• 한국한의학연구원논문집
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• 제16권2호
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• pp.159-166
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• 2010

Objective : The purpose of this study is to compare the Effect of Acupuncture on Local Acupoints and Distal Acupoints for Patients with Whiplash Injury. Method : From January 1st 2009 to September 31th 2009, 10 patient were divided into 2 groups. One group was taken Local Acupoints, and the other group was taken Distal Acupoints. To check pain and treatment satisfaction, visual analog scale(VAS) and five-point likert scale were used before and after treatment. Result : Both acupuncture theraphy showed improvement in VAS and five-point likert scale. And Local Acupoints group showed more effective than Distal Acupoints group on five-point likert scale. Conclusion : This Study suggests that Acupuncture on Local Acupoints and Distal Acupoints can be applicable to improve symptom in Patients with Whiplash Injury.

• 대한치과보철학회지
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• 제30권2호
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• pp.203-224
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• 1992

The purpose of this study was to evaluate the stress distribution developed in supporting structures by distal extension removable partial denture with 4-types of direct retainer. The direct retainers examined were Akers clasp, RPI clasp, RPA clasp and RPL clasp in bilateral & unilateral free end case. 3-dimensional photoelastic stress analysis was used to record the isochromatic fringe patterns and to calculate the compressive stress at measuring points. The results were as follows. 1. In bilateral free end case, RPI clasp exhibited the similar stress distribution on distal and mesial alveolar crest but Akers clasp exhibited higher stress concentration on distal alveolar crest than mesial alveolar crest. 2. In bilateral free end case, RPA clasp and RPL clasp exhibited the similar stress distribution on distal and mesial alveolar crest and RPL clasp exhibited higher stress concentration on buccal alveolar crest than lingual alveolar crest. 3. Akers clasp produced high stress concentration on residual alveolar ridge distally, but RPI clasp, RPA clasp and RPL clasp produced even stress distribution on residual alveolar ridge. 4. Removable partial denture in unilateral free end case exerted higher stress on abutment tooth root apex than bilateral distal extension removable partial denture.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.133-137
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• 1999

Purpose: There are so many different methods with the their own advantages and disadvantages for acute AC dislocation and distal unstable clavicle fracture. We evaluated the usefulness of temporary Bosworth's coracoclavicular fixations using the cannulated screw and reviewed our clinical results. Materials and Methods: We evaluated 34 cases of temporary coracoclavicular fixations with cannulated screw and washer for acute AC dislocation(25cases in the Type V, Ⅲ) and distal unstable clavicle fracture(9cases in the Type ⅡB, Ⅱ+Ⅲ). All cases were fixed by the same techniques, guided cannulated screw under C-arm after the repair of the CC ligament within 1 week. Bases on the regular check, screws were removed at the 6-12 weeks under local anesthesia. The final clinical and radiological results(average 14 months follow-up) were rated with the UCLA scale. Results : All shoulders were gained nearly full ROM passively at the 3-4 weeks. The overall satisfactory resuIts(excellent or good) were achieved 88%(22/25) in the acute AC dislocation and all in the distal unstable clavicle fracture. There were no definite complications except three initial fixations loosening. Conclusion: Temporary Bosworth's coracoclavicular fixation using the cannulated screw with guided pin was simple precedure and provided enough initial stability for acute AC dislocation and distal unstable clavicle fracture.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.143-148
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• 2016

Background: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. Methods: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. Results: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. Conclusions: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.514-522
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• 2022

Objective : A distal navigation of a large bore aspiration catheter during mechanical thrombectomy (MT) is important. However, delivering a large bore aspiration catheter is difficult to a tortuous or atherosclerotic artery. We report the experience of anchoring with balloon guide catheter (BGC) and stent retriever to facilitate the passage of an aspiration catheter in MT. Methods : When navigating an aspiration catheter failed with a conventional co-axial microcatheter delivery, an anchoring technique was used. Two types of anchoring technique were applied to facilitate distal navigation of a large bore aspiration catheter during MT. First, a passage of aspiration catheter was attempted with a proximal BGC anchoring technique. If this technique also failed, another anchoring technique with distal stent retriever was tried. Consecutive patients who underwent MT with an anchoring technique were identified. Details of procedure, radiologic outcomes, and safety variables were evaluated. Results : A total of 67 patients underwent MT with an anchoring technique. Initial trial of aspiration catheter passage with proximal BGC anchoring technique was successful for 35 patients (52.2%) and the second trial with distal stent retriever anchoring was successful for 32 patients (47.8%). Overall, navigation of a large bore aspiration catheter was successful for all patients (100%) without any procedure related complications. Conclusion : Our study showed the usefulness of anchoring technique with proximal BGC and distal stent retriever during MT, especially in those with an unfavorable anatomical structure. This technique could be an alternative option for delivering an of aspiration catheter to a distal location.

• 대한족부족관절학회지
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• 제9권2호
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• pp.146-150
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• 2005

Purpose: We made a radiological comparison between $60^{\circ}$ distal Chevron osteotomy with short armed two parts and $40^{\circ}$ distal Chevron osteotomy with long armed one part performing operation in cases of hallux valgus angle of less than $40^{\circ}$, intermetatarsal angle of less than $15^{\circ}$. Materials and Methods: 12 cases with $60^{\circ}$ distal Chevron osteotomy and 12 cases with $40^{\circ}$ distal Chevron osteotomy were selected from October 2000 to March 2005. We have analysed the hallux valgus angle, 1-2 intermetatarsal angle, metatarsal length, distal metartarsal articular angle and angulation at osteotomy site on lateral view in each radiological films taken at preoperative, postoperative and 3 months after operation presuming bone union. All cases were women, both sides were 9 cases and average age was 52.3 years old. Results: Data taken at preoperative, postoperative and 3 months follow up films in $60^{\circ}$ distal Chevron osteotomy were as follows; the hallux valgus angles were $32.1^{\circ}$, $10.9^{\circ}$, $13.8^{\circ}$, the 1-2 intermetatarsal angles were $13.6^{\circ}$, $8.5^{\circ}$, $8.4^{\circ}$, the metatarsal length were 60.6 mm, 58.8 mm, 58 mm, the distal metartarsal articular angles were $13^{\circ}$, $6^{\circ}$, $6.6^{\circ}$ and 3 cases were over $3^{\circ}$ angulation at lateral view. In $40^{\circ}$ distal Chevron osteotomy, the hallux valgus angles were $34.5^{\circ}$, $11.6^{\circ}$, $15.3^{\circ}$, the 1-2 intermetatarsal angles were $12.7^{\circ}$, $8.2^{\circ}$, $7.8^{\circ}$, the metatarsal length were 59.2 mm, 56.9 mm, 55.9 mm, the distal metartarsal articular angles were $12^{\circ}$, $7.3^{\circ}$, $7.3^{\circ}$ and there were no case with angulation over $3^{\circ}$ at lateral view. Conclusion: In comparison between $60^{\circ}$ distal Chevron osteotomy and $40^{\circ}$ distal Chevron osteotomy measuring at postoperative and follow up, most of all data were similar, but 3 cases over $3^{\circ}$ angulation at lateral view happened in $60^{\circ}$ Chevron osteotomy. This result showed that $40^{\circ}$ distal Chevron osteotomy fixing with screws through long armed one part may have benefit than $60^{\circ}$ distal Chevron osteotomy fixing with K-wires through short armed two parts in making rigid fixation, even though there is a personal difference of technigue.

• 대한방사선기술학회지:방사선기술과학
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• 제33권1호
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• pp.19-24
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• 2010

본 연구는 원위요골의 회전에 따른 골밀도의 변화를 알아보고 원위요골 골밀도와 요추 골밀도를 비교 분석하였다. 골밀도 측정시 정확한 측정 자세를 알아보고자 자체 제작한 보조기구를 이용하여 수술, 기형이나 외상력이 없는 20, 30대 남성 11명을 대상으로 전완부를 DR(digital diagnostic IR-1100-150 ; Philips)로 촬영하였고 남성 21명을 DXA(QDR 4500W ; HOLOGIC, USA)로 골밀도 측정을 시행하였다. 실험은 두 가지로 수행하였다. 첫째, 보조기구를 이용하여 11명을 대상으로 전완부를 DR로 중립위(0도)를 기준으로 내회전 및 외회전 각각 3, 6, 9도에서 촬영하였고 둘째, 요추 및 전완부(Forearm)의 골밀도를 21명을 대상으로 DXA 장비를 이용해 중립위(0도)를 기준으로 내회전 및 외회전 각각 5, 10도에서 측정하였고 통계프로그램 SPSS 12.0v으로 비교 분석하였다. 그 결과 DR로 촬영한 11명의 원위요골 회전각은 내회전인 경우가 82%(n = 9)로 가장 많았으며, 평균 내회전 각도는 7도였다. 외회전 6도와 중립위(0도)에서도 1명(9%)씩 나타났다. 전체평균 회전각은 내회전 5.1도였다. DXA로 측정한 21명의 원위요골 회전각은 내회전인 경우가 43%(n = 9)로 가장 많았으며, 평균 내회전 각도는 7.2도였다. 외회전은 24%(n = 5)이고 평균 외회전 각은 6도이며 중립위(0도)은 33%(n = 7)로 나타났다. 전체평균 회전각은 내회전 4.1도였다. 요추와 원위요골의 상관 계수는 r = 0.30, p = 0.18로 통계적 유의성은 없었다. 요추의 골밀도가 원위요골의 골밀도를 대변하지 못하기 때문에 원위요골 골밀도의 평가는 원위요골에서 측정해야 한다. 전완부 골밀도 측정시 중립위는 원위요골이 외회전이 대부분이기 때문에 최저 골밀도의 회전각에서 일정하게 골밀도를 측정하기 위해서는 중립위 보다 내회전이 필요하며 내회전 각은 약 5도가 추천된다.

• 대한방사선치료학회지
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• 제30권1_2호
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• pp.35-40
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• 2018

목 적 : 본원에서 사용하는 양성자 에너지는 크기에 따라 도달거리가 달라지며, Compensator는 Distal 두께에 따라 Energy의 크기를 다르게 할 수 있으며 이로 인해 Dose rate이 변화된다. 따라서 Compensator distal의 두께를 변화시키면서 Dose 분포 및 Beam on time에 대한 영향을 평가해보고자 한다. 대상 및 방법 : 본원에서 양성자치료를 받은 에너지가 낮은 환자 5명을 대상으로 실험하였다. 선택된 환자들의 기존 치료 시 Beam on time을 확인하였으며 이 후 양성자치료계획시스템(TPS)을 통하여 Compensator의 Distal 두께를 기존 두께에서 2 cm씩 최대 14 cm까지 증가시켜가며 치료계획을 비교 평가하였다. Dose 분포를 평가하기 위하여 Target의 Conformity Index(CI)값과 Homogeneity Index(HI)값, Target 후면부의 Organ at risk(OAR)의 최대선량을 비교하였으며 치료시간에 대한 영향을 평가하고자 Compensator Distal 두께 별로 제작하여 Beam on time을 비교하여 평가하였다. 결 과 : Compensator의 Distal 두께를 증가시켜 Homogeneity Index, Conformity Index를 분석한 결과 모든 환자에서 동일한 수치가 나왔다. Target 후면부의 OAR을 비교한 결과 Abdomen의 Spine cord에 최대 7 cGy, Eyeball의 RT Lens에서 88 cGy, Nasal cavity의 RT Lens에 391 cGy, Mediastinum의 Trachea에 51 cGy, Pelvis의 Small bowl에 661 cGy 증가하였다. Beam on time을 비교한 결과 Abdomen의 경우 기존 126초에서 최대 62초, Eyeball의 경우 105초에서 37초, Nasal cavity의 경우 기존 187초에서 134초, Mediastinum의 경우 기존 100초에서 40초, Pelvis의 경우 기존 440초에서 118초로 감소하였다. 결 론 : 연구결과 Compensator의 distal 두께가 두꺼워질수록 에너지의 크기를 증가시킬 수 있으며 Dose rate이 증가하여 Beam on time이 감소하는 효과가 있었다. 이는 Beam on time이 많이 소요되는 호흡동조치료를 요하는 Liver, 마취를 하는 소아환자에게 적용한다면 치료시간 단축과 환자의 편의성 면에서 큰 도움을 줄 것으로 평가된다. 하지만 에너지의 크기가 증가할수록 Distal penumbra가 증가하기 때문에 Target 후면부에 OAR이 인접해 있는 경우는 양성자치료계획 시 Penumbra의 영향을 고려한 적절한 Compensator 두께를 설정할 필요가 있을 것으로 사료된다.

• 대한족부족관절학회지
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• 제17권2호
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• pp.130-135
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• 2013

Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.18-25
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• 2011

Purpose: In the process of replantation of the amputated fingertips, the primary concern was given to survival of the amputees, while the functional aspect of digits after the surgery has been easily neglected. Although an internal fixation with a K-wire is often a part of replantation of the amputated fingertips, little consideration had been given to the study of relationship between distal interphalangeal joint fixation and post operative range of motion. A comparative study in relation to post operative range of motion was done on two different groups, one group with K-wire insertion and the other group without a K-wire insertion at the distal interphalangeal joint. Materials and Methods: The study was done on the cases of a single digit amputation conducted at our institute (the age in the range of 10 to 60) in about four-year of time span from March of 2005 to March of 2009. The cases with a thumb replantation, osteomyelitis or articular surface injury have been excluded from this study. The cases of both head and shaft fracture, except the insertion site of tendon, of distal phalanx of internal fixation with a single K-wire were reviewed for this study. A group of 24 cases without distal interphalangeal joint fixation in comparison to a group of 22 cases with distal interphalangeal joint fixation was reviewed to assess the postoperative range of motion at distal interphalangeal joint on the 6th week after the surgery. And, on the 30th month after the surgery, a group of 10 cases without distal interphalangeal joint fixation in comparison to a group of 10 cases with joint fixation was reviewed. A K-wire was removed in about 5 weeks after the fracture was reunited under the radiographic image, immediately followed by a physical therapy. Result: The active range of motion for a group without interphalangeal joint fixation was measured $49.0^{\circ}$ on average, while $28.6^{\circ}$ was measured for a group with interphalengeal fixation on the 6th week after the surgery. On the 30th month after the surgery, the active range of motion was measured $52.0^{\circ}$ and $55.0^{\circ}$ on average for a group without and with interphalangeal fixation respectively. Conclusion: In the process of replantation of the amputated fingertips, short-term(on the 6th week) improvement of postoperative active motion of range can be expected in the cases without distal interphalangeal fixation in comparison to the cases of interphalangeal joint fixation with a K-wire. However, there seems to be no difference on motion of range in a long-term (on the 30th month) follow up period.