Objective : Although there is no consensus on the ideal treatment of the craniocervical instability, biomechanical stabilization and bone fusion can be induced through occipito-cervical fusion (OCF). The authors conducted this study to evaluate efficacy of OCF, as well as to explore methods in reducing complications. Methods : A total of 16 cases with craniocervical instability underwent OCF since the year 2002. The mean age of the patients was 51.5 years with a mean follow-up period of 34.9 months. The subjects were compared using lateral X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. Results : All patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.1. At the end of follow-up after surgery, the mean Nurick score was 2.0. After surgery, most patients' posterior occipito-cervical angle entered the normal range as the pre operation angle decresed from 121 to 114 degree. There were three cases with complications, such as, vertebral artery injury, occipital screw failure and wound infection. In two cases with cerebral palsy, occipital screw failures occurred. But, reoperation was performed in one case. Conclusion : OCF is an effective method in treating craniocervical instability. However, the complication rate can be quite high when performing OCF in patients with cerebral palsy, rheumatoid arthritis. Much precaution should be taken when performing this procedure on high risk patients.
Objectives : Skeletal muscle atrophy occurs in response to a variety of conditions. The unloading to muscle occurs clinically in limb immobilization, bed rest, spinal cord injury and peripheral nerve damage, resulting in significant loss of muscle mass and force production. Muscle disuse is accompanied by an increase in apoptotic signaling, which mediates some of the responses to unloading in the muscle. In this study we tested the hypothesis that Daeyeoung-jeon extract would improve muscle recovery after reloading following disuse. Method : Twenty young male Sprague-Dawley rats were used for the studies. The hindlimb immobilization was performed with casting tape to keep the left ankle joint in a fully extended position. No intervention was performed on the right leg and used as intact region. The Rats in Daeyeoung-jeon treated group (DYJ) were orally administrated Daeyeoung-jeon water extract, and rats of Control group were given with saline only. After 2 weeks of immobilization, all animals were sacrificed, and the whole gastrocnemius muscles were dissected from both legs. The morphology of right and left gastrocnemius muscles in both DYJ and Control groups were assessed by hematoxylin and eosin staining. Moreover, to investigate the immobilization-induced muscular apoptosis, the immunohistochemical analysis of Bax and Bcl-2 was carried out. Results : Daeyeoung-jeon represented the significant protective effects against the reductions of the left gastrocnemius muscles weight and average cross section area to compared with Control group. The treatment with Daeyeoung-jeon extract significantly reduced the immunoreactivity of BAX and increased the immunoreactivity of Bcl-2 in gastrocnemius muscle compared with Control group. Conclusion : Daeyeoung-jeon has protective effects against immobilization-induced muscle atrophy by regulating the activities of apoptosis-associated BAX/Bcl-2 proteins in gastrocnemius muscle.
Transactions of the Korean Society of Mechanical Engineers B
/
v.37
no.10
/
pp.953-959
/
2013
In this study, a multibody dynamic model of the cervical spine was developed for a virtual in-vitro cadaveric experiment. The dynamic cervical spine model was reconstructed based on Korean CT images and the material properties of joints and soft tissue obtained from in-vitro experimental literature. The model was validated by comparing the inter-segmental rotation, multi-segmental rotations, load-displacement behavior, ligament force, and facet contact force with the published in-vitro experimental data. The results from the model were similar to published experimental data. The developed dynamic model of the cervical spine can be useful for injury analysis to predict the loads and deformations of the individual soft-tissue elements as well as for virtual in-vitro cadaveric experiments.
Journal of the Korean Society of Physical Medicine
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v.12
no.4
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pp.39-46
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2017
PURPOSE: The effectiveness of the stretching to increase the range of motion of the joint, reduce the risk of injury, enhance athletic performance or decrease post exercise muscle soreness. This study was to compare the effect of the stretching method applied on the shortened hamstring muscle for flexibility, strength, pressure pain threshold value and muscle tone. METHODS: This study is a two-group pretest- posttest design. Fifty-four healthy young adults were randomly assigned to a vibration-assisted stretching group (VASG, n=27) or a static stretching group (SSG, n=27). Participants performed each stretch in 4 sets of 30 seconds each. A 30-second break time was provided between the sets. The range of motion, strength, pressure pain threshold values and muscle tone of the hamstring muscle were measured to compare the effects of the stretching methods. RESULTS: Both the VASG and the SSG participants showed significant improvement in the range of motion and strength (p<.05); however, the increase in the VASG was significantly higher than that in the SSG (p<.05). The pressure pain threshold values and muscle tone were significantly decreased only in the VASG (p<.05). CONCLUSION: These findings indicate that vibration-supported stretching is an effective intervention for people with hamstring shortening, with high pain level and muscle tone decrease.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.27
no.1
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pp.179-188
/
1997
This study was intended to compare the diagnostic ability between Waters' radiograph and CT in the diagnosis of midfacial fracture. The study group included 44 patients(male:32, female :12, age range :16-74 years old) with facial injury who underwent surgery. Waters' radiograph and both axial and coronal scanning were performed before surgery. Three oral radiologists and three non-oral radiologist interpreted 44 Waters' radiographs and 88 CT in three ways; 1) interpretation using Waters' radiograph only, 2) interpretation using CT only, 3) interpretation using Waters' radiograph and CT. The interpretation sites were confined to the walls of maxillary sinus; anterior, posterior, medial, lateral and superior wall. ROC curves were made with the findings during surgery as a gold standard except the posterior wall, where the joint evaluation of Waters' radiograph and CT by other three oral radiologists was used. ROC areas were compared according to the interpreting methods, the interpretation sites, and groups (R group ; oral radiologist group, N group ; non-oral radiologist group). The obtained results were as followed : 1. The diagnostic ability of CT only and Waters' radiograph and CT was higher than Waters' radiograph only in both groups(P<0.05). But there was no difference between CT only and Waters' radiograph and CT. 2. Generally, the diagnostic ability for the lateral antral wall was the highest and that for the posterior antral wall was the lowest in both groups(P<0.05). 3. In R group, for the anterior antral wall the diagnostic ability using CT only was increased but for the medial, lateral and superior antral walls the diagnostic ability was increased in only using Waters' radiograph and CT. 4. In N group, for the anterior and medial walls the diagnostic ability using CT only was increased. But for the posterior, lateral and superior antral walls there were no difference among three interpreting methods. 5. The diagnostic ability of R group was higher than N group in all interpreting methods.
At the posterior aspect of distal thigh, major nerves, vessels, muscles and tendons were located. So, if abscess occurs within deep muscular fascia of posterior aspect of distal thigh, it can be widely and deeply spread to proximal thigh, popliteal fossa, posterior proximal leg, surrounding areas of knee joint along deep fascia, muscles and tendons. In that case, it is difficult to eradicate the abscess using antibiotics without surgical drainage and debridement. But, it is often impossible to obtain satisfactory view of operative field with conventional technique and critical damage to major nerves and vessels in the popliteal fossa during operation may occur. We performed endoscopic treatment for extensive deep abscesses occurred in posterior aspect of distal thigh in 64-year-old man, and obtained satisfactory result without injury to the normal structures including major nerves and vessels. So we report this case with a review of relevant literatures.
Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge $1^{st}$ metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-$1^{st}$ metatarsal, calcaneus-$1^{st}$ metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-$1^{st}$ metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of $21^{\circ}$ and $25^{\circ}$ to $12^{\circ}$ and $19^{\circ}$, respectively, at last followup. Also, calcaneus-$1^{st}$ metatarsal angle was increased from the mean $114^{\circ}$ to $114^{\circ}$. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.18
no.1
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pp.13-25
/
1988
Bone destruction was induced experimentally by the insertion of a bit of the arsenic compound into the pulp chambers of the right premolars and the artificial bone defects were produced in the periapical regions of the left premolars in 7 dogs. The serial standardized periapical radiographs using aluminum stepwedge attached to the XCP instruments, and resin bite blocks were taken following insertion of arsenic compound and at 2, 4, 7, 10, 14, 17, 21, 24 and 28 days in case of bone destruction and following bone injury and weekly thereafter for a total of 14 weeks in case of bone formation. The errors of the method were determined with error estimators described by the Duinkerke. All radiographs were evaluated by the visual examination after joint evaluation by three dental radiologists and analysed with densitometer. The following results were obtained; 1. Analysis of the bone destruction process 1) The error of the method in estimating two distances proved to be small (S.D. for the measuring error; 0.04㎜, S.D. for the over-all error; 0.06㎜, S.D. for the positioning error; 0.05㎜) 2) The radiographic changes were observed after 7 days in 6 cases, 4 days in 1 case and 10 days in 1 case by the visual examination. 3) Aluminum equivalent values were diminished after 2 days and the diminution of 0.58±0.19㎜ was demanded to be detected by the visual examination. 2. Analysis of the bone formation process 1) The error of the method in estimating two distances proved to be small (S.D. for the measuring error; 0.03㎜, S.D. for the over-all error; 0.04㎜ S.D. for the positioning error; 0.04㎜) 2) The radiographic changes were observed after 2 weeks in 5 cases and 3 weeks in 2 cases by the visual examination. 3) Aluminum equivalent values were increased after 1 week and the increase of 0.45±0.15㎜ was demanded to be detected by the visual examination. 4) Aluminum equivalent values were increased continuously for 7 or 9 weeks but there as only extremely small change after 10 weeks.
Objectives: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. Methods: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. Results: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. Conclusions: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.
The purposes of this study were to assess dynamic stability toward pelvis-spine column distortion during running and to compare the typical three-dimensional angular kinematics of the trunk motion; cervical, thoracic, lumbar segment spine and the pelvis from the multi-segmental spine model between exercise group and non-exercise group. Subjects were recruited as exercise healthy women on regular basis (group A, n=10) and non-exercise idiopathic scoliosis women (group B, n=10). Data was collected by using a vicon motion capture system (MX-T40, UK). The pelvis, spine segments column and lower limbs analysiaed through the 3D kinematic angular ROM pattern. There were significant differences in the time-space variables, the rotation motion of knee joint in lower limbs and the pelvis variables; obliquity in side bending, inter/outer rotation in twisting during running leg movement. There were significant differences in the spinal column that is lower-lumbar, upper-lumbar, upper-thoracic, mid-upper thoracic, mid-lower thoracic, lower thoracic and cervical spine at inclination, lateral bending and twist rotation between group A and group B (<.05, <.01 and <.001). As a results, group B had more restrictive motion than group A in the spinal column and leg movement behaved like a 'shock absorber". And the number of asymmetry index (AI) showed that group B was much lager unbalance than group A. In conclusion, non-exercise group was known to much more influence the dynamic stability of equilibrium for bilateral balance. These finding suggested that dynamic stability aimed at increasing balance of the trunk ROM must involve methods and strategies intended to reduce left/right asymmetry and the exercise injury.
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