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  • Title/Summary/Keyword: posterior attachment

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ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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Arthroscopic All Inside Repair of Lateral Meniscus Root Tear -Technical note- (외측 반월상 연골 경골 후방 부착부 파열의 관절경적 All-Inside 봉합술 - 수술술기 -)

  • Ahn, Jin-Hwan;Lee, Dong-Hoon;Chang, Moon-Jong
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.63-68
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    • 2007
  • Purpose: The authors introduce a new technique of arthroscopic all inside repair using anterolateral and anteromedial portals for lateral meniscus root complete radial tear in patients who underwent concurrent anterior cruciate ligament (ACL) reconstruction. Operative technique: Arthroscope is placed through anteromedial portal and suture hook (LinvatecTM, Largo, Florida, USA) is delivered through anterolateral portal. By rotating the suture hook, it penetrates posterior horn of the torn meniscus from femoral to tibial surface for vertical orientation. PDS No. 1 (EthiconTM, Somerville, NJ, USA) is delivered through the suture hook, and then it is withdrawn. Both end of PDS No. 1 are taken out through the anterolateral portal. MAXON 2-0 (SynetureTM, Norwalk, Connecticut, USA) is used to penetrates remnant of tibial attachment of the torn meniscus from tibial to femoral surface in a same manner. MAXON 2-0 is changed for PDS No. 1 from tibial to femoral surface by shuttle relay technique. PDS No. 1 is tied using SMC (Samsung Medical Center) knot. Conclusion: All inside repair is a useful technique to achieve anatomical repair and to restore the hoop tension in lateral meniscus root complete radial tear.

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EFFECTS OF ELECTRICAL STIMULATION ON THE NORMAL PERIODONTIUM (전기자극이 정상 치주조직에 미치는 영향)

  • Lim, Kyung-Seok;Kwon, Young-Hyuk;Lee, Man-sup;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.32 no.1
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    • pp.89-112
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    • 2002
  • The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.

Smartphone Fundus Photography in an Infant with Abusive Head Trauma (학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견)

  • Kim, Yong Hyun;Choi, Shin Young;Lee, Ji Sook;Yoon, Soo Han;Chung, Seung Ah
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.11
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    • pp.1313-1316
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    • 2017
  • Purpose: To report fundus photography using a smartphone in an infant with abusive head trauma. Case summary: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15-20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant's eye with a strong vitreoretinal attachment. Conclusions: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case.

Conversion of implant overdenture to an implant assisted removable partial denture in maxilla: case report (상악 임플란트 피개의치에서 임플란트 보조 국소의치로의 전환: 증례보고)

  • Seong-Soo Cho;Min-Gyu Song;Yoon-Hyuk Huh;Chan-Jin Park;Lee-Ra Cho;Kyung-Ho Ko
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.54-63
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    • 2024
  • The long-term use of an implant overdenture shows problems, such as wear of attachment, concentrated occlusal forces on the anterior teeth, fracture of artificial teeth and rotation of denture. By transitioning to an Implant-assisted removable partial denture (IARPD) using additional implant placement, the problems can be solved. In this case report, a transition was made from implant overdenture to IARPD utilizing surveyed crowns to distribute occlusal forces concentrated on anterior teeth and to prevent denture rotation in a skeletal Class III patient. Design of definitive prosthesis with appropriate function and aesthetics was determined through several stages of provisional restorations. In this case, appropriate posterior occlusion and maintenance of peri-implant bone level of definitive prosthesis were observed.

The Relationship between the Anterior Cruciate Ligament Tear and the Posterior Cruciate Ligament Index on MRI Findings (자기공명영상 상 전방십자인대 파열과 후방십자인대 곡선값의 연관성)

  • Kang Jae Do;Kim Kwang Yul;Kim Hyung Cheon;Lee Sung Chun
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.109-114
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    • 2002
  • Propose : The purpose of this retrospective study was to test the posterior cruciate ligament (PCL index) for diagnosis of a tear of the anterior cruciate ligament (ACL) by means of MR imaging. Materials and Methods : From Mar. 1997 to Feb. 2001, concomitant magnetic resonance imaging (MRI) and knee joint arthroscopy were performed in 56 patients of either pain or instability of the knee. The shortest distance between the femoral and tibial attachment of PCL (X) and the distance from that line to the tip of the arc marked by the PCL (Y) on the sagittal plane images were measured. The quotient of these two parameters (Y/X) defined the PCL index. Results : Using MRI diagnosis, there were 35 patients diagnosed with ACL rupture and 21 patients were ruled out of ACL injury. Using arthroscopy, 32 of the 35 patients diagnosed by MRI showed ACL rupture, and 20 of the 21 patients were ruled out of ACL injury. The mean PCL index was 0.40 in the 33 patients diagnosed with ACL rupture through arthroscopy. The mean PCL index was 0.23 in 23 patients with an uninjured ACL through arthroscopy. In 33 patients with ruptured ACL, this value exceeds 0.31. The index value was 0.31 in 3 patients with uninjured ACL. The value of the index was not above 0.31 with an uninjured ACL. PCL index on MRI had a sensitivity of 91% and a specificity of 94% for determining the status of the anterior cruciate ligament. Conclusion : Injury to the ACL changes the PCL index markedly. In diagnostically unreliable MR images, amelioration of the PCL index could help in the diagnosis of ACL injury.

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Effect of location of glass fiber pre-impregnated with light-curing resin on the fracture strength and fracture modes of a maxillary complete denture (광중합형 레진에 함침시킨 유리섬유의 위치가 상악 총의치의 파절강도와 파절양상에 미치는 영향)

  • Yoo, Hyun-Sang;Sung, Su-Jin;Jo, Jae-Young;Lee, Do-Chan;Huh, Jung-Bo;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.279-284
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    • 2012
  • Purpose: This study evaluated the effect of glass fiber pre-impregnated with light-curing resin on the fracture strength and fracture modes of a maxillary complete denture. Materials and methods: Maxillary acrylic resin complete dentures reinforced with glass fiber pre-impregnated with light-curing resin (SES MESH, INNO Dental Co., Yeoncheongun, Korea) and without reinforcement were tested. The reinforcing material was embedded in the denture base resin and placed different regions (Control, without reinforcement; Group A, center of anterior ridge; Group B, rugae area; Group C, center of palate; Group D, full coverage of denture base). The fracture strength and fracture modes of a maxillary complete denture were tested using Instron test machine (Instron Co., Canton, MA, USA) at a 5.0 mm/min crosshead speed. The flexure load was applied to center of denture with a 20 mm diameter ball attachment. When fracture occurred, the fracture mode was classified based on fracture lines. The data were analyzed with one-way ANOVA at the significance level of 0.05. Results: There were non-significant differences (P>.05) in the fracture strength among test groups. Group A showed anteroposterior fracture and posterior fracture mainly, group B, C and control group showed partial fracture on center area mostly. Most specimen of group D showed posterior fracture. Conclusion: The location and presence of the fiber reinforcement did not affect the fracture strength of maxillary complete denture. However, reinforcing acrylic resin denture with glass fiber has a tendency to suppress the crack.

Finite Element Analysis of Stress Distribution on Telescopic System for Mandibular Implant Supported Overdenture (이중관 구조 하악 임플랜트 피개의치의 응력 분포에 관한 유한요소법적 분석)

  • Oh, Jung-Ran;Woo, Yi-Hyung;Lee, Sung-Bok;Bak, Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.4
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    • pp.359-371
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    • 2008
  • Purpose: The purpose of this study was to investigate the stress distribution in mandibular implant overdentures with telescopic crowns compared to bar attachment. Material and methods: Three-dimensional finite element models consisting of the mandibular bone, 4 implants, and primary bar-splinted superstructure or secondary splinted superstructure with telescopic crowns were created. Vertical and oblique loads were directed onto the occlusal areas of the superstructures to simulate the maximal intercuspal contacts and working contacts such as group function occlusion. Maximum stress and stress distribution were analysed in mandibular bone, implant abutments, and superstructures. Results: 1. In comparison of von Mises stress on mandibular bone, telescopic overdenture had a little lower stress values in vertical load and working side load except oblique load. In the mandible, the telescopic overdenture distributed more uniform stress than the bar overdenture. 2. In comparison of von Mises stress on implant abutments, telescopic overdenture had much lower stress values in all load conditions. In implant abutments, the telescopic overdenture distributed stress similar to the bar overdenture. Stress was concentrated on the distal surfaces of the posterior implant abutments in both mandibular overdentures. 3. In comparison of von Mises stress on superstructures, the telescopic overdenture had much more stress values in all load conditions. However, the telescopic overdenture distributed more uniform stress on superstructure than the bar overdenture. In the bar overdenture, stress was concentrated on each cental area of bar structures and connected area between implant abutments and bar structures. Conclusion: In the results of this study, the telescopic overdenture had lower stress values than the bar overdenture in mandibular bone and implant abutments, but more stress values in superstructures. However, if optimal material was selected in making superstructures, the telescopic overdenture was compared to the bar overdenture in stress distribution.

Comparison of Exposure Dose by Using AEC Mode of Abdomen AP Study in Radiography (복부 전후 방향 검사의 자동노출제어 사용 시 선량 비교 연구)

  • Kim, Ki-Won;Kwon, Yong-Rak;Seo, Seong-Won;Kwon, Kyung-Tae;Oh, Joo-Young;Son, Soon-Yong;Son, Jin-Hyun;Min, Jung-Whan
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.205-211
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    • 2015
  • We evaluated the effectiveness of TL (Time Limit) method by comparing with NTL (Non-time limit) method when it is used for examinations for abdomen Anterior Posterior (AP) in this paper. The evaluation was conducted based on the comparison of dose, and of signal to noise ratio (SNR) and contrast to ratio (CNR) on both methods. The experiments were conducted with XGEO GC 80 (Samsung, Korea), Unfors ThinX RAD (Unfors, Sweden) and Rando Phantom (Alderson research laboratories, USA) and shielding material with the size of 5.5×9×0.1cm3. It was set to activate only two upper ionization chambers in automatic exposure control(AEC) mode and the tube-voltage was set to 80kVp. When the exposure time was limited, it is limited to 51 msec. The images both by NTL AEC method and TL AEC method were acquired when with and without attachment of shielding material on the upper ionization chambers. The images were evaluated by SNR and CNR which are the image evaluation methods using 'Image J'. The NTL AEC method showed increases in dose as much as 130.7% at maximum and 80% at minimum than other methods. The TL AEC method showed decreases in mAs and exposure dose than the NTL AEC method as much as 43.8% and 44.4% respectively. There were no significant differences in SNR or CNR for the experiments ((p0.05). Therefore, it is suggested that the TLAEC mode is more effective when examining patients who have high BMI index or a patient with a metallic substance in the body after surgery.