• The Journal of the Korean bone and joint tumor society
• /
• v.13 no.2
• /
• pp.195-200
• /
• 2007

Dedifferentiated parosteal osteosarcoma is an uncommon variant of osteosarcoma. Dedifferentiation is known to be associated with a greater metastatic potential and a more rapid lethal clinical course. Thus recognition of dedifferentiation is important to establish the treatment strategy. But there may be few significant clinical clues to distinguish between dedifferentiated parosteal osteosarcoma and conventional one. A 29-year-old woman presented with 2-year history of discomfort and swelling in her proximal thigh. Examination showed a large, hard, non-mobile mass. Radiographs revealed a large ossified mass attached to the proximal femur. Diagnosis of parosteal osteosarcoma was established by MRI and needle biopsy. But she had a history of abrupt severe thigh pain and increased swelling before surgery. Follow up MRI showed enlargement of mass with invasion to muscle around tumor. The patient underwent an en-bloc resection of tumor and reconstruction. Histological examination showed parosteal sarcoma with dedifferentiation. The patient expired due to local recurrence of tumor and distant lung metastasis 2 months after the surgery. In case with rapid growth of a lesion or unusual severe pain, one must have a high index of suspicion with regard to dedifferentiation.

• The korean journal of orthodontics
• /
• v.31 no.1 s.84
• /
• pp.1-13
• /
• 2001

The extraction lot orthodontic treatment can be adopted for aligning crowded dentition, improving facial esthetics and solving a skeletal discrepancy as alternative for a surgical option. Mandibular second premolar extraction was often selected as treatment plan when there we very little or no space shortage in lower arch or limited retraction of the lower incisors was required. The primary object of this study was evaluate a pretreatment condition and examine the amount of tooth movement ior a mandibular second premolar extraction in growing patients. Pretreatment and posttreatment lateral cephalograms of 14 cases that had their four first premolar extracted (4/4 group), 15 cases with upper first and lower second premolar extraction (4/5 group) were selected. Structural method superimposition was conducted to evaluate a difference of dental change between 4/4 and 4/5 group. The results were as follows, 1. Pretreatment factor for 4/4 extraction or 4/5 extraction choice included maxillary incisor axis to occlusal plane, Class II molar relationship, IMPA and interincisal angle. 2. The amount of molar anterior movement in 4/5 group was greater than that of 4/4 group(p<0.05). 3. There was no significant difference between 4/4 group and 4/5 group in aspects of maxillary tooth movement(p<0.05).

• Journal of the Korean Society of Radiology
• /
• v.85 no.1
• /
• pp.240-246
• /
• 2024

Epithelioid angiosarcoma is a rare variant of angiosarcoma characterized by an epithelioid morphology that mimics carcinoma. Therefore, multicentric epithelioid angiosarcoma is easily misdiagnosed as bone metastasis from carcinoma and has an aggressive clinical course. Here, we present a rare case of a 61-year-old male with multicentric epithelioid angiosarcoma of the bone. Plain radiography, CT, and MRI revealed multiple osteolytic lesions in both femurs; some lesions showed soft tissue extension with cortical bone destruction. Interestingly, PET-CT revealed that the lesions were only distributed along the bones of the lower extremities, including the pelvic bones, femurs, and tibiae. Despite histological analysis initially suggesting metastatic carcinoma, after additional immunohistological staining, including that for vascular markers (CD31 and ERG), the final diagnosis was epithelioid angiosarcoma. A better understanding of the clinicoradiological features of this disease may help eliminate diagnostic confusion and provide better management.

• The Journal of the Korean bone and joint tumor society
• /
• v.14 no.2
• /
• pp.146-151
• /
• 2008

Multiple primary malignant neoplasm of the combination of the musculoskeletal system and the gastrointestinal system were very rare. A case of synchronous double primary malignant neoplasm consisted of myxofibrosarcoma of forearm and adenocarcinoma of rectum in a 52 year-old man was found. The patient had pain and swelling on forearm for 1 year. Histologically, the lesion on forearm showed myxofibrosarcoma. In systemic evaluation, the adenocarcinoma of rectum was found by the sigmoidoscopy, and metastasis on lung and intracardiac mass were found by the CT scan. We performed surgical excision and pre and postoperative chemotherapy after pathologic confirmation. He died of pulmonary thromboembolism after postoperative 2 months. We report this case of exceedingly rare combination of the musculoskeletal system and the gastrointestinal system.

• The Journal of the Korean bone and joint tumor society
• /
• v.13 no.1
• /
• pp.43-47
• /
• 2007

Sj$\"{o}$gren's syndrome is a systemic, autoimmune disorder of the exocrine glands with associated lymphocytic infiltrates of the affected glands and characteristic of dry eye and mouth. We report a case of Sj$\"{o}$gren's syndrome in which the patient presented systemic symptoms without sicca symptoms and had radiologic findings mimicking multiple skeletal metastasis and was finally confirmed with Sj$\"{o}$gren's syndrome with renal tubualr acidosis.

• The korean journal of orthodontics
• /
• v.30 no.5 s.82
• /
• pp.657-668
• /
• 2000

The purpose of this study was to evaluate the amount and interrelationship of the soft tissue of nose and maxillary changes and to identify the nasal morphologic features that indicate susceptibility to nasal deflection in such a manner that they would be useful in presurgical prediction of nasal changes after maxillary advancement surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patients (13 males and 12 females) who had severe anteroposterior skeletal discrepancy. The patients had received presurgical orthodontic treatment. They underwent a Le Fort I advancement osteotomy, rigid internal fixation, alar cinch suture and V-Y advancement lip closure. The presurgical and postsurgical lateral cephalograms and lateral and frontal facial photographs were evaluated. The computerized statistical analysis was carried out. Soft tissue of nose change to h point change ratios were calculated by regression equations. The results were as follows 1. The correlation of maxillary hard tissue horizontal changes and nasal soft tissue vortical changes were high and the ${\beta}_0$ for soft tissue to ADV were 0.228 at ANt, 0.257 at SNt. 2. The correlation of maxillary hard tissue and nasal soft tissue horizontal changes were high and the ${\beta}_0$ for soft tissue to ADV were 0.484 at ANt, 0.431 at SNt, 0.806 at Sn. 3. The correlation of maxillary hard tissue horizontal changes and width changes of ala of nose were high and the ${\beta}_0$ lot alar base width ratio to ADV were 0.002. 4. The DRI, Prominence of nose, Pre-Op CA is not a quantitative measure that can be used clinically to improve the predictability of vertical and horizontal nasal tip deflection. In this study, increases in nasal tip projection and anterosuperior rotation occur when there is an anterior vector of maxillary movement. These nasal changes were Quantitatively correlated to magnitude of maxillary(A point) movement.

• The Journal of Dong Guk Oriental Medicine
• /
• v.9
• /
• pp.179-191
• /
• 2000

Anti-bone resorption properties of the Korean herbal medicine, CEDR, which is comprised 5 herbs of [Drynariae Rhizoma, Loranthi Ramus, Cibotii Rhizoma, Amydae carapax, Psoraleae semen], were investigated. Mouse calvarial osteoblast cells were isolated and cultured. Mouse osteoblasts, which were stimulated by PTH, $1,25(OH)_2D_3$, $TNF-\alpha$ and IL-1 as bone resorption agents, showed increased collagenolysis by producing the active gelatinase. IL-1 in stimulating bone resorption was examined using fetal mouse long bone organ culture. IL-1 stimulated bone resorption and produced marked resorption when present simultaneously. The results of in vitro cytotoxicities showed that CEDR extracts have no any cytotoxicities in concentrations of $1-60{\mu}g/ml$ and furthermore there is no any cytotoxicity even in concentration of $120{\mu}g/ml$ on mouse calvarial bone cells. CEDR extracts had protective activity against PTH (5 units/ml, or $IL-1{\alpha}$ (1 ng/ml) or $TNF-\alpha$ or $1,25(OH)_2D_3$ (20 ng/ml), $IL-1{\alpha}$ and $IL-1{\beta}-induced$ collagenolysis in the mouse calvarial cells. Pretreatment of the CEDR extracts for 1 h, which by itself had little effect on cell survival, did not enhance the collagenolysis, nor significantly reduced the collagenolysis by pretreatment. Furthermore, the medicinal extracts were shown to have the protective effects against collagenolysis induced by $IL-1{\alpha}$ and $IL-1{\beta}$. Pretreatment of the extracts for 1 h significantly reduced the collagenolysis. Interestingly, the CEDR extracts were shown to have the inhibiting effects against gelatinase enzyme and processing activity induced by the bone resorption agents of PTH, $1,25(OH)_2D_3$, $TNF-\alpha$, $IL-1{\beta}$ and $IL-1{\alpha}$ with strong protective effect in pretreatment with the extracts. CEDR extracts were shown to have the inhibiting effects against $IL-1{\alpha}-$ and $IL-1{\beta}-stimulated$ bone resorption and the effect of the pretreatment with a various concentrations of the medicinal extracts were significant. These results indicated that the CEDR extracts are highly stable and applicable to clinical uses in osteoporosis.

• The Journal of the Korean bone and joint tumor society
• /
• v.20 no.1
• /
• pp.14-21
• /
• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

• The korean journal of orthodontics
• /
• v.29 no.1 s.72
• /
• pp.95-106
• /
• 1999

This study was performed to examine the effect of bisphosphonate, an inhibitor of bone resorption, on the formation of osteoclast and bone resorption during experimental tooth movement. Whether bisphosphonate has a cytotoxicity in high dose was also examined. Eighty-seven male Sprague-Dawley rats, weighing 260-350g, were classified into normal (no appliance + $0.9\%$ NaCl), control (appliance + $0.9\%$ NaCl) and four bisphosphonate-treated (appliance + 0.8, 4, 20 or 100mg/kg) groups. The maxillary left first molar was moved mesially with the tipping movement using 50-70g of force. Bisphosphonate(etidronate disodium) was injected intraperitoneally with a dose of 0.8, 4, 20, or 100 mg/kg simultaneously with the application or the orthodontic force. They were killed at day 1, 3, or 7 after the application or the orthodontic force. The activities of serum acid phosphatase and lactate dehydrogenase (LDH) were assayed, and osteoclasts and the degree of bone resorption were examined histologically. The results obtained were as follows: 1. Acid phosphatase activities were significantly higher in the appliance groups, both control and bisphosphonate-treated (4, 20, and 100 mg/kg) groups, at days 1 and 3 than these in normal. At day 1, bisphosphonate-treated(4, 20mg/kg) groups showed even higher acid phosphatase than control. However, at day 7, no significant difference was noted between the control and bisphosphonate-treated groups. 2. LDH activities in the 4, 20mg/kg bisphosphonate-treated groups were increased during the experimental Periods examined, but there were no significant differences in the 0.8, 100mg/kg bisphosphonate-treated groups. 3. There was no bone resolution at day 1, but severe bone resorption was observed at days 3 and 7 in the control. Bone resorption was reduced by bisphosphonate-treatment at day 3. Bone resolution observed at day 7 was similar between the control and bisphosphonate-treated groups. 4. Few osteoclasts were observed at the alveolar bone in the control and bisphosphonate-treated groups at day 1. At day 3, numerous osteoclasts were shown in the control, the degree of which was reduced in bisphosphonate-treated groups. These results suggest that the inhibition of the osteoclast formation was not the mechanism of bone resorption by the bisphosphonate-treatment during experimenal tooth movement. There was no distinct cytotoxicity with a high dose of bisphosphonate. And the drug should be administrated repeatedly to maintain the inhibitory effect of bone resolution.

• The korean journal of orthodontics
• /
• v.32 no.2 s.91
• /
• pp.107-115
• /
• 2002

The aim of this study was to investigate experimentally the mechanical and histological effect of drilling process on the stability of micro-implant used for the orthodontic anchorage. For this purpose, 32 micro-implants(Osas$^{(R)}$, Epoch medical, ${\phi}$1.6 mm) were inserted into maxilla, mandible and palate in two beagle dogs. 16 micro-implants(8 per dog) were inserted after drilling with pilot drilling bur (drill method group). 16 micro-implants(8 per dog) were inserted without drilling (drill-free method group). After 1 week, micro-implants were loaded by means of Ni-Ti coil spring (Ni-Ti springs-extension$^{(R)}$, Ormco) with 200-300 gm force. Following 12 weeks, the micro-implants and the surrounding bone were removed. Before sacrifice, the mobilities were tested with Periotest$^{(R)}$(Siemens). Undecalcified serial sections with the long axis were made and the histologic evaluations were done. The results of this study were as follow ; 1. The osseointegration was found in both of drill-free method group and drill method group 2. Two of drill method group and one of drill-free method group in 32 micro-implants were lost after loading. 3. The mobilities of drill-free method group were less than drill method group 4. The bone contact on surface of micro-implants in drill-free method group was more than drill method group but there was no significant difference between groups. 5. The bone density in threads of micro-implants in drill-free method group was more than drill method group and there was significant difference between groups. These results suggest that drill-free method in insertion of micro-implants is superior to drill method on the stabilities, bone remodeling and osseointegrations under early loading.