• 제목/요약/키워드: joint classifications

검색결과 28건 처리시간 0.026초

Reliability of cone-beam computed tomography for temporomandibular joint analysis

  • Gorucu-Coskuner, Hande;Atik, Ezgi;El, Hakan
    • 대한치과교정학회지
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    • 제49권2호
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    • pp.81-88
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    • 2019
  • Objective: The aim was to assess the intraobserver and interobserver reliabilities of temporomandibular joint linear measurements and condylar shape classifications performed with cone-beam computed tomography (CBCT). Methods: CBCT images of 30 patients were measured at two different time points by two orthodontists using the Dolphin 3D program (n = 60). Anterior, posterior, and superior joint space measurements and sagittal joint morphology classification in the sagittal view and medial and lateral joint space and mediolateral width measurements and coronal joint morphology classification in the coronal view were recorded. Intraclass-interclass correlation coefficients (ICC) and kappa statistics were used to assess intraobserver and interobserver reliability for the measurements and morphology classifications, respectively. Results: The ICC values were good for measurements of the posterior joint space by observer I and for measurements of the posterior, medial, and lateral joint spaces by observer II, while the other intraobserver measurements were excellent. Only the mediolateral width measurements showed excellent interobserver ICC values, while the other measurements showed good interobserver ICC values. Intraobserver agreement for the sagittal morphology classifications was moderate (${\kappa}=0.479$) and almost perfect (${\kappa}=0.858$) for observers I and II, respectively, while the corresponding agreement for the coronal morphology classifications was substantial for both observers. The interobserver agreement values for sagittal and coronal morphology classifications were slight (${\kappa}=0.181$) and fair (${\kappa}=0.265$), respectively. Conclusions: Linear temporomandibular joint measurements were reproducible and reliable in both intraobserver and interobserver evaluations. However, interobserver agreement for assessments of condylar shape was low.

Classification and surgical management of temporomandibular joint ankylosis: a review

  • Upadya, Varsha Haridas;Bhat, Hari Kishore;Rao, B.H. Sripathi;Reddy, Srinivas Gosla
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권4호
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    • pp.239-248
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    • 2021
  • The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/CAM can efficiently overcome the shortcomings of stock prostheses.

비인강암에서 AJCC와 Ho 병기 결정법에 따른 T병기의 비교 (A Comparison of T Classification of the AJCC and Ho Staging Systems for Nasopharyngeal Carcinoma)

  • 이상욱;서인석;강미정;조석현;김경래;이형석
    • 대한두경부종양학회지
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    • 제18권2호
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    • pp.179-183
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    • 2002
  • Objective: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal carcinoma (NPC) classifications was made in terms of patient distribution and efficacy in predicting prognosis. Materials and Methods: Between Jan. 1981 and Dec. 1998, 60 cases of node negative nasopharyngeal carcinoma were retrospectively reviewed. The extent of disease each patients restaged according to the 4th and 5th AJCC system and Ho system, respectively. Results: The overall and disease free 5-year survival rates were 61.1% and 62.6%, respectively. Among T classifications of 4th AJCC, 5th AJCC and Ho staging system were not observed significantly different in disease-free survival rates, respectively. Conclusion: We observed a better patient distribution with AJCC 1997 comparing to AJCC 1988. The new classification also attained better statistical significances among stages in the overall survival and disease free survival rates was needed.

단순 방사선 검사를 이용하여 석회성 건염에서 발생하는 석회 침착물의 성상에 대한 예측이 가능한가? (Is it Possible to predict the Characteristics of Calcific Deposition in Calcific Tendinitis of Shoulder Joint?)

  • 김성재;이희제;이광현;박동혁;이봉근
    • 대한정형외과 초음파학회지
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    • 제7권2호
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    • pp.77-83
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    • 2014
  • 목적: 본 연구의 목적은 견관절의 석회성 건염에서 발생하는 석회 침착물의 성상에 대한 기존의 단순 방사선학적 분류법들이 가지는 진단적 정밀도(precision)에 대한 평가로써, 관측자간 일치도를 평가하고, 석회 침착물의 치약형 성상 여부를 예측하는데 있어서의 진단적 정확도(accuracy)를 평가하여, 기존의 방사선학적 분류법들이 가지는 진단적 검사로써의 유용성에 대하여 평가하는 것이다. 대상 및 방법: 2010년 3월부터 2013년 9월까지 본원에서 견관절 석회성 건염으로 수술적 치료를 받은 26명 환자(26예 견관절)를 대상으로 후향적 연구를 시행하였다. 관절경하에서 관측한 석회 침착물의 성상은 총 26예 중 14예에서 분필 가루형이었고, 12예에서 치약형이었다. 수술 전 단순 견관절 방사선 검사상 나타나는 석회 침착물의 형태를 G$\ddot{a}$rtner, DePalma, Patte이 기술한 3가지 분류 체계에 따라 각각 2인의 평가자가 분석하였으며, Cohen's kappa를 이용하여 각 분류법의 관측자간 일치도를 평가하였다. 단순 방사선상에서 G$\ddot{a}$rtner 분류 III형, DePalma 분류 I형, Patte 분류 II형의 각각의 치약형 석회 침착물의 예측에 대한 민감도 및 특이도, 양성 우도비 및 음성 우도비, 그리고 진단적 승산비(diagnostic odds ratio)를 평가하였다. 치약형 석회 침착물 성상의 기준은 관절경하에서 관측한 성상을 기준으로 하였다. 결과: 단순 방사선상에서 평가한 석회 침착물의 형태에 대한 평가자간 신뢰도는 Patte 분류에서 Kappa 값이 0.62로 가장 높았고, DePalma가 0.56, G$\ddot{a}$rtner가 0.36 순이었다. 치약형 침착물을 예측하는 단순 방사선상의 침착물 형태의 민감도는 G$\ddot{a}$rtner 분류 III형, DePalma 분류 I형, Patte 분류 II형에서 각각 순서대로 83.3%, 91.7%, 58.3%였으며, 특이도는 각각 85.7%, 50.0%, 64%였다. 양성 우도비는 각각 순서대로 5.833, 1.833, 1.633였으며, 음성 우도비는 각각 0.194, 0.167, 0.648이었다. 진단적 승산비는 각각 순서대로 30.00, 11.00, 2.52이었다. 결론: 견관절의 석회성 건염에서 발생하는 석회 침착물의 성상의 예측에 대한 기존의 분류법을 이용한 평가 결과, 진단적 정밀도 및 정확도 모두에서 높은 수치를 보이는 분류법은 없었다. 따라서 추후 초음파와 같은 검사를 이용하여 석회 침착물 성상의 예측 가능 여부에 대한 추가적 연구가 필요할 것으로 생각된다.

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Femoral Periprosthetic Fractures after Total Knee Arthroplasty: New Surgically Oriented Classification with a Review of Current Treatments

  • Rhee, Seung Joon;Cho, Jae Young;Choi, Yoon Young;Sawaguchi, Takeshi;Suh, Jeung Tak
    • Knee surgery & related research
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    • 제30권4호
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    • pp.284-292
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    • 2018
  • Purpose: As the number of total knee arthroplasties (TKAs) increases, the incidence of femoral periprosthetic fractures after TKA is also increasing. This review aimed to suggest a new surgically oriented classification system for femoral periprosthetic fractures. Methods: We investigated the classifications, and current treatment trends for femoral periprosthetic fractures after TKA by means of a thorough review of the relevant literature. Results: Numerous studies reported good results of surgical treatment with modern fixatives including locking compression plates and retrograde intramedullary nails. However, few classifications of femoral periprosthetic fractures reflect the recent developments in surgical treatment. Conclusions: We recommend that surgical management be considered the first-line treatment for femoral periprosthetic fractures after TKA. Our new classification will help in deciding the surgical treatment option for femoral periprosthetic fractures after TKA.

급성 외상성 비골근 탈구의 수술적 치료 (Surgical Treatment of Acute Traumatic Peroneal Tendon Dislocation)

  • 최은석;박홍기
    • 대한족부족관절학회지
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    • 제9권2호
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    • pp.179-183
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    • 2005
  • Purpose: Acute traumatic peroneal tendon dislocation is relatively rare disease and their methods of treatment is controversial, that we want to assess the characters and outcomes of 8 patients with early surgical treatments. Materials and Methods: We evaluated the results of 8 patients who can follow up more than 28 months using sex, age, side, injury sports, concomitant injuries, Eckert and Davis classifications, anatomic variants, results and complications. Results: All of 8 patients was male, average age was 27, Right side was dominant (5/8), causal sports was variable. Concomitant injuries were distal tibiofibular ligament syndesmosis injury, Peroneus longus injury, lateral collateral ligament injury. On behalf of Eckert and Davis classifications 5 patients were Grade 1 and other 3 patients were Grade 2. 1 case of low lying peroneus brevis belly was found as an anatomic variants. 6 of patients shown excellent results, 2 patients were good. Post operative complications were discomfort of operation site and mild limited dorsiflexion on ankle joint. Conclusion: Careful history and physical exam is important for diagnosis. And surgical treatments can expect good results.

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견구축증(Frozen Shoulder)에서 견갑상신경차단과 견관절강내 주사의 통증 치료 효과 (Comparison of Suprascapular Nerve Block and Shoulder Joint Injection for Treatment of Frozen Shoulder)

  • 정현규;이상곤
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.226-229
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    • 1998
  • Background: Treatment for frozen shoulder is various and difficult. It is important for pain clinicians to plan more effective and simpler treatment modalities. Pain clinicians have done suprascapular nerve block(SSNB) for treatment of frozen shoulder, but the effectiveness of treatment has been unsatisfactory. Shoulder joint injection(SJI) using local anesthetics and steroid mixture is a relatively simple procedure. This study was performed to compare therapeutic effects of SSNB and SJI in frozen shoulder. Methods: Eighty patients suffering from frozen shoulder were randomly divided into two groups. Group 1 had been treated with SSNB and physiotherapy for 3 weeks. Group 2 had been treated with SJI and physiotherapy for the same duration. Pain scores and treatment results were compared and analyzed at the time of 2 months after treatment started. Results: The VAS scores after SJI were lower than those of SSNB. Therapeutic results according to Haggart's classifications were significantly effective in group 2. Conclusion: These results show that SJI is more effective than SSNB for treatment of frozen shoulder.

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류마티스 관절염 환자의 운동프로그램 적용효과와 망분석(network analysis) (Analysis of the Effect and Network of Exercise Programs on Rheumatoid Arthritis Patients)

  • 이혜영;서문자;이은옥
    • 근관절건강학회지
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    • 제11권1호
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    • pp.74-87
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    • 2004
  • Purpose: This study aims to analyze the outcome of exercise programs for Rheumatoid Arthritis patients and its tendency with network analysis. Method: 30 articles from Medline search of foreign nursing journals(1966-2002) and 5 from three Korean nursing journals(1970-2002) were surveyed. The contents analyses were focused on outcome measures and network analysis of exercise programs. Results: Exercise programs result in improving muscle strength(91.7%), aerobic capacity(72.9%), and 50 feet walk time(57.3%). Among several exercises, water exercise, and Tai-chi are in the middle of weight-bearing exercises. In the experimental design, non-randomized control trials were 40%, and the functional status of subjects were not classified in 40% of the articles surveyed. Conclusion: Considering the results, muscle strength, aerobic capacity, and 50 feet walk time were tested as valid outcome measures. Tai-chi exercise could be recommended as proper exercise for Rheumatoid arthritis patients because of its low intensity of weight-bearing exercise. In terms of research methods, the randomized trials and functional classifications of rheumatoid arthritis should be done more strictly.

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Ground support performance in deep underground mine with large anisotropic deformation using calibrated numerical simulation (case of mine-H)

  • Hu, Bo;Sharifzadeh, Mostafa;Feng, Xia-Ting;Talebi, Roo;Lou, Jin-Fu
    • Geomechanics and Engineering
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    • 제21권6호
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    • pp.551-564
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    • 2020
  • High-stress and complex geological conditions impose great challenges to maintain excavation stability during deep underground mining. In this research, large anisotropic deformation and its management by support system at a deep underground mine in Western Australia were simulated through three-dimensional finite-difference model. The ubiquitous-joint model was used and calibrated in FLAC3D to reproduce the deformation and failure characteristics of the excavation based on the field monitoring results. After modeling verification, the roles of mining depth also the intercept angle between excavation axis and foliation orientation on the deformation and damage were studied. Based on the results, quantitative relationships between key factors and damage classifications were presented, which can be used as an engineering tool. Subsequently, the performance of support system installation sequences was simulated and compared at four different scenarios. The results show that, first surface support and then reinforcement installation can obtain a better controlling effect. Finally, the influence of bolt spacing and ring spacing were also discussed. The outcomes obtained in this research may play a meaningful reference for facing the challenges in thin-bedded or foliated ground conditions.

연조직종양의 새로운 WHO 분류를 중심으로: 지방세포종, 섬유모세포성/근육섬유모세포성종, 소위섬유조직구종, 평활근종, 혈관주위종과 근골격종에 대하여 (Adipose Tumor, Fibroblastic/Myofibroblastic Tumors, So-called Fibrohistiocytic Tumors, Smooth Muscle Tumors, Pericytic Tumors and Skeletal Muscle Tumors: An Update Based on the New WHO Soft Tissue Classification)

  • 서경진
    • 대한골관절종양학회지
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    • 제14권1호
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    • pp.1-9
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    • 2008
  • 연조직종양의 이해는 과거 10년 동안에 걸쳐 주요 변화와 더불어 실질적인 진보가 있었고, 이를 바탕으로 연조직종양의 새로운 분류가 WHO에 의해 2002년에 이루어졌다. 이 개정은 이전에 발표와 상당히 다른 내용의 접근을 하였고, 이 작업에 유전학과 분자생물학 그리고 임상분야의 전문가들이 참여하였다. 여기에서는 과거에 알고 있었거나 특성이 알려진 많은 종양을 포함하여 새로운 큰 변화나 작은 변화가 일어난 부분에 대해서 정리를 하였다. 이러한 내용을 연조직종양의 새로운 WHO 분류를 중심으로 지방세포종, 섬유모세포성/근육섬유모세포 성종과 소위섬유조직구종, 평활근종, 혈관주위종과 근골격종을 중심으로, 큰 변화와 작은 변화로 나누어서 설명하고 새롭게 소개되는 병명을 소개하고 정리하였다. 이 새로운 WHO의 연조직종양의 분류를 이해하여, 종양의 진단과 예후의 재현을 용이하게 하는 필수적인 지침으로 사용할 수 있을 것으로 생각된다.

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