrided bone analysis and macroscopic and histological observations. Ten feet of living specimens were observed using ultrasonography. We found that a bony ridge was present at the boundary between the attachments of the ATFL and calcaneofibular ligament (CFL) to the fibula. These two attachments could be distinguished based on a difference in fiber orientation. Histologically, the ATFL was attached to the anterodistal part of the fibula via fibrocartilage anterior to the bony ridge indicating the border with the CFL attachment. Using ultrasonography in living specimens, the bony ridge and hyperechoic fibrillar pattern of the ATFL could be visualized. We established that the bony ridge corresponded to the posterior margin of the ATFL attachment itself. The ridge was obvious, and the superior fibers of the ATFL have directly attached anteriorly to it. This bony ridge could become a valuable and easy-to-use landmark for ultrasound imaging of the ATFL attachment if combined with the identification of the fibrillar pattern of the ATFL.
An experiment was conducted to observe the 5% CCFZ solution penetration depth through ray parenchyma and ray tracheid of Larix kapempferi. Moisture content was adjusted 28% for both sapwood and heartwood. Even though the moisture content was same, heartwood was 1.3 times less permeable than sapwood and the difference was found statistically significant. Due to anatomical differences between ray parenchyma and ray tracheid, ray parenchyma was about 1.3 times more permeable than ray tracheid. Penetration speed was high initially and it decreased rapidly in course of time.
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