• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.14-29
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• 2006

Developments in computer technology have made possible the 3-dimensional (3-D) evaluation of hard and soft tissues in orthodontic diagnosis, treatment planning and post-treatment results. In this study, Korean adults with normal occlusion (male 30, female 30) were scanned by a 3-D laser scanner, then 3-D facial images formed by the Rapidform 2004 program (Inus Technology Inc., Seoul, Korea.). Reference planes in the facial soft tissue 3-D images were established and a 3-D coordinate system (X axis-left/right, Y axis-superior/inferior, Z axis-anterior/posterior) was established by using the soft tissue nasion as the zero point. Twenty-nine measurement points were established on the 3-D image and 43 linear measurements, 8 angular measurements, 29 linear distance ratios were obtained. The results are as follows; there were significant differences between males and females in the nasofrontal angle $(male:\;142^{\circ},\;female:\;147^{\circ})$ and transverse nasal prominence $(male:\;112^{\circ},\;female:\;116^{\circ})$ (p<0.05). The transverse upper lip prominence was $107^{\circ}$ in males, $106^{\circ}$ in females and the transverse mandibular prominence was $76^{\circ}$ in both males and females. Li-Me' was 0.4 times the length of Go-Me'(mandibular body length) and the mouth height was also 0.4 times the width of the mouth width. The linear distance ratio from the coronal reference plane of FT, Zy, Pn, ULPm, Li, Me' was -1/-1/1/0.5/0.5/-0.6 respectively. The 3-D facial model of Korean adults with normal occlusion were be constructed using coordinate values and linear measurement values. These data may be used as a reference in 3-D diagnosis and treatment planning for malocclusion and dentofacial deformity patients and applied for 3-D analysis of facial soft tissue changes before and after orthodontic treatment and orthognathic surgery.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.238-244
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• 2003

Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.85-97
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• 1998

The purpose of this study was to observe the effects of sodium fluoride on the bony repair and regeneration processes after the rapid palatal expansion in the growing dogs. Eighteen dogs were divided into experimental and control groups. They were in the late mixed dentition. The rapid Palatal expansion was undertaken in all the animals($180^{\circ}$ turn/day) for ten days. The animals were sacrificed on 0, 15 and 45 days after the finish of expansion. One mg NaF/kg of body weight/day were given orally to the experimental group. Blood samples were drawn before and after expansion and the se겨m calcium, phosphate and alkaline phosphatase level were measured. The undecalcified bone section of midpalatal suture area was made, and observed under the light microscopy The results were as follows ; 1. The day after expansion, the infiltration of inflammatory cells were prominent and the new bone formation started at the edges of the two palatal plates bodering the midpalatal suture in both groups. Especially, the newly formed osteoid were very extensive and the osteoblasts lining the osteoid were very active in the experimental group. 2. At fifteen days after expansion, the active osteoblasts lining the osteold at the surface of trabecular bony spicules and active new bone formation were observed in the both groups. However, the cellular activity and new bone formation were more prominent In the experimental group. 3. At forty five days after expansion, the continuous osteoid and new bone formation and active osteoblasts were observed in the experimental group. But these phenomena were not observed in the control group. In the control group, the numerous osteoclasts were adjacent midpalatal suture and the bony remodeling process was begun. The serum alkaline phosphatase level was maintained highly in the experimental group, but decreased in the control. According to the above results, the author reached the conclusion that sodium fluoride has the stimulation effects on the osteoid production of the osteoblasts during the healing process after the rapid Palatal expansion more continuously.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.28-37
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• 2017

Mineral trioxide aggregate have been used for many years as a pulp therapy material. The most widely used product, Proroot white $MTA^{(R)}$ has a major drawback that it causes tooth discoloration. This study assessed discoloration of crown when various MTA-based materials were placed in the coronal aspect of the root canal. Seventy-five single-rooted, unrestored premolar teeth were selected. The teeth were randomly assigned to four experimental groups, each of $Biodentine^{(R)}$, Proroot $wMTA^{(R)}$, $Endocem^{(R)}$, $RetroMTA^{(R)}$ and one negative control groups. Color measurements were utilized by the Commission International de I'Eclairage's L*a*b* system with spectrophotometer. The color was assessed eight times : initial, 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after the placement. Statistical analysis was performed using the 2-way repeated analysis of variance and Bonferroni's method with p < 0.05. Proroot $wMTA^{(R)}$ induced significant decreases in $L^*$ values during experiment period. Tooth samples from the $Endocem^{(R)}$ group presented indistinct grayish color changes. The $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ showed color stability. Consequently, while Proroot $wMTA^{(R)}$ and $Endocem^{(R)}$ that contain bismuth oxide as a radiopacifier showed tooth discoloration, displayed no sign of discoloration $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ that contain zirconium oxide as a radiopacifier.

• Investigative Magnetic Resonance Imaging
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• v.3 no.1
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• pp.66-72
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• 1999

Purpose : To evaluate the usefulness of Dual Echo in Steady State(DESS) image in the diagnosis of chondromalacia of the knee compared with turbo spin-echo MR images Materials and Methods : We included 26 patients with chondromalacia of the knee. MR imaging was obtained with a 1.5T imager. Sagittal and coronal double echo T2 weighted images(TR/TE 3000-4200/16-96msec, FOV $140-160{\times}140-160mm$, matrix size $180{\times}256$, slice thickness 4.0mm, interslice gap 0.5mm), and sagittal DESS image(TR/TE 25.4/9.0msec, flip angle $35-45^{\circ}$, FOV $150-160{\times}150-160mm,{\;}matrix{\;}size{\;}192{\times}256$, effective slice thickness 1.5mm) were obtained. Cartilage lesions were staged according to a modified scheme proposed by Outerbirdge: grade 0, normal; grade 1, softening or/and swelling; grade 2, mild surface fibrillation or/and less than 50% of cartilage thickness; grade 3, severe surface fibrillation or/and loss of more than 50% of cartilage thickness but without exposure of subchondral bone; and grade 4, complete loss of cartilage with subchondral bone exposure. Gradings were determined by two readers with consensus, and patellofemoral, medial and lateral tibiofemoral compartments were evaluated. Results : Arthroscopic findings revealed grade 1 in seven cases, grade 2 in 21 cases, grade 3 in six cases, and grade 4 in 18 cases. Sensitivity of turbo spin-echo MR image was as follows; 0%, 14%, 0%, 61% in each grade, and sensitivity of DESS image was as follows; 0%, 33%, 50%, 67%, in each grade(p=0.001). In the detection of chondromalacic lesions regardless of gradings, sensitivity, specificity and accuracy of conventional MR image were 59.6% 88.6% 78.8%, and of DESS image, 73.1% 88.4%, 82.2%(p=0.007). Conclusion : For chondromalacia of knee joints, DESS images showed higher sensitivity than turbo spin-echo MR images. Therefore, DESS images will be helpful for diagnosis of chondromalacia of knee joints.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.100-115
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• 1999

The purpose of this study was to investigate the distribution of calcitonin gene-related peptide containing nerve fibers in rat pulp after dentinl injury by means of immunohistochemistry and confocal laser scanning microscope. The Spague-Dawley rats weighing about 250-300gm were used. The animals were devided into normal control and experimental groups. Experimental animals were sacrified 1, 2, 4, 7, 10, 21days after dentinal injury (dentin cutting, and then acid etching with 35% phosphoric acid) on the maxillary molar teeth. The maxillary teeth and alveolar bone were removed and immersed in the 4% paraformaldehyde in 0.1M phosphate buffer (pH 7.4), then were decalcified with 15% formic acid for 10 days. Serial frozen $50{\mu}m$ thick sections were cut on a cryostat. The rabbit CGRP antibody was used as a primary antibody with a dilution of 1:2000 in 0.01M PB. The sections were incubated for 48 hours at $4^{\circ}C$, and placed into biotinylated antirabbit Ig G as a secondary anti body with dilution of 1:200 in 0.01M PB and incubated in ABC(avidin-biotin complex). The peroxidase reaction was visualized by incubating the sections in 0.05% 3,3 diaminobenzidine tetrahydrochloride containing 0.02% $H_2O_2$. For the confocal laser scanning microscopic examination, Primary antibody reaction was same as immunoperoxidase stainning, but fluorescein isothiocyanate(FITC)-conjugate antirabbit IgG as a secondary antibody was used. The confocal laser scanning microscope was used for the examination. A series of images of optical sections was collected with a 20x objective at $3{\mu}m$ intervals throughout the depth of specimen. FITC fluerescence was registrated through a 488nm and 568nm excitation filter, and images were saved on optical disk. The stereoscopic images and three dimentionnal images were reconstructed by computer software, and then were analyzed. The results were as follows : 1. In normal control group, CGRP containing nerve fibers were coursed through the root with very little branching, and then formed a dense network of terminals in coronal pulp. 2. A slight increase in CGRP containing nerve fibers at 1 and 2day postinjury was noted subjacent to the injury site. In the 4day group, there were an extensive increase in the number of reactive fibers, followed by a partial return toward normal levels at 7~10 day postinjury, and return by 21days. 3. The sprouting of the CGRP containing nerve fibers was evident within 2day after dentinal injury, and by 4days there was a maximal increased, but was decreased at 7days and returned to normal 10~21 day postinjury. 4. In confocal laser scanning microscopic exammination, the distinct distribution pattern and sprouting reaction of CGRP containing nerve fibers were observed in stereoscopic images and three dimentional images. These results suggest that CGRP containing nerve fiber can be important role in the response to dental injury and pain regulation.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.33-38
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• 2009

Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

• Progress in Medical Physics
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• v.19 no.4
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• pp.209-218
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• 2008

According to improved radiation therapy technology such as IMRT and proton therapy, the accuracy of patient alignment system is more emphasized and IGRT is dominated research field in radiation oncology. We proposed to study the feasibility of cone-beam CT system using simple x-ray imaging systems for image guided proton therapy at National Cancer Center. 180 projection views ($2,304{\times}3,200$, 14 bit with 127 ${\mu}m$ pixel pitch) for the geometrical calibration phantom and humanoid phantoms (skull, abdomen) were acquired with $2^{\circ}$ step angle using x-ray imaging system of proton therapy gantry room ($360^{\circ}$ for 1 rotation). The geometrical calibration was performed for misalignments between the x-ray source and the flat-panel detector, such as distances and slanted angle using available algorithm. With the geometrically calibrated projection view, Feldkamp cone-beam algorithm using Ram-Lak filter was implemented for CBCT reconstruction images for skull and abdomen phantom. The distance from x-ray source to the gantry isocenter, the distance from the flat panel to the isocenter were calculated as 1,517.5 mm, 591.12 mm and the rotated angle of flat panel detector around x-ray beam axis was considered as $0.25^{\circ}$. It was observed that the blurring artifacts, originated from the rotation of the detector, in the reconstructed toomographs were significantly reduced after the geometrical calibration. The demonstrated CBCT images for the skull and abdomen phantoms are very promising. We performed the geometrical calibration of the large gantry rotation system with simple x-ray imaging devices for CBCT reconstruction. The CBCT system for proton therapy will be used as a main patient alignment system for image guided proton therapy.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.109-114
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• 1999

Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

• Restorative Dentistry and Endodontics
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• v.33 no.2
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• pp.148-161
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• 2008

The purpose of this study was to evaluate the effect of chlorhexidine (CHX) on microtensile bond strength (${\mu}TBS$) of dentin bonding systems. Dentin collagenolytic and gelatinolytic activities can be suppressed by protease inhibitors, indicating that MMPs (Matrix metalloproteinases) inhibition could be beneficial in the preservation of hybrid layers. Chlorhexidine (CHX) is known as an inhibitor of MMPs activity in vitro. The experiment was proceeded as follows: At first, flat occlusal surfaces were prepared on mid-coronal dentin of extracted third molars. GI (Glass Ionomer) group was treated with dentin conditioner, and then, applied with 2 % CHX. Both SM (Scotchbond Multipurpose) and SB (Single Bond) group were applied with CHX after acid-etched with 37% phosphoric acid. TS (Clearfil Tri-S) group was applied with CHX, and then, with adhesives. Hybrid composite Z-250 and resin-modified glass ionomer Fuji-II LC was built up on experimental dentin surfaces. Half of them were subjected to 10,000 thermocycle, while the others were tested immediately. With the resulting data, statistically two-way ANOVA was performed to assess the ${\mu}TBS$ before and after thermo cycling and the effect of CHX. All statistical tests were carried out at the 95 % level of confidence. The failure mode of the testing samples was observed under a scanning electron microscopy (SEM). Within limited results, the results of this study were as follows; 1. In all experimental groups applied with 2 % chlorhexidine, the microtensile bond strength increased, and thermo cycling decreased the micro tensile bond strength (P > 0.05). 2. Compared to the thermocycling groups without chlorhexidine, those with both thermocycling and chlorhexidine showed higher microtensile bond strength, and there was significant difference especially in GI and TS groups. 3. SEM analysis of failure mode distribution revealed the adhesive failure at hybrid layer in most of the specimen. and the shift of the failure site from bottom to top of the hybrid layer with chlorhexidine groups. 2 % chlorhexidine application after acid-etching proved to preserve the durability of the hybrid layer and microtensile bond strength of dentin bonding systems.