• Imaging Science in Dentistry
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• v.37 no.1
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• pp.19-26
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• 2007

Purpose : To examine whether the maxillofacial skeletal morphology correlates with the condylar position and the anatomic characteristics of articular eminence using measurements of lateral cephalometric radiographs and individualized sagittal temporomandibular joint (TMJ) tomographs. Materials and Methods : I compared measurements of 202 TMJs of 101 orthodontic patients of Kangnung National University Dental Hospital. 1 used Pearson's correlation for comparison of the measuring values in lateral cephalometric radiographs and individualized sagittal TMJ tomographs. Results : Large occlusal plane angle tendency showed decreased width of posterior eminence slope, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large mandibular plane angle tendency showed decreased superior joint space, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large genial angle tendency showed decreased depth of articular fossa, decreased posterior slope angle of eminence and anterior position of condylar head. Large anterior facial height and large posterior facial height tendency showed increased width of posterior slope of eminence, increased depth of articular fossa, increased posterior slope angle of eminence and posterior position of condylar head. Conclusion : Maxillofacial skeletal morphology has correlation with the anatomic characteristics of TMJ. Individualized sagittal TMJ tomographs can provide useful information for anatomical analysis of TMJ.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.928-933
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• 2001

Intraventricular arachnoid cyst has been rarely reported. Here we present two cases of symptomatic intraventricular arachnoid cysts in the fourth ventricle and right lateral ventricle. The first patient was a 38-year-old female who complained of headache and left facial hypesthesia. Computed tomography and MR scan revealed large cystic lesion in the fourth ventricle. After cyst wall removal, facial hypesthesia disappeared immediately and headache improved slowly. The second patient was a 9-year-old girl who complained of headache, vomiting and paresthesia in her right low extremity. Cystic lesion in the right lateral ventricle was detected in the CT and MR scan. The symptoms improved after cyst wall removal. Surgical findings of these two cases showed that the cyst walls were attached firmly to the choroid plexus. Symptomatic intraventricular arachnoid cyst must be treated appropriately and we recommend complete cyst wall removal.

• Anatomy and Cell Biology
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• v.57 no.3
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• pp.463-467
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• 2024

Pneumatisation of the maxillary sinus (MS) is variable. The archived cone-beam computed tomography file of a 54-year-old female was retrospectively evaluated anatomically. Nasal or retrobullar recesses of the MSs (NRMS) were found. The MSs were bicameral. NRMSs extended from the postero-lateral chambers of the MSs into the lateral nasal walls. The right NRMS was reached superior to the middle turbinate and the ethmoidal bulla was applied on its anterior side. The left NRMS had two medial pouch-like ends, one beneath the ethmoidal bulla and the other on the anterior side of the basal lamella of the middle turbinate. Additional anatomical findings were the uncinate bulla, infraorbital recesses of the MS, maxillary recess of the sphenoidal sinus, and atypical posterior insertions of the superior nasal turbinates, maxillo-ethmoido-sphenoidal and ethmoido-sphenoidal. The NRMS is a novel finding and could lead to erroneous endoscopic corridors if not documented before the interventions.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.151-157
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• 2018

Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.663-668
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• 2008

Purpose: Pedicled transverse rectus abdominis myocutaneous(TRAM) flap has been a gold standard for breast reconstruction and one of surgical techniques preferred by many surgeons. The authors examined the course of deep epigastric artery focusing on distance from margins of rectus abdominis to pedicle and location of choke vessels to get minimal muscles during pedicled TRAM flap operation. Methods: Eleven rectus abdominis muscle from nine cadavers were used in this study. Rectus abdominis was separated from the cadavers, deep inferior and superior epigastric artery were isolated and then 8 anatomical landmarks in medial and lateral margins of rectus abdominis were designated. Distance to a pedicle meeting first horizontally was measured and vertical location from umbilicus to choke vessel was determined. In addition, 32 rectus abdominis images of 16 women(average age: 37.2 years old) from 64 channel abdomen dynamic computerized tomography were also examined with the same anatomical landmarks with those of cadavers. Results: Average distance from four landmarks on lateral margin of rectus abdominis to pedicle was 1.9 - 3.4cm and 1.8 - 3.8 cm on medial margin. Choke vessel was located between middle and inferior tendinous intersection in all cases and average distance between two tendinous intersection was 6.7 - 7.0 cm on medial margin and 6.2 cm on lateral margin. Location of inferior tendinous intersection was on umbilicus or superior of it in all cases and its average distance from umbilicus was 1.8 - 5.6 cm on medial margin and 2.7 - 6.2 cm on lateral margin. Conclusion: Distance from medial and lateral margins of rectus abdominis muscle to pedicle was the shortest in inferior tendinous intersection and that was averagely 1.8 cm on medial margin and 1.9 cm in average on lateral margin. All choke vessels were located between middle and inferior tendinous intersection.

• Journal of Korean Neurosurgical Society
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• v.57 no.6
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• pp.460-464
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• 2015

Objective : Bilateral C1 lateral mass and C2 pedicle screw fixation (C1LM-C2P) is an ideal technique for correcting atlantoaxial instability (AAI). However, the inevitable situation of vertebral artery injury or unfavorable bone structure may necessitate the use of unilateral C1LM-C2P. This study compares the fusion rates of the C1 lateral mass and C2 pedicle screw in the unilateral and bilateral methods. Methods : Over five years, C1LM-C2P was performed in 25 patients with AAI in our institute. Preoperative studies including cervical X-ray, three-dimensional computed tomography (CT), CT angiogram, and magnetic resonance imaging were performed. To evaluate bony fusion, measurements of the atlanto-dental interval (ADI) and CT scans were performed in the preoperative period, immediate postoperative period, and postoperatively at 1, 3, 6, and 12 months. Results : Unilateral C1LM-C2P was performed in 11 patients (44%). The need to perform unilateral C1LM-C2P was due to anomalous course of the vertebral artery in eight patients (73%) and severe degenerative arthritis in three patients (27%). The mean ADI in the bilateral group was 2.09 mm in the immediate postoperative period and 1.75 mm in 12-months postoperatively. The mean ADI in the unilateral group was 1.82 mm in the immediate postoperative period and 1.91 mm in 12-months postoperatively. Comparison of ADI measurements showed no significant differences in either group (p=0.893), and the fusion rate was 100% in both groups. Conclusion : Although bilateral C1LM-C2P is effective for AAI from a biomechanical perspective, unilateral screw fixation is a useful alternative in patients with anatomical variations.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.330-333
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• 2014

Objective : To identify the accuracy and efficiency of the computed tomographic (CT)-based navigation system on upper cervical instrumentation, particularly C1 lateral mass and C2 pedicle screw fixation compared to previous reports. Methods : Between May 2005 and March 2014, 25 patients underwent upper cervical instrumentation via a CT-based navigation system. Seven patients were excluded, while 18 patients were involved. There were 13 males and five females; resulting in four degenerative cervical diseases and 14 trauma cases. A CT-based navigation system and lateral fluoroscopy were used during the screw instrumentation procedure. Among the 58 screws inserted as C1-2 screws fixation, their precise positions were evaluated by postoperative CT scans and classified into three categories : in-pedicle, non-critical breach, and critical breach. Results : Postoperatively, the precise positions of the C1-2 screws fixation were 81.1% (47/58), and 8.6% (5/58) were of non-critical breach, while 10.3% (6/58) were of critical breach. Most (5/6, 83.3%) of the critical breaches and all of non-critical breaches were observed in the C2 pedicle screws and there was only one case of a critical breach among the C1 lateral mass screws. There were three complications (two vertebral artery occlusions and a deep wound infection), but no postoperative instrument-related neurological deteriorations were seen, even in the critical breach cases. Conclusion : Although CT-based navigation systems can result in a more precise procedure, there are still some problems at the upper cervical spine levels, where the anatomy is highly variable. Even though there were no catastrophic complications, more experience are needed for safer procedure.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.22-28
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• 2016

Objectives: The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction. Materials and Methods: Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance. Results: The overall mean volume fraction of gutta-percha was $68.51{\pm}6.75%$ for CL, $86.56{\pm}5.00%$ for UL, and $88.91{\pm}5.16%$ for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group. Conclusions: WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.462-467
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• 2018

Background: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. Methods: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. Results: The average VSA of the lateral column was $22^{\circ}{\pm}6^{\circ}$, and that of the intermediate column was $29^{\circ}{\pm}8^{\circ}$ in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was $30{\pm}3mm$ at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. Conclusions: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.

• Neurospine
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• v.15 no.4
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• pp.362-367
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• 2018

Objective: To assess the efficacy of cervical open-door laminoplasty by hydroxyapatite implant insertion between the lamina and the lateral mass without suturing. Methods: All patients who underwent cervical open-door laminoplasty with C2/C7 undermining and insertion of hydroxyapatite implants from C3 to C6 were retrospectively evaluated for surgical time and neurological outcomes according to the Japanese Orthopaedic Association (JOA) score. To assess the alignment of the cervical spine and postoperative cervical pain, the C2-7 angle and a visual analogue scale score were used, respectively. Results: The population consisted of 102 women and 222 men ranging in age from 32 to 90 years. The average surgical time was 86 minutes. Fourteen of 1,296 hydroxyapatite implants were kept in place with sutures due to a weak restoration force of the hinge during surgery. No hydroxyapatite implant dislocation was detected on cervical computed tomography at 1 year after surgery. The average JOA score was $10.2{\pm}2.5$ before surgery and $14.6{\pm}2.8$ at 1 year after surgery. The average recovery rate was 61.8%. The average C2-7 angle at the neutral position was $7.1^{\circ}{\pm}6.2^{\circ}$ before surgery and $6.5^{\circ}{\pm}6.3^{\circ}$ at 1 year after surgery. Conclusion: This method enabled us to achieve minimal exposure of the lateral mass, prevention of lateral mass injury and dural injury, and a shorter surgical time while maintaining acceptable surgical outcomes. The idea that firm suture fixation is needed to prevent spacer deviation during cervical open-door laminoplasty may need to be revisited.