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Alteration Analysis of Normal Human Brain Metabolites with Variation of SENSE and NEX in 3T Multi Voxel Spectroscopy (3T Multi Voxel Spectroscopy에서 SENSE와 NEX 변화에 따른 정상인 뇌 대사물질 변화 분석)

  • Seong, Yeol-Hun;Rhim, Jae-Dong;Lee, Jae-Hyun;Cho, Sung-Bong;Woo, Dong-Chul;Choe, Bo-Young
    • Progress in Medical Physics
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    • v.19 no.4
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    • pp.256-262
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    • 2008
  • To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

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The Comparison between Single Shot Turbo Spin Echo and B-FFE (Balanced Turbo Field-echo) in the Differentiation of Focal Liver Lesions (국소 간병변 감별에서 단발고속스핀에코 기법과 균형항정상 태세차를 이용한 고속영역 기법간의 비교)

  • Kim, Young-Chul;Kim, Myeong-Jin;Cha, Seung-Whan;Chung, Yong-Eun;Han, Kwang-Hyup;Choi, Jin-Sub
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.39-48
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    • 2007
  • Purpose : To determine the diagnostic accuracy of four different sequences : moderately T2 weighted, two heavily T2-weighted single shot turbo spin-echo sequence and breath-hold axial-2D balanced turbo field-echo sequence(bFFE) for characterization of focal lesions. Materials and Methods : During the 3-month period between June and August 2005, seventy-six patients were proved to have ninety-three focal hepatic lesions on MR imaging. The patients consisted of 49 men and 27 women (age range, 15-75 years; mean age, 56.23 years). All MR images were acquired on a 1.5-T MR using the following sequences: 1. A breath-hold axial T2-weighted single shot turbo spin-echo sequence, 2. a breath-hold axial-2D balanced turbo field-echo sequence. Two radiologists performed quantitative analysis. Another radiologist measured the lesion-to-liver contrast-to-noise ratio at the region-of-interest in the four sequences. Results : There was no significant difference in inter-observer variability between the four sequences. The accuracy for both cyst and malignancy of moderate T2 weighted MRI (echo time: 80 msec) was also highest. There was significant difference for lesion characterization between moderate T2 weighted MRI and balanced steady state procession (p-value: 0.004) in the second reader. For longer echo time, the CNR of cystic lesions were markedly increased in comparison to lesions of other component. Conclusion : The accuracy and inter-observer variability of single shot turbo spin echo T2 weighted sequence was higher than bFFE. Although there was no statically significant difference, moderate T2 weighted MRI (echo time: 80 msec) was more accurate than heavily T2 weighted sequence (echo time: 300 msec). If the results for lesion characterization is equivocal in TE 80, the addition of heavily T2 weighted MRI (echo time: 180 msec) can be helpful.

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A Retrospective study of the type of patients, the distribution of implant and the survival rate of $Xive^{(R)}$ implant (($Xive^{(R)}$)임플란트 식립시 환자 유형 및 식립부 분포와 생존율에 대한 후향적 연구)

  • Myung, Woo-Chun;Lee, Jung-Seok;Chae, Gyung-Joon;Jung, Ui-Won;Kim, Chang-Sung;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.37 no.3
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    • pp.523-534
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    • 2007
  • This study is an analysis of types of patients and distribution of implant site and survival rate of $Xive^{(R)}$ implant. The following results on patient type, implant distribution and survival rate were compiled from 324 implant cases of 140 patients treated at the periodontal dept. of Yonsei University Hospital and G dental clinic between February 2003 and April 2006. 1. There are no dissimilarities between men and women, with patients in their 30, 40, 50s accounting for 80% of patients and accounted for 82% of implant treatments; the largest share of patients and implant treatments. 2. Mn, posterior area. accounted for 57% of implant treatments followed by Mx. posterior area(29%), Mx, anterior area(8%) and Mn, anterior area(6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 96% and fully edentulous patient accounted for the remaining 4%. 4. The major cause of tooth loss is periodontal disease, followed by dental canes, trauma and congenital missing. 5, The distribution of bone quality for maxillae was 54,2% for type III, followed by 30.8% for type II, 15% for type IV and 0% for type I. As for mandible, the distribution was 63% for type II, followed by 34% for type III, 2,5% for type I and 0,5% for type IV. 6. The distribution of bone quantity for maxillae was 55% for type C, followed by 35% for type B, 8% for type D and 2% for type A. As for mandible, the distribution was 60% for type B, followed by 32% for type C, 7% for type A and 0% for type D. 7. The majority of implants were those of 9.5-13 mm in length(95%) and regular diameter in width(82%). 8. The total survival rate was 98%. The survival rate was 97% in the maxillae region and 99% in the mandible region. 9. The survival rate in type I was 83%, in type II was 99%, in type III was 97% and in type IV was 100%. As for the bone quantity, the survival rate in type A and D(100%) was most, followed by type B(99%) and type C(96%). The results showed that $Xive^{(R)}$ implant could be used satisfactorily compare for the other implant system. But we most to approach carefully in certain extreme condition especially with poor bone quality and quantity.

A Study on the Subjective Symptoms of the Printers in Chunbuk Area (전북지역 인쇄공의 심신 자각증상 조사연구)

  • 김성숙;유은주;이종섭
    • Journal of Environmental Health Sciences
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    • v.17 no.2
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    • pp.67-77
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    • 1991
  • The purpose of this study was to investigate the psychosomatic health status of printers. The 77 printers and 24 control group were analysed about salary, drinking, smoking, education, sex, marriage, age and working age by the THI (Todai Health Index) questionaire. THI was modified from CMI(Cornell Medical Index) and developed by Tokyo University Research Team in Japan. The resuts obtained were summarized as follows. 1. The printers, who get more salary showed high score about mental conplaints, especially, mental irritability(j), nervusness (E), lie Scale(L), aggressiveness(F) and irregualr life(G) and lower salary showed generally high score about physical complaints, especially, mouth and anus (D), digestive symptom(C) multiple subjective symptom(I). 2. According to the printers drinking amount shows the difference, eg nondrinker scored higher on mouth and anus(D), 90mg/week drinker scored higher on multiple subjective symptom(I), digestive symptom(C), depression(K), nervousness(E), and irregular life(G), 91~179mg/week drinker scored higher on impulsiveness(H), mental irritability(J), 270~359mg/week drinker scored higher on respiratory(A), lie scale (L) and aggressiveness (F). 3. The nonsmoker scored high level on mouth and anus(D), mental irritability(J). The previous smoker scored on multiple symptom(I), eyes and skin(B), digestive(C), lie scale(L), and depression(K). The present smoker scored on respiratory(A), impulsivehess(H), aggressiveness(F), nervousness(E), and irregular life(G). 4. According to the printers working age showed almost high score about subjective symptoms on 1~3 year. 5. Men printers high scored on respiratory(A). lie scale(L), aggressiveness(F), women printers scored about mental complaints, especially, impulsiveness(H), mental irritability(J), depression (K), nervousness (E). 6. According to the printers age showed high scored about, below 20 years were lie scale(L). aggressiveness(F), irregular life(G) 21~30years were multiple subjective symptom(I) respiratory (A), eyes and skin(B), mouth and anus(D), impulsiveness(H), mental irritability(J), depression (K), nervousness(E), and over 41 years were digestive(C). 7. Married printers scored high level on eyes and skin(B), digestive(C) and impulsivehess(H), and single printers on respiratory(A), mouth and anus(D), lie scale(L), mental irritability(J). 8. According to education shows the difference, eg high school scored higher on eyes and skin (B), mental irritability(J), depression(K), nervousness(E), collage and over scored higher on multiple subjective symptom(I ), respiratory (A), mouth and anus (D), lie scale (L), aggressiveness (F), irregular life (G), and middle school scored high on digestive (C), impulsiveness (H).

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A Survey for the Construction of Nursing Theory According to Korean Culture -Traditional View of Human and Expectation of Sick Role- (한국문화에 따른 간호정립을 위한 기초조사연구 I -전통적인 인간관과 환자역할기대를 중심으로-)

  • 박정숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.782-798
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    • 1996
  • This study was a survey done for the purpose of constructing a nursing theory according to Korean culture and to identify the traditional Korean view of humans and the expectations of the sick role, and to confirm changes from the traditional view of humans and expectations of the sick role according to general characteristics of the population. The subjects were all adults over 18 years old. 517 who lived in six large cities and 191 who lived in five rural communities. Data collection was done from November 19th, 1994 to January 19th, 1995 using a tool to measure the traditional view of humans and expectations of the sick role which was developed by the investigator through a literature review. Collected data were analyzed using frequency, percent, Cronbach alpha, 1-test, F-test and Scheffe post hoc contrasts, with the SAS program. The results of this study are summerized as follows : 1. The Traditional view of human score for all subject was 49.92, which shows that Korean traditional view of human is moderate. High scored items were "human need to live by making harmony with nature, not by overcoming the nature" (3.44), "Filial duty to parents and elders is important" (3.31), "Think of family more than a individual" (2.96). 2. The differences in the traditional view of humans between residential districts showed that the residents of Chungbuk(56.00), Kyungbuk(55.26), Chonbuk(51.32), Taegu(50.59) had a more traditional view of humans than those in Pusan(45.42) and Seoul (47.27). 3. The differences in the traditional view of humans according to general characteristics showed that rural community residents, males, older people, people with lower levels of education, married and house-resident groups had a significantly higher traditional view of humans than urban residents, females, younger people, people with a higher levels of education, single and apartment-resident groups. There were differences according to religion and job. Buddhism had a higher traditional view of humans than those of atheism, Christianity and Catholicism and physical workers, a significantly highers score, than technicians and professional workers. 4. Daily expected task performance during illnesses was lowest for patients with stroke (2.16) and psychosis(2.40), in which case almost no daily general tasks were expected, followed by arthritis 4.06, peptic ulcer 4.79, headache 4.99 and cough 5.58. The amount of expected role exemption during illnesses was also highest for stroke(2.25), followed by psychosis(2.08), arthritis(1.64), peptic ulcer(1.29), headache(1.16) and cough(1.09). The amount of daily task performance in the acute stage(3.05) was significantly lower than that of convalescent stage(4.95). 5. Total expectation of role exemption according to general characteristics showed that there was no significant differences in urban /rural community, marriage, level of education and religion. By sex, women showed higher expectation of role exemption during illnesses than men. By age, the 31-40 year old group showed lower expectation of role exemption than the 41-50 year old group or over the 61 year old group.or over the 61 year old group.

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Endosaccular Treatment of Very Large and Giant Intracranial Aneurysms with Parent Artery Preservation : Single Center Experience with Long Term Follow-up

  • Huh, Chae Wook;Lee, Jae Il;Choi, Chang Hwa;Lee, Tae Hong;Choi, Jae Young;Ko, Jun Kyeung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.450-457
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    • 2018
  • Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.

Acute Achilles Tendon Rupture : - Isokinetic plantarflexion torque evaluation after Krackow suture technique - (급성 아킬레스건 파열 - Krackow 봉합술 후 등속성 족저 굴곡력의 분석 -)

  • Jung, Hong-Geun;Yoo, Suk-Ju;Lee, Sung-Chul;Park, Hee-Gon;Kim, Ki-Young;Kim, Myung-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.181-189
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    • 2002
  • Purpose: We try to evaluate the functional outcomes of the ankle with isokinetic plantaflexion torque for acute achilles tendon rupture cases those treated by primary repair with the Krackow suture technique and early rehabilization. Materials and Method: The authors studied retrospectively, 15 patients of acute achilles tendon rupture treated and followed over six months, from July 1997 to May 2001. There were 12 men and 3 women, and mean age was 39.6year. The repair method of ruptured tendon was single or double Krackow suture technique. One week(5days-2weeks) after operation, early ROM with ankle-foot orthosis was started. We used Arner-Lindholm Scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. We analyzed the dorsiflexion peak torque and plantarflexion peak torque of the ankle statistically with strength test with Cybex dynamometer. Result: In clinical results, we had 11 excellent cases(73%) and 3 good cases(20%). In patients satisfaction degree, 11 excellent cases(66.6%), 3 good cases(20%) and 2 fair cases(13.4%). And in strength deficit, 3 none deficit (20%), 9 minimal deficit(60%). We evaluated the isokinetic plantar flexion torque in 3months or 6months after operation. After 3 months, isokinetic test showed the mean functional deficits, 32% and 25% at $30^{\circ}$ and $120^{\circ}/sec$, in 7 cases(46.6%) of 15 cases respectively. After 6 months, the mean deficits were in 21%, 24% at 30. and $120^{\circ}/sec$, respectively. At 3 and 6 months' follow up, absolute value of isokinetic test showed increase of 25. 31bs to 421bs and 19.61bs to 271bs at $30^{\circ}$ and $120^{\circ}/sec$, respectively. Conclusion: We had good result for acute achilles tendon rupture treated by Krakow suture technique and early range of motion exercise of the ankle. After 6 months, strength deficit was 21% in all of cases but were able to return pre-injured state. This study shows Krakow suture technique was recommended method for primary repair and early rehabilization of achilles tendon ruptue.

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Family Solidarity between Old Parents and Adult Children, Welfare Distribution, and Suicidal Ideation of Elderly (노부모와 성인자녀간의 가족결속도가 노인의 자살생각에 미치는 영향 연구: 복지유통관점 중심으로)

  • Jung, Myung-Hee;Kim, Eun-Jeong
    • Journal of Distribution Science
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    • v.12 no.8
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    • pp.91-102
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    • 2014
  • Purpose - Today, the importance of the service industry has increased. Social welfare businesses that follow the non-profit principle have neglected the distribution of the service. However, an intangible service, when produced and consumed, has a similar service delivery system to common service distribution and social welfare. Therefore, the author has assumed the efficiency of the service delivery system of social welfare to be equivalent to the service distribution industry. Hence, various kinds of social welfare services for the prevention of elderly suicide, from the perspective of distribution, are discussed. Studies on generational relations have thus far investigated depression from parent-children conflict, and satisfaction with their lives. Studies on the relationship between family solidarity and elderly suicide by analyzing existing social problems are rare. This study investigated the effects of family solidarity between old parents and adult children upon elderly suicide by analyzing serious psychological and social problems. This study revealed basic measures for elderly suicide prevention through services that could elevate family solidarity from the perspective of social welfare service distribution. Research design, data, and methodology - The subjects were 468 elderly, 65 years or older, at 18 senior welfare centers and halls for the elderly at Seoul and Gyeonggi-do. Questionnaire surveys, excluding invalid answers, were analyzed. Convenience sampling was used from February 5, 2014 to March 5, 2014. The findings were: First, women and those having spouses with advanced educational backgrounds and social activities had primary solidarity such as contact solidarity, affectionate solidarity, functional solidarity (giving help), and functional solidarity (receiving help). In addition, those who had good health, from a subjective point of view, had more solidarity. Second, the elderly who were men and single, and who had poorer educational backgrounds thought of suicide, lacked social activities, and had poor health, from a subjective point of view. Third, family solidarity between old parents and adult children had significantly negative influence on the suicidal ideation of the elderly. Results - The study revealed the following implications. First, the preparation for old age should consider not only economic welfare but also the psychological welfare due to the relationship with children. Second, the phenomenon of elderly suicide because of a lack of family solidarity could increase national loss and have great influence upon welfare in old age. Therefore, planning of welfare services for the elderly should consider the value of relationships with children to improve the psychological welfare of the elderly. Third, the social expenses of government-oriented support for parents should be discussed from the people's point of view. Conclusions - The subjects of the study comprised the elderly at Seoul and Gyenggi-do; therefore, it would be difficult to extrapolate the findings to all the elderly in the nation. The subject visited senior welfare centers as well as halls for the elderly; therefore, it would be difficult to assume that the trends were representative of the elderly in the nation.

Demineralized Bone Matrix (DBM) as a Bone Void Filler in Lumbar Interbody Fusion : A Prospective Pilot Study of Simultaneous DBM and Autologous Bone Grafts

  • Kim, Bum-Joon;Kim, Se-Hoon;Lee, Haebin;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.225-231
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    • 2017
  • Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

Kirschner Wire Fixation for the Treatment of Comminuted Zygomatic Fractures

  • Kang, Dai-Hun;Jung, Dong-Woo;Kim, Yong-Ha;Kim, Tae-Gon;Lee, JunHo;Chung, Kyu Jin
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.119-124
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    • 2015
  • Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.