• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.687-695
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• 2007

Statement of problem: The proper contact relation between adjacent teeth in each arch plays an important role in the stability and maintenance of the integrity of the dental arches. Proximal contact has been defined as the area of a tooth that is in close association, connection, or touch with an adjacent tooth in the same arch. Purpose: The aim of this study was to develop a digital device for measuring the proximal tooth contact tightness by pulling a thin stainless steel strip (2mm wide, 0.03mm thick) inserted between proximal tooth contact. Material and method: This device consists of measuring part, sensor part, motor part and body part. The stainless steel strip was connected to a stain gauge. The strain gauge was designed to convert the frictional force into a compressive force. This compressive force was detected as a electrical signal and the electrical signal was digitalized by a A/D converter. The digital signals were displayed by a micro-processor. The pulling speed was 8mm/s. Results: For testing reliability of the device in vivo, two healthy young adults (A, B) participated in this experiment. The tightness of proximal tooth contact between the second premolar and the first molar of mandible (subject A) and maxilla (subject B) was measured fifteen times for three days at rest. We double-checked the accuracy of the device with a Universal Testing Machine. Output signals from the Universal Testing Machine and the measuring device were compared. Regression analysis showed high linearity between these two signals. In vivo test, no significant differences were found between measurements. Conclusion: This device has shown to he capable of producing reliable and reproducible results in measuring proximal tooth contact. Therefore, it was considered that this device was appropriate to apply clinically.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.302-308
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• 2013

Purpose: To present clinical results of proximal first metatarsal opening wedge osteotomy and low profile plate fixation in hallux valgus deformity. Materials and Methods: Thirty-two patients (39 feet) underwent surgery for hallux valgus deformity. Fourteen patients (18 feet; Group A) underwent proximal first metatarsal opening wedge osteotomy fixed with low profile titanium plate ($Arthrex^{(R)}$), and 18 patients (21 feet; Group B) underwent proximal chevron osteotomy with two K-wires. Improvement in hallux valgus angle (HVA), 1, 2 intermetatarsal angle (IMA), range of motion of 1st metatarsophalangeal joint, VAS score, and the length of first metatarsal on weight-bearing radiograph were evaluated preoperatively and at final follow-up. Results: HVA improved from $36.2{\pm}6.6$ degrees to $11.7{\pm}5.1$ degrees, and 1, 2 IMA improved from $15.7{\pm}2.6$ degrees to $7.2{\pm}1.9$ degrees. VAS score improved from $7.2{\pm}1.2$ to $1.4{\pm}0.9$. There were no significant differences clinically and radiologically. Conclusion: Proximal first metatarsal opening wedge osteotomy with stable fixation using low profile plate may be an effective surgical option for correction of hallux valgus deformity.

• Restorative Dentistry and Endodontics
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• v.17 no.1
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• pp.141-152
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• 1992

Four endodontic instruments from different manufacturers(K - file, Hedstrom - file, K - flex - file, Cavi - Endo) were used to shape 80 mesial canals of extracted posterior teeth. The instrument's ability to enlarge and shape the canals as the original canal shape was assessed by superimposing radiographs of canals obtained before and after canal shaping. The results were as follows 1. Hedstrom - file enlarged canals greater than K - file, K - flex - file, and Cavi - Endo(P<0.05). There are no differences in canal enlargement among K - flex, K - flex - file, and Cavi - Endo(P<0.05). 2. All the instruments showed no difference in canal enlargement between convex side and concave side of B point in proximal and clinical radiographic views, but at the concave side of C point canals were enlarged greater than at the convex side(proximal view of K - file: P<0.05, the others: P<0.01). 3. There was no difference m canal enlargement between convex side and concave side in proximal view of A and D points of K - file and K - flex - file(P<0.05). But in clinical view, canal enlargement at convex side of A point and concave side of D point was greater than that at concave side of A point and convex side of D point respectively. 4. Hedstrom - files showed greater canal enlargement at convex side of A points and concave side of D points (P<0.05 or P<0.01). Cavi - Endo showed no difference in canal enlargement between convex side and concave side at A and D points in proximal view(P<0.05). Bur canal enlargement was greater at concave side than at convex side of D point in clinical view. 5. K - file and Cavi - Endo showed no differences in canal enlargement between convex and concave side in proximal and clinical view (P<0.05). K - flex - file showed greater canal enlargement at concave side in proximal and clinical view(P<0.0:5). Hedstrom file showed no difference in canal enlargement between convex side and concave side in proximal view, but showed greater canal enlargement at concave side in clinical view(P<0.05).

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.49-56
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• 2022

Background: The treatment approach for proximal humeral fractures is determined by various factors, including patient age, sex, dominant arm, fracture pattern, presence of osteoporosis, preexisting arthritis, rotator cuff status, and medical comorbidities. However, there is a lack of consensus in the literature regarding the optimal treatment for displaced proximal humeral fractures. This study aimed to assess and quantify the decision-making process for either conservative or surgical treatment and the choice of surgical method among shoulder surgeons when treating proximal humeral fractures. Methods: Forty sets of true anteroposterior view, scapular Y projection view, and three-dimensional computed tomography of proximal humeral fractures were provided to 12 shoulder surgeons along with clinical information. Surveys regarding Neer classification, decisions between conservative and surgical treatments, and chosen methods were conducted twice with an interval of 2 months. The factors affecting the treatment plans were also assessed. Results: The inter-rater agreement was fair for Neer classification (kappa=0.395), moderate for the decision between conservative and surgical treatments (kappa=0.528), and substantial for the chosen method of surgical treatment (kappa=0.740). The percentage of agreement was 71.1% for Neer classification, 84.6% for the decision between conservative and surgical treatment, and 96.4% for the chosen method of surgical treatment. The fracture pattern was the most crucial factor in deciding between conservative and surgical treatments, followed by age and physical activity. Conclusions: The decision between conservative and surgical treatment for proximal humeral fractures showed good agreement, while the chosen method between osteosynthesis and arthroplasty showed substantial agreement among shoulder surgeons.

• Journal of Gastric Cancer
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• v.24 no.2
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• pp.137-144
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• 2024

Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.20-25
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• 2008

Purpose: The purpose of this study is comparison of radiological and clinical outcomes between proximal metatarsal osteotomy and distal chevron osteotomy for the correction of hallux valgus. Materials and Methods: In this retrospective study, we included subjects who underwent the correction of hallux valgus in our institution between March 2001 and August 2006, with a minimum follow-up of 12 months. The group of proximal metatarsal osteotomy was 23 patients (34 feet); the group of distal chevron osteotomy was 20 patients (26 feet). The group of proximal metatarsal osteotomy was composed of 26 severe cases (76.5%) and 8 moderate cases (23.5%); the group of distal chevron osteotomy was composed of 13 severe cases (50.0%) and 13 moderate cases (50.0%). Results: Compared to preoperative values, the hallux valgus angle, the first-second intermetatarsal angle and the distance of first-fifth metatarsal head were significantly decreased in two groups (p<0.05). In each parameter, the hallux valgus angle was decreased 66.3% (proximal metatarsal osteotomy) versus 49.6% (distal chevron osteotomy), which were significant (p=0.037). The first-second intermetatarsal angle and the distance of first-fifth metatarsal head were not significant. Mayo clinic forefoot scoring system (FFSS) score was significantly improved in two groups (p<0.05). The ratio of improvement was not significant (p=0.762). In severe group, hallux valgus angle and the first-second intermetatarsal angle was significantly decreased in proximal metatarsal osteotomy group compared to distal chevron osteotomy group (p<0.05), but the difference of the distance of first-fifth metatarsal head and FFSS score was not significant in both groups. In moderate group, the difference of all parameters was not significant in both groups. Conclusion: Although both proximal metatarsal osteotomy and distal chevron osteotomy showed satisfactory result in FFSS, proximal metatarsal osteotomy was more proper operative technique than distal chevron osteotomy in severe group, because of superiority of correction in radiological parameters.

• Physical Therapy Korea
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• v.13 no.4
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• pp.71-78
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• 2006

This study examined the effects of socket flexion angle in trans-tibial prosthesis on stump/socket interface pressure. Ten trans-tibial amputees voluntarily participated in this study. F-socket system was used to measure static and dynamic pressure in stump/socket interface. The pressure was measured at anterior area (proximal, middle, and distal) and posterior area (proximal, middle, and distal) in different socket flexion angles ($5^{\circ}$, $0^{\circ}$, and $10^{\circ}$). Paired t-test was used to compare pressure differences in conventional socket flexion angle of $5^{\circ}$ with pressures in socket flexion angles of $0^{\circ}$ and $10^{\circ}$ (${\alpha}$=.05). Mean pressure during standing in socket flexion angle of $10^{\circ}$ decreased significantly in anterior middle area (19.7%), posterior proximal area (10.4%), and posterior distal area (16.3%) compared with socket flexion angle of $5^{\circ}$. Mean pressure during stance phase in socket flexion angle of $0^{\circ}$ increased significantly in anterior proximal area (19.3%) and decreased significantly in anterior distal area (19.7%) compared with socket flexion angle of $5^{\circ}$. Mean pressure during stance phase in socket flexion angle of $10^{\circ}$ decreased significantly in anterior proximal area (19.6%) and increased significantly in anterior distal area (8.2%) compared with socket flexion angle of $5^{\circ}$. Peak pressure during gait in socket flexion angle of $0^{\circ}$ increased significantly in anterior proximal area (23.0%) compared with socket flexion angle of $5^{\circ}$ and peak pressure during gait in socket flexion angle of $10^{\circ}$ decreased significantly in anterior proximal area (22.7%) compared with socket flexion angle of $5^{\circ}$. Mean pressure over 80% of peak pressure ($MP_{80+}$) during gait in socket flexion angle of $0^{\circ}$ increased significantly in anterior proximal area (23.9%) and decreased significantly in anterior distal area (22.5%) compared with socket flexion angle of $5^{\circ}$. $MP_{80+}$ during gait in socket flexion angle of $10^{\circ}$ decreased significantly in anterior distal area (34.1%) compared with socket flexion angle of $5^{\circ}$. Asymmetrical pressure change patterns in socket flexion angle of $0^{\circ}$ and $10^{\circ}$ were revealed in anterior proximal and distal region compared with socket flexion angle of $5^{\circ}$. To provide comfortable and safe socket for trans-tibial amputee, socket flexion angle must be considered.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.432-461
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• 1995

The basic principles in the design of Class II amalgam cavity preparations have been modified but not changed in essence over the last 90 years. The early essential principle was "extension for prevention". Most of the modifications have served to reduce the extent of preparation and, thus, increase the conservation of sound tooth structure. A more recent concept relating to conservative Class II cavity preparations involves elimination of occlusal preparation if no carious lesion exists in this area. To evaluate the ideal ClassII cavity preparation design, if carious lesion exists only in the interproximal area, three cavity design conditions were studied: Rodda's conventional cavity, simple proximal box cavity and proximal box cavity with retention grooves. In this study, MO amalgam cavity was prepared on maxillary first premolar. Three dimensional finite element models were made by serial photographic method. Linear, eight and six-nodal, isoparametric brick elements were used for the three dimensional finite element model. The periodontal ligament and alveolar bone surrounding the tooth were excluded in these models. Three types model(B option, Gap option and R option model) were developed. B option model was assumed perfect bonding between the restoration and cavty wall. Gap option model(Gap distance: $2{\mu}m$) was assumed the possibility of play at the interface simulated the lack of real bonding between the amalgam and cavity wall (enamel and dentin). R option model was assumed non-connection between the restoration and cavty wall. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as followed. 1. Rodda's cavity form model showed greater amount of displacement with other two models. 2. The stress and strain were increased on the distal marginal ridge and buccopulpal line angle in Rodda's cavity form model. 3. The stress and strain were increased on the central groove and a part of distal marginal ridge in simple proximal box model and proximal box model with retention grooves. 4. With Gap option, Rodda's cavity form model showed the greatest amount of the stress on distal marginal ridge followed by proximal box model with retention grooves and simple proximal box model in descending order. 5. With Gap option, simple proximal box model showed greater amount of stress on the central groove with proximal box model with retention grooves. 6. Retention grooves in the proximal box played the role of supporting the restorations opposing to loads.

• Imaging Science in Dentistry
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• v.34 no.1
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• pp.1-5
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• 2004

Purpose: To evaluate the diagnostic accuracy of occlusal and proximal caries detection using CCD, CMOS, PSP and film system. Materials and Methods : 32 occlusal and 30 proximal tooth surfaces were radiographed under standardized conditions using 3 digital systems; CCD (CDX-2000HQ, Biomedysis Co., Seoul, Korea), CMOS (Schick, Schick Inc., Long Island, USA), PSP (Digora/sup (R)/FMX, Orion Co./Soredex, Helsinki, Finland) and I film system (Kodak Insight, Eastman Kodak, Rochester, USA). 5 observers examined the radiographs for occlusal and proximal caries using a 5-point confidence scale. The presence of caries was validated histologically and radiographically. Diagnostic accuracy was evaluated using ROC curve areas (Az). Results: Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. For occlusal caries, Kodak Insight film had an Az of 0.765, CCD one of 0.730, CMOS one of 0.742 and PSP one of 0.735. For proximal caries, Kodak Insight film had an Az of 0.833, CCD one of 0.832, CMOS one of 0.828 and PSP one of 0.868. No statistically significant difference was noted between any of the imaging modalities. Conclusion: CCD, CMOS, PSP and film performed equally well in the detection of occlusal and proximal dental caries. CCD, CMOS and PSP-based digital images provided a level of diagnostic performance comparable to Kodak Insight film.

• Journal of Gastric Cancer
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• v.12 no.3
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• pp.187-193
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• 2012

Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. Materials and Methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. Results: There were 5 males and 5 females. The mean age was $56.5{\pm}0.5$ years. The mean operation time was $188.5{\pm}0.5$ minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was $25.2{\pm}0.5$. The length of proximal resection free margin was $3.1{\pm}0.1$ cm and distal was $3.7{\pm}0.1$ cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.