• Archives of Plastic Surgery
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• 제37권2호
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• pp.187-190
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• 2010

Purpose: Pediatric trigger thumb is a condition of flexion deformity of the interphalangeal (IP) joint. The known surgical treatment is the release of the flexor pollicis longus by transection of the A1 pulley. We report two cases of pediatric trigger thumb that were resolved by releasing of additional pulley as well as A1 pulley. Methods: From March 2006 to April 2008, a total of 10 children with trigger thumb were operated. In two cases, transection of only the A1 pulley was insufficient to relieve the triggering. When more distally dissection, we found an additional pulley. After release of the additional pulley, the full extension of IP joint is obtained. Results: There were no significant complications. In 8 cases, the trigger thumbs were resolved by transecting only the A1 pulley, does not extend beyond the base of the proximal phalanx. In one case, the additional pulley was found to be more distal to the A1 pulley. It was necessary to extend the release up to the half in the proximal phalangeal shaft. In other case, the additional pulley was immediately adjacent to the A1 pulley. Conclusion: In most cases of trigger thumb, division of just A1 pulley is sufficient to relieve the triggering. However, dividing the A1 pulley in two patients proved to be insufficient to relieve the flexed deformity. In these cases, we found that the additional pulley, different from previous known A1 pulley, had existed, which must be transected to allow full excursion of flexor pollicis longus.

• 한국정밀공학회지
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• 제25권2호
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• pp.148-155
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• 2008

The aim of the study is to interpret the distribution of occlusal force by 3-dimensional finite element analysis of ISP(Implant Supported Prosthesis) supported by minimum number of implant to restore the edentulous patients. For this study, the Astra Tech implant system is used. Geometric modeling for 6 and 4 fixture ISP group is performed with respect to the bone, implant and one piece superstructure, respectively. Implants are arbitrarily placed according to the anatomical limit of lower jaw and for the favorable distribution of occlusal force, which is applied at the end of cantilever extension of ISP with 30mm. Element type is tetrahedral for finite element model and the typical mechanical properties, Young's modulus and Poisson's ratio of each material, cortical, cancellous bone and implant material are utilized for the finite element analysis. From this study, we can see the distribution of equivalent stress equal to real situation and speculate the difference in the stress distribution in the whole model and at each implant fixture, From the analysis, the area of maximum stress is distributed on distal contact area between bone and fixture in the crestal bone. The maximum stress is 53MPa at the 0.2mm area from the bone-implant interface in the maximum side for 300N load condition for 4 fixture case, which is slightly less than the stress calculated from allowable strain. This stress has not been deduced to directly cause the loss of crestal bone around implant fixture, but the stress can be much reduced as the old peoples may have lower chewing force. Thus, clinical trial may be performed with this treatment protocol to use 4 fixtured ISP for old patients.

• Journal of Yeungnam Medical Science
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• 제28권2호
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• pp.180-186
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• 2011

Obstruction of the bile duct owing to the direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but bile duct tumor thrombus caused by the intrabiliary transplantation of a free-floating tumor is a rare complication of hepatocellular carcinoma A 50-year-old woman was diagnosed with HCC with bile duct tumor thrombi. She received transarterial chemoembolization (TACE) because her liver function was not suitable for surgery at the time of diagnosis. After TACE, infected biloma occurred recurrently. Thus, resection of the HCC, including the bile duct tumor thrombi, was performed. Six months after the surgery, recurred HCC in the distal common bile duct as drop metastasis was noted. The patient was treated with tomotherapy and has been alive for three years as of this writing, without recurrence. The prognosis of HCC with bile duct tumor thrombi is considered dismal, but if appropriate procedures are selected and are actively carried out, long-term survival can occasionally be achieved.

• 한국운동역학회지
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• 제19권1호
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• pp.27-36
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• 2009

본 연구에서는 수직점프시 몸통운동의 제약이 수직점프의 수행에 미치는 영향을 알아보기 위해 10명의 성인 남성을 대상으로 몸통을 자유롭게 사용한 일반적인 형태와 몸통동작을 제한한 형태의 수직점프를 비교, 분석하였다. 분석 결과 몸통동작을 제한한 경우 비 제약점프에 비해 10% 정도의 수행 손실이 있었는데, 이는 이지 순간의 중심 높이보다는 이 지속도의 차이에 의해 발생하였다. 몸통의 운동은 엉덩관절의 모멘트 파워를 증가시켜 추진의 초기 시점부터 지면반력의 증가에 기여하였는데 이러한 요인이 수행력 증가의 주요한 요인으로 작용하였다. 반면 몸통운동이 제한된 점프에서는 엉덩관절에서의 역학적 출력의 감소를 보상하는 측면에서 무릎관절의 역할이 증가하였으나 충분치 못하였다. 또한 몸통동작의 제한으로 엉덩관절 무릎관절 발목관절의 순차적인 신전패턴과는 상이하게 추진시점 직후 엉덩관절과 무릎관절이 동시에 신전하는 형태의 점프가 이루어져 협응패턴의 변화가 나타났다. 결국 본 연구의 결과 몸통의 적절한 사용은 수직점프의 수행 향상에 효과적으로 기여하는 것으로 나타났다.

• Journal of Korean Dental Science
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• 제10권2호
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• pp.87-95
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• 2017

This case study was to report the possible increase in the denture retention and psychological relief using the implant-supported fixed prostheses in a completely edentulous patient. The implants were placed in the anterior portion of the mandible in a patient who had completely edentulous state following the extraction of residual abutment teeth, and consequently a distal extension removable partial denture was fabricated. The patient's adaptation and satisfaction to the new prosthesis was monitored and confirmed in terms of masticatory function and esthetics, by restoring the oral condition similar to initial status before the residual teeth extraction. After 6 months, radiographic examination confirmed that both the abutment teeth and the implants were stable and well maintained. Considering the relatively short clinical follow-up period, however, continuous long-term monitoring was required.

• 대한치과보철학회지
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• 제60권4호
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• pp.442-452
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• 2022

무치악 환자의 구강 재건을 위한 임플란트를 활용한 치료 계획으로는 임플란트 지지 고정성 가공 의치, 임플란트 피개 의치, 임플란트 보조 국소의치 등이 있으며, 각각의 방식에 대한 적응증과 장단점이 다양하다. 본 증례의 환자는 상악 국소의치의 모든 잔존 지대치의 발거가 필요했으며 후방부 잔존골이 부족하여 식립 가능한 임플란트의 개수가 한정적이었다. 따라서 골 지지가 양호한 전방부에 4개의 임플란트 식립하여 임플란트 지지 서베이드 크라운과 후방연장 임플란트 보조 국소의치로 수복해주었고 환자에게 경제적으로 효과적이면서도 심미적, 기능적으로 만족스러운 결과를 제공하였다. 상악 무치악 환자에게 이와 같은 치료 계획은 경우에 따라 임플란트 피개의치의 대안으로 사용될 수 있으며 임상적, 생역학적 유효성을 검증하기 위해 더 많은 연구가 필요하다.

• The Journal of Advanced Prosthodontics
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• 제13권2호
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• pp.79-88
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• 2021

Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.215-224
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• 2022

Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

• The Journal of Advanced Prosthodontics
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• 제16권1호
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• pp.1-11
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• 2024

PURPOSE. The present experiment aimed to evaluate the placement accuracy of fully guided implant surgery using a mucosa-supported surgical guide when the protocol of osteotomy and installation was modified (MP) compared to when the protocol was sequentially and conventionally carried out (CP). MATERIALS AND METHODS. For 24 mandibular dentiform models, 12 dentists (6 experts and 6 beginners) performed fully guided implant placements two times at the right first and second molar sites using a mucosa-supported surgical guide, once by the CP (CP group) and at the other time by the MP (MP group). The presurgical and postsurgical stereolithographic images were superimposed, and the deviations between the virtually planned and actually placed implant positions and the procedure time were compared statistically (P < .05). RESULTS. The accuracies were similar in the CP and MP groups. In the CP group, the mean platform and apex deviations at the second molar site for the beginners were +0.75 mm and +1.14 mm, respectively, which were significantly larger than those for the experts (P < .05). In the MP group, only the mean vertical deviation at the second molar site for the beginners (+0.53 mm) was significantly larger than that for the experts (P < .05). The procedure time was significantly longer for the MP group (+94.0 sec) than for the CP group (P < .05). CONCLUSION. In fully guided implant surgery using a mucosa-supported guide, the MP may improve the placement accuracy when compared to the CP, especially at sites farther from the most-posterior natural tooth.

• 대한치과보철학회지
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• 제45권6호
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• pp.753-759
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• 2007

Statement of problem. In distal extension removable partial denture, the preservation of health of abutment teeth is very important, but abutment teeth are subjected to unfavorable stress under unilateral loading specially. Purpose. The purpose of this study was to investigate the biomechanical effects of mandibular removable partial dentures with various prosthetic designs under unilateral loading, using strain gauge analysis. Material and methods. Artificial teeth of both canines were anchored bilaterally in a mandibular edentulous model made of resin. Bilateral distal extension removable partial dentures with splinted and unsplinted abutments were fabricated. Group 1: Clasp-retained mandibular removable partial denture with unsplinted abutments Group 2: Clasp-retained mandibular removable partial denture with splinted abutments by 6-unit bridge. Group 3: Bar-retained mandibular removable partial denture Strain gauges were bonded on the labial plate of the mandibular resin model, approximately 2 mm dose to the abutments. Two unilateral vertical experimental loadings (30N and 100N) were applied subsequently via miniature load cell that were placed at mandibular left first molar region. Strain measurements were performed and simultaneously monitored from a computer connected to data acquisition system. For within-group evaluations, t-test was used to compare the strain values and for between-group comparisons, a one-way analysis of variance (ANOVA) was used and Tukey test was used as post hoc comparisons. Results. The strain values of group 1 and 2 were tensile under loadings. In contrast, strain values of group 3 were compressive in nature. Strain values increased as the applied load in increased from 30N to 100N (p<.05) except for right side in group 1. Under 30N loading, in left side, group 1 showed higher strain values than groups 2 and 3 in absolute quantity (p<.05). And group 2 showed higher strain values than group 1 (p<.05). In right side, group 1 and 2 showed higher strain values than group 3 in absolute quantity (p<.05). Under 100N loading in left side, group 1 showed higher strain values than groups 2 and 3 in absolute quantity (p<.05). And group 2 showed higher strain values than group 1 (p<.05). In right side, group 1 and 2 showed higher strain values than group 3 in absolute quantity (p<.05). Under 30N loading, group 2 and 3 showed higher strain values in right side than in left side. Under 100N loading, right side strain values were higher than left side ones for all groups. Conclusion. Splinting of two isolated abutments by bridge reduced the peri-abutment strain in comparison with unsplinted abutments under unilateral loading. Bar-retained removable partial denture showed the lowest strain of three groups, and compressive nature.