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Comparison of Femoral Anteversion Angle and Determination of Reliability Measured at Three Different Anatomical References of the Tibial Crest During the Trochanteric Prominence Angle Test

  • Lee, Ji-Hyun;Yoon, Tae-Lim;Choi, Sil-Ah;Cynn, Heon-Seock
    • Physical Therapy Korea
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    • v.19 no.4
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    • pp.55-60
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    • 2012
  • The trochanteric prominence angle test (TPAT) has been used to measure the femoral anteversion angle between the tibial crest and the vertical line. However, the exact anatomical reference of the tibial crest has not yet been identified in the literature. Thus, the purposes of this research were twofold: first, to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest (the proximal tibial crest, the proximal third of tibial crest, and the proximal half of tibial crest) and, second, to determine inter-and intra-rater reliabilities of the femoral anteversion angle measured at these three different anatomical references of the tibial crest during the TPAT. We recruited 14 healthy subjects, and a total of 28 legs were examined. The TPAT was measured using a digital inclinometer. A 1-way repeated-measure analysis of variance was used to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest, and intraclass correlation coefficients (ICCs) were calculated to determine reliability. The femoral anteversion angle measured at the proximal tibial crest was significantly higher than that at the proximal third of the tibial crest and the proximal half of the tibial crest. The inter-and intra-rater reliabilities of femoral anteversion angle were measured at three anatomic references of the tibial crest were all found to be high during the TPAT (ICC=.9 0~.98). In conclusion, clinicians should recognize that the different degrees of the femoral anteversion angle could be measured when different anatomical references of the tibial crest were used, and that reliabilities were high when an exact anatomical reference of the tibial crest was used during the TPAT.

Long-Term Outcomes of Proximal Gastrectomy versus Total Gastrectomy for Upper-Third Gastric Cancer

  • Son, Myoung Won;Kim, Yong Jin;Jeong, Gui Ae;Cho, Gyu Seok;Lee, Moon Soo
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.246-251
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    • 2014
  • Purpose: There are two surgical procedures for proximal early gastric cancer (EGC): total gastrectomy (TG) and proximal gastrectomy (PG). This study aimed to compare the long-term outcomes of PG with those of TG. Materials and Methods: Between January 2001 and December 2008, 170 patients were diagnosed with proximal EGC at Soonchunhyang University Cheonan Hospital, of which 64 patients underwent PG and 106 underwent TG. Clinicopathologic features, postoperative complications, blood chemistry data, changes in body weight, and oncological outcomes were analyzed and retrospectively compared between both groups. Results: Tumor size was smaller and the number of retrieved lymph nodes was lower in the PG group. The postoperative complication rate was 10.9% in the TG group and 16.9% in the PG group. The incidence of Los Angeles grade C and D reflux esophagitis was significantly higher in the TG group. Hemoglobin level was higher and body weight loss was greater in the TG group at 2, 3, and 5 years postoperatively. The albumin levels at 3 and 5 years were lower in the TG group. There was no significant difference in the 5-year overall survival rates between the two groups (P=0.789). Conclusions: Postoperative complications and oncologic outcomes were observed to be similar between the two groups. The PG group showed better laboratory data and weight loss than did the TG group. Moreover, severe reflux esophagitis occurred less frequently in the PG group than in the TG group. PG can be considered as an effective surgical treatment for proximal EGC.

Evaluation of proximal contact strength by postural changes

  • Kim, Hee-Sun;Na, Hyun-Joon;Kim, Hee-Jung;Kang, Dong-Wan;Oh, Sang-Ho
    • The Journal of Advanced Prosthodontics
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    • v.1 no.3
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    • pp.118-123
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    • 2009
  • STATEMENT OF PROBLEM. Proper proximal contact is important for maintaining and stabilizing the dental arch. However, the proximal contact strength (PCS) is not a constant value and can be affected by a variety of factors. PURPOSE. This study examined the influences of postural changes on the posterior PCS. MATERIAL AND METHODS. Twelve adults with a normal occlusion and had not undergone prosthetic treatment or proximal restoration were participated in this study. A metal strip was inserted into the proximal surface and removed at a constant velocity. The contact strength was measured in every contact point between canine to second molar in both arches. The PCSs were obtained initially in the upright position, secondly in the supine position and finally in the upright position again. All measurements were repeated after a 2 hour period. Statistical analysis was carried out using the Friedman test (P < .05). RESULTS. Generally, a decrease in PCS occurred when the posture was changed from the initial upright to supine position, while it increased when the posture was changed from the supine to upright position. A significant change was observed in all areas except for between the canine-first premolar in the maxilla and between the first molar-second molar in the mandible areas. CONCLUSION. The posterior PCS, which dentists generally believe to be a static feature of occlusion, is affected significantly by posture.

Clinical and Experimental Studies on Colon Fistulation in Ruminant (반추수의 결장루 조성술에 관한 실험적 및 임상적 연구)

  • Jang Kwang-Ho;Kweon Oh-Kyeong;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.437-470
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    • 1994
  • These studies were performed to establish more effective surgical method for correcting congenital atresia coli in calves. Distal colon fistulation, proximal colon fistulation and colon anastomosis which could be applied for surgical repair of intestinal obstruction were carried out in goatlings experimentally and in calves with atresia coli clinically. After treatment of the animals clinical signs, blood component values, body weight gain, survival and necropsy findings were observed. In goatlings, clinical signs after colon fistulation were diarrhea, anorexia and vitality loss, and those of proximal colon fistulation group were severer than those of distal colon fistulation group. Surviviability after operation was 9~16 weeks in distal colon fistulation group, 2~8 weeks in proximal colon fistulation group, and 2-3 days in colocolic anastomosis group, respectively. There were no alterations in blood component values among experimental groups. Weight gain rates were 54.6% in distal colon fistulation group and 42.9% in proximal colon fistulation group compared with those of control. Necropsy findings observed in experimental groups were distension of intestine and excessive fluid in abomasum and intestine. Two calves with atresia coli died 1 day and 6 days after operation but one with colon fistulation survived more than two months. Preoperative clinical signs in calves with atresia coli were abdominal distension, progressive anorexia, no defecation and postoperative clinical signs wert diarrhea and periodic abdominal distension. After operation there were no alterations in blood component values between the calf with atresia coli and control calf. Weight gain rate of calf with atresia coli was similar to that of control but revealed the tendency to decrease from the 2nd month after operation. Necropsy findings observed in two calves with atresia coli were intestinal distension. intraluminal excessive fluid, blind atretic sac and absence of intrarectal content. It was concluded that proximal or distal colon fistulation could be available for surgical correction of congenital atresla coli and prognosis of distal colon fistulation was better than of proximal colon fistulation, but that extensive colocolic anastomosis could not be compatible with life in ruminants.

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Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates

  • Rhee, Yong Girl;Cho, Nam Su;Cha, Sang Won;Moon, Seong Cheol;Hwang, Sang Phil
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.2-9
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    • 2014
  • Background: Indirect reduction technique offers a valid option in the treatment of proximal humerus fracture. The purpose of this study is to evaluate the functional outcome and the complication rate after indirect reduction and internal fixation of unstable proximal humeral fractures with use of a locking plate. Methods: Twenty four patients with acute proximal humerus fracture were managed with indirect reduction and internal fixation with a locking plate. The mean follow-up period was 15.5 months. Results: The anatomical reduction of the medial cortex buttress was seen in 16 patients (66%) of the Group A and the non-anatomical reduction was seen in 8 patients (33%) of the Group B. Mean union time was $3.2{\pm}1.9$ months; it was $2.2{\pm}0.6$ months in the Group A and $5.3{\pm}2.2$ months in the Group B (p < 0.05). In our series, there were 6 cases of complications and these include 2 cases of varus malunion, 2 cases of shoulder stiffness, 1 case of heterotrophic ossification, 2 cases of screw perforation and 1 case of impingement. Conclusions: We conclude from our studies that indirect reduction and internal fixation using locking plate for acute proximal humerus fracture can give good results with bony union and predictable good overall functional outcome. If the medial cortex buttress is well maintained, a better anatomical reduction would be achieved, the union would be prompted, the pain would be further reduced and the range of the motion would be recovered more promptly.

A radiographic study of growth plate closure compared with age in the Korean native goat

  • Choi, Hojung;Shin, Heejae;Kang, Sangkyu;Lee, Heechun;Cho, Jongki;Chang, Dongwoo;Lee, Youngwon;Jeong, Seong Mok;Park, Seongjun;Shin, Sang Tae
    • Korean Journal of Veterinary Research
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    • v.46 no.3
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    • pp.285-289
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    • 2006
  • This study was performed to assess the growth plate closure time with aging in the Korean native goat. Radiographs of proximal and distal epiphysis of humerus, radius, ulna, femur and tibia were obtained at 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 17, 18, 20, 21, 30, 43 and 52 weeks after birth in 30 Korean native goats. The secondary ossification centers were scrutinized and assessed the maturity process on the basis of the criteria(stage 0 to 10). The secondary ossification centers of proximal and distal epiphysis of humerus, radius, femur and tibia and proximal ulna epiphysis appeared immediately after birth. While, that of distal ulna epiphysis appeared during the 1st to 2nd week of life. The fusion of distal humeral epiphysis occurred during the period from 8 to 12 months. The fusion of proximal radial epiphysis and distal tibial epiphysis were found at 1 year. The fusion of proximal and distal epiphysis of ulna and femur, proximal epiphysis of humerus and tibia and distal epiphysis of radius were found at 1 year or more than 1 year. As a result, growth plate closure was highly related to age in the Korean native goat and it is suggested that the estimation of animal's age might be useful by illustration of maturity process of the secondary ossification centers in the Korean native goat.

The efficacy of the reverse contrast mode in digital radiography for the detection of proximal dentinal caries

  • Miri, Shimasadat;Mehralizadeh, Sandra;Sadri, Donya;Motamedi, Mahmood Reza Kalantar;Soltani, Parisa
    • Imaging Science in Dentistry
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    • v.45 no.3
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    • pp.141-145
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    • 2015
  • Purpose: This study evaluated the diagnostic accuracy of the reverse contrast mode in intraoral digital radiography for the detection of proximal dentinal caries, in comparison with the original digital radiographs. Materials and Methods: Eighty extracted premolars with no clinically apparent caries were selected, and digital radiographs of them were taken separately in standard conditions. Four observers examined the original radiographs and the same radiographs in the reverse contrast mode with the goal of identifying proximal dentinal caries. Microscopic sections $5{\mu}m$ in thickness were prepared from the teeth in the mesiodistal direction. Four slides prepared from each sample used as the diagnostic gold standard. The data were analyzed using SPSS (${\alpha}=0.05$). Results: Our results showed that the original radiographs in order to identify proximal dentinal caries had the following values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively: 72.5%, 90%, 87.2%, 76.5%, and 80.9%. For the reverse contrast mode, however, the corresponding values were 63.1%, 89.4%, 87.1%, 73.5%, and 78.8%, respectively. The sensitivity of original digital radiograph for detecting proximal dentinal caries was significantly higher than that of reverse contrast mode (p<0.05). However, no statistically significant differences were found regarding specificity, positive predictive value, negative predictive value, or accuracy (p>0.05). Conclusion: The sensitivity of the original digital radiograph for detecting proximal dentinal caries was significantly higher than that of the reversed contrast images. However, no statistically significant differences were found between these techniques regarding specificity, positive predictive value, negative predictive value, or accuracy.

Application of Proximal Stimulation for Somatosensory Evoked Potentials in Patients with Diabetic Polyneuropathy (당뇨병성 다발신경병증 환자에서 체감각유발전위검사 시 근위부 자극법의 적용)

  • Kwon, Hyung-Min;Nam, HyunWoo;Sung, Jung-Joon;Lee, Chang-Hee;Park, Young Joo;Moon, Min Kyong
    • Annals of Clinical Neurophysiology
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    • v.5 no.2
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    • pp.181-186
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    • 2003
  • Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.

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Photoelastic Stress Analysis of Proximal Margins in Dental Restorations (치관보철물(齒冠補綴物)의 인접변연부위(隣接邊緣部位)에 작용(作用)하는 Stress에 관(關)한 광탄성학적(光彈性學的) 분석(分析))

  • Lim, Chung-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.18 no.1
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    • pp.37-47
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    • 1980
  • The purpose of this study was to investigate the stresses in different proximal margins and to measure, quantitatively, the effect of different modifications in the design of preparations on the stresses using two-dimensional photoelasticity. Photoelastic stress analysis is based on the phenomenon, exhibited by most transparent solids, of becoming birefringent, or doubly refracting, when strained. Two birefringent materials were used in this study, PSM-1 and PSM-5 in .standard sheet ($10'{\times}10'{\times}\frac{1}{4}'$ thickness), PSM-1(polyester) was used for constructing the substructure, and PSM-5(epoxy resin) was used in making the restorations to be investigated. Two birefringent materials were used in the construction of composite photoelastic model. Seven variable models were constructed. The peripheral dimensions of all model were constant and the models represent an occlusomesial section of a lower posterior molar. Model 1 represents the knife edge margin (shoulderless), Model 2 represents the chamfer, Model 3 represents a rounded shoulder(no sharp angle between the axial wall and gingival floor), Model 4 represents a flat shoulder (axial wall is a $90^{\circ}$ angle to the gingival wall), Model 5 represents $+15^{\circ}$ angulation, Model 6 has a $-15^{\circ}$ angulation, and Model 7 is the same as Model 4 except that it has a $45^{\circ}$ bevel. Improved artificial stone was used to represent dental cement in luting the composite photoelastic model. Static loading procedures(100 pounds) were used at preplanned sites. The results were as follows; 1. The stresses in the proximal portion of all tested models were compressive in nature when the proximal shoulders were loaded vertically on the same proximal marginal ridge. 2. The round and chamfered preparations were the optimum designs in proximoocclusal restorations. They showed the lowest stress concentration factor, i.e. 2.16 and 2.23, respectively. The knife edged shoulder had the highest value, K=5.39. Round type shoulder geometry experiments reduced the stress concentration factor (S.C.F.) 3. The gingival portion of proximal shoulder geometry was a critical location for stress concentration.

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Radiographic Evaluation of Limb Bone Development in Miniature Porcine (미니돼지의 팔다리 뼈 성장에 대한 방사선학적 평가)

  • Chang, Jin-Hwa;Jung, Joo-Hyun;Choi, Min-Cheol
    • Journal of Life Science
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    • v.17 no.10
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    • pp.1315-1320
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    • 2007
  • Epiphyseal development in the long bones was studied radiographically in minipigs. Radiographs of the proximal and distal epiphyses of humerus, radius, ulna, femur and tibia were obtained at 4, 8, 12, 20, 40, 48, 96 and 144 weeks of age in total 58 minipigs. The assessment of maturity process was made in accordance with the criteria proposed by Owada and Sutow. The secondary ossification centers developed rapidly from 4 weeks of age to 40 weeks of age, and gradually thereafter until 96 weeks of age. The earliest epiphyseal fusion was apparent in the proximal radius, proximal and distal femur at 96 weeks of age. The complete fusion of the epiphyseal line in the long bones was evident on 144 weeks of age and was observed in most long bones such as the proximal humerus, the proximal and distal ulna and the distal radius, and the proximal tibia in minipigs.