• 제목/요약/키워드: surgical anatomy

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광간섭단층촬영술을 이용한 치아우식증의 발견 (Early caries detection using optical coherence tomography: a review of the literature)

  • 박영석;조병훈;이승표;손원준
    • Restorative Dentistry and Endodontics
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    • 제36권5호
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    • pp.367-376
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    • 2011
  • 치아우식증의 조기 발견은 외과적 삭제를 피하면서, 적절한 치료를 할 수 있는 좋은 기회를 제공한다. 광간섭단층촬영술은 최근 각광받기 시작한 3차원 이미지 기술로서, 안과에서 광학적 생검의 목적으로 빈번히 이용되는 것을 필두로 다양한 의학 분야에 적용되어 왔고, 최근 초기 우식증의 발견에 전도유망하여 다양한 연구가 진행 중이다. 이 기술은 저 상관도 간섭계의 원리에 근거하고 있으며, 장점으로는 비침습적이고, 방사선을 사용하지 않으며, 3차원 이미지 구축이 가능하다는 점이다. 본 연구에서는 광간섭단층촬영술의 원리와 개략적인 개발 과정에 대한 기술과 함께 치아우식증에 관한 연구들에 대하여 고찰해 보았고, 이를 통해 이 기술의 응용 가능성을 확인하였다. 그럼에도 불구하고, 임상적인 유용성을 입증하기 위해서는 몇 가지 기술적 문제를 해결해야 하고, 보다 많은 생체 내 실험이 뒷받침되어야 할 것이다.

상악동 중격;임플란트 수술 계획시 파노라마와 치과용 전산화 단충촬영 분석 (Maxillary sinus septum;panoramic radiographic and dental computed tomographic analyses in the planning of implant surgery)

  • 소현자;정동근;권진희;유소현;김형섭
    • Journal of Periodontal and Implant Science
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    • 제36권1호
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    • pp.147-154
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    • 2006
  • Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

부신 제거 백서에 티타늄 임플랜트 매식후 주위 골형성에 관한 연구 (The Study of Bone Formation around Titanium Implants Placed in Adrenalectomized Rat's Tibia)

  • 최갑림;김종렬;박봉수;성일용
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권3호
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    • pp.274-287
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    • 2000
  • The use of dental implants has increased tremendously in recent years and is expected to increase even more in the future. The successful outcome of any implant procedure is surely dependent on interrelationship of the various components of an equation that includes biocompatibility of implant material, macroscopic and microscopic nature of the implant surface, the status of implant bed, surgical technique, undisturbed healing phase and subsequent prosthetic design and long-term loading phase. The purpose of this study was to clarify the effects of adrenalectomy on the osseointegration of pure titanium implants. Seventy rats, 11 weeks of age, were divided into two groups : an adrenalectomized group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm) was placed into left tibia of 70 rats, 35 in control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows: 1. Histopathogically, findings, newly formed bone was seen at 3 weeks control group and became lamellar bone at 12 weeks. At 6 weeks, lipocytes were observed in bone marrow space. Thickness of regenerated trabecular bone increased till 6 weeks after then, that decreased gradually. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 4 to 12 weeks in experimental group compared to control group. 3. Fibronectin immunoreactivity was very strong at 3 and 4 weeks control group. And after that reduced gradually. But it was continuously strong from 1 to 12 weeks experimental group. 4. CD44 immunoreactivity was very strong in the newly formed osteoblasts at 3 and 4 weeks control group. But it reacted minimally later. However, it reacted continuously strong from 3 to 12 weeks experimental group. From these results, bone to implant contact ratio decreased gradually from 4 weeks in adrenalectomized group compared to control group. CD44 and fibronectin immunoreactivities were strong at all times in adrenalectomized rats. Therefore, it could be stated that immature bone remained continuously for a long time and not readily proceeded into mature status.

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간질 환자와 의료인이 인지하는 간질 환자를 위한 교육 요구도 비교조사 (A Survey on the Difference in Perceptions on Educational Need in Patients with Epilepsy and Medical Personnel)

  • 최미리;김연희;소연자;윤선무;이근숙;임상순;김금순;최스미
    • 대한간호학회지
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    • 제30권6호
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    • pp.1400-1410
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    • 2000
  • Purpose : To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. Methods : Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire with 5 indicating the highest need. The data were analyzed with descriptive statistics, students t-tests, and chi-square. Results : Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. Conclusions : Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.

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악관절원판의 인위적 전방변위술시행후 악관절구성조직에서 Fibronectin의 분포변화 (DISTRIBUTION IN FIBRONECTIN OF THE RABBIT TEMPOROMANDIBULAR JOINT TISSUES FOLLOWING SURGICAL INDUCTION OF ANTERIOR DISK DISPLACEMENT : IMMUNOHISTOCHEMICAL STUDY)

  • 김욱규;정인교;박봉수
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제25권4호
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    • pp.337-349
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    • 1999
  • The extracellular matrix(ECM) is a complex network of different combination of collagens, glycosaminoglycans, laminin, fibronectin, and many other glycoproteins including proteolytic enzymes. The composition and organization of the ECM contributes to the uniques physical or biomechanical properties of a tissue. Fibronectins(FN) are dimeric glycoproteins located on cell surfaces, in the matrix of connective tissue, and in blood. Fibronectins mediate cell attachment to collagen substratum and have been implicated in a variety of important biological processes, including embryogenesis and cell differentiation. The purpose of this study was to determine the effects of surgical induction of anterior disk displacement(ADD) on distribution of fibronectin in the rabbit temporomandibular joint(TMJ) tissues included the articular cartilage, disc, retrodiscal tissue, articular eminence using an immunohistochemical technique. The left TMJ was exposed surgically, and all discal attachments were severed except for the posterior attachment. The disk was then repositioned anteriorly and sutured to the zygomatic arch. The right TMJ served as a shamoperated control. Normal joints were used as a nonoperated control. Fourty-five rabbits were used for experiments in total. For fibronectin immunohistochemical study, eighteen rabbits (one normal group and 5 experimental groups, each group consists of 3 rabbits) were used. The experimental rabbits were sacrified after operation period of 2, 3, 4, 6 and 8 weeks on fibronectin. The obtained results were as follows ; 1. Fibronectin immunoreaction on all TMJ tissues(mandibular condyle, articular disc, retrodiscal tissue, articular eminence) in the normal rabbit was observed. Especially the reverse cell layer and proliferation zone of articular cartilage of condyle show strong positive reaction. 2. Depletion of fibronectin in the all TMJ tissues except hypertrophic zone of articular cartilage occurred at 2 weeks following induction of ADD. 3. The restoration of immunoreaction at 4 weeks was observed and a progressive increasing reaction at 6 weeks, 8 weeks also was found. Our study generally showed degenerative changes in TMJ tissues after ADD although TMJ tissues adapted or degenerated to abnormal loads and stress distribution according to the remodeling capacity of TMJ tissues.

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Gross, organoleptic and histologic assessment of cadaveric equine heads preserved using chemical methods for veterinary surgical teaching

  • Rodrigo Romero Correa;Rubens Peres Mendes;Diego Darley Velasquez Pineros;Aymara Eduarda De Lima;Andre Luis do Valle De Zoppa;Luis Claudio Lopes Correia da Silva;Ricardo de Francisco Strefezzi;Silvio Henrique de Freitas
    • Journal of Veterinary Science
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    • 제25권2호
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    • pp.29.1-29.11
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    • 2024
  • Background: Preservation of biological tissues has been used since ancient times. Regardless of the method employed, tissue preservation is thought to be a vital step in veterinary surgery teaching and learning. Objectives: This study was designed to determine the usability of chemically preserved cadaveric equine heads for surgical teaching in veterinary medicine. Methods: Six cadaveric equine heads were collected immediately after death or euthanasia and frozen until fixation. Fixation was achieved by using a hypertonic solution consisting of sodium chloride, sodium nitrite and sodium nitrate, and an alcoholic solution containing ethanol and glycerin. Chemically preserved specimens were stored at low temperatures (2℃ to 6℃) in a conventional refrigerator. The specimens were submitted to gross and organoleptic assessment right after fixative solution injection (D0) and within 10, 20, and 30 days of fixation (D10, D20, and D30, respectively). Samples of tissue from skin, tongue, oral vestibule, and masseter muscle were collected for histological evaluation at the same time points. Results: Physical and organoleptic assessments revealed excellent specimen quality (mean scores higher than 4 on a 5-point scale) in most cases. In some specimens, lower scores (3) were assigned to the range of mouth opening, particularly on D0 and D10. A reduced the range of mouth opening may be a limiting factor in teaching activities involving structures located in the oral cavity. Conclusions: The excellent physical, histologic, and organoleptic characteristics of the specimens in this sample support their usability in teaching within the time frame considered. Appropriate physical and organoleptic characteristics (color, texture, odor, and flexibility) of the specimens in this study support the use of the method described for preparation of reusable anatomical specimens.

A Understanding of the Temporal Stem

  • Choi, Chan-Young;Han, Seong-Rok;Yee, Gi-Taek;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • 제47권5호
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    • pp.365-369
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    • 2010
  • Objective : There has been inconsistency about definition of the temporal stem despite of several descriptions demonstrating its microanatomy using fiber dissection and/or diffusion tensor tractography. This study was designed to clarify three dimensional configurations of the temporal stem. Methods : The fronto-temporal regions of several formalin-fixed human cerebral hemispheres were dissected under an operating microscope using the fiber dissection technique. The consecutive coronal cuts of the dissected specimens were made to define the relationships of white matter tracts comprising the temporal stem and the subcortical gray matters (thalamus, caudate nucleus, amygdala) with inferior limiting (circular) sulcus of insula. Results : The inferior limiting sulcus of insula, limen insulae, medial sylvian groove, and caudate nucleus/amygdala were more appropriate anatomical structures than the roof/dorso-lateral wall of the temporal horn and lateral geniculate body which were used to describe previously for delineating the temporal stem. The particular space located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus could be documented. This space included the extreme capsule, uncinate fasciculus, inferior occipito-frontal fasciculus, anterior commissure, ansa peduncularis, and inferior thalamic peduncle including optic radiations, whereas the stria terminalis, cingulum, fimbria, and inferior longitudinal fiber of the temporal lobe were not passing through this space. Also, this continued posteriorly along the caudate nucleus and limiting sulcus of the insula. Conclusion : The temporal stem is white matter fibers passing through a particular space of the temporal lobe located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus. The three dimensional configurations of the temporal stem are expected to give the very useful anatomical and surgical insights in the temporal lobe.

Preoperative imaging of the inferior alveolar nerve canal by cone-beam computed tomography and 1-year neurosensory recovery following mandibular setback through bilateral sagittal split ramus osteotomy: a randomized clinical trial

  • Hassani, Ali;Rakhshan, Vahid;Hassani, Mohammad;Aghdam, Hamidreza Mahaseni
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권1호
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    • pp.41-48
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    • 2020
  • Objectives: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. Materials and Methods: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). Results: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). Conclusion: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

Effects of Danggwieumja on the Healing of Full-Thickness Skin Injury in Rat

  • Kim, Bum-Hoi
    • 동의생리병리학회지
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    • 제25권5호
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    • pp.887-893
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    • 2011
  • The purpose of this study was to investigate the wound healing effects of Danggwieumja (DG), which is commonly used for skin inflammation, skin wound, skin pruritus, and chronic hives etc. The 1.5 cm ${\times}$ 1.5 cm full-thickness skin wound was induced to two groups, DG (n=16) and Saline (n=16) group. The DG extract and Saline were orally administrated daily for 15 days after skin wound induction. Then, the body weight of rats and the congestion indices were daily measured for 15 days after skin wound induction. The wound contractions and epithelizations were also measured. The wound contractions were daily measured for 15 days after wound induction and wound epithelizations were measured for 8 days from day 7 after wound induction. For evaluating angiogenesis, the immunoreactivities of vWF and VEGF protein were measured immunohistochemistrically on day 15. In results, although the percentage increases in mean body weight of rats in the DG and Saline groups hve no significant differences, DG extract decreased the time of wound healing and congestion around wound, and improved wound contraction and epithelization. The contraction percentage of DG group was significantly increased on day 5 (P<0.05) and day 7 (P<0.01) than that of Saline group. DG group showed significant increase of wound epithelization on day 7 (P<0.05) as compared to Saline group. Moreover, DG extract reduced the inflammation of skin dermis and promoted the growth of vascular vessels of dermis by accelerating vascular endothelial growth factor (VEGF) protein. These results suggest that DG has the beneficial effects on skin incision wound and can be the suitable wound healing agent for various surgical wounds.

Distally Based Sural Artery Adipofascial Flap based on a Single Sural Nerve Branch: Anatomy and Clinical Applications

  • Mok, Wan Loong James;Por, Yong Chen;Tan, Bien Keem
    • Archives of Plastic Surgery
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    • 제41권6호
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    • pp.709-715
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    • 2014
  • Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.