• Title/Summary/Keyword: 골 절단

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Treatment of Squamous Cell Carcinoma in Extremity & Trunk (사지와 체부에 발생한 편평상피 세포암의 치료)

  • Shin, Duk-Seop;Kim, Beom-Jung
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.7-13
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    • 2012
  • Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Photoelastic stress analysis of the mandibular unilateral free-end removable partial dentures according to the design (하악 편측 유리단 가철성 국소의치의 설계에 따른 광탄성 응력 분석)

  • Park, Cheol-Woo;Kay, Kee-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.206-214
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    • 2009
  • Statement of problem: There are common clinical cases in which the mandibular first and second molars are missing unilaterally. Purpose: This study was designed to compare and evaluate the magnitude and distribution of stress produced by four kinds of mandibular unilateral free-end removable partial dentures that could be applied clinically in Kennedy class II cases. Material and methods: Four unilateral free-end removable partial dentures using clasp, Konus crown, resilient attachment, and flexible resin were fabricated on the photoelastic models of the Kennedy class II cases. The vertical load of 6㎏ was applied on the central fossa of the first molar of every removable partial denture in the stress freezing furnace and the photoelastic models were frozen according to the stress freezing cycle. After these models were sliced mesio-distally to a thickness of 6mm, the photoelastic isochromatic white and black lines of the sliced specimens were examined with the transparent photoelastic experiment device and photographs were taken with a digital camera. The fringe order numbers at eight measuring points in the photograph were measured with the naked eye. Results: The maximum fringe order number of each sliced specimen and the fringe order number at the residual ridge just below the loading point were in the decreasing order of the unilateral removable partial dentures using flexible resin followed by clasp, resilient attachment, and Konus crown. The fringe order number at the root apex of the second premolar was in the decreasing order of the unilateral removable partial dentures using clasp followed by flexible resin, Konus crown, and resilient attachment. Conclusion: The removable partial denture using Konus crown showed the most equalized stress distribution to the supporting alveolar bone of abutment teeth and residual ridge under the vertical loads. The removable partial denture using flexible resin can be applied to the case that has a better state of residual ridge than abutment teeth.

Secondary Chondrosarcoma Arising from Osteochondroma(tosis) (골연골종(증)에서 발생한 속발성 연골육종)

  • Cho, Hyun-Min;Rhee, Seung-Koo;Kang, Yong-Koo;Chung, Yang-Guk;Lee, An-Hi;Park, Jung-Mi;Bahk, Won-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.21-26
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    • 2010
  • Purpose: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). Materials and Methods: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and fi ve were female. The mean age was 34 years. The mean follow-up period was 54 months. Results: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. Conclusion: Comprehensive understanding of clinical, radiological and pathological features of secondary chondro sarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.

HISTOLOGICAL CHANGES IN THE ELONGATED BONE AFFECTED BY OSTEODISTRACTION OF THE MANDIBLE IN THE DOG (성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화)

  • Baek, Sun-Ho;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.404-416
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    • 2001
  • Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

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The effect of tumor necrosis factor (TNF)-α to induce matrix metalloproteinase (MMPs) from the human dental pulp, gingival, and periodontal ligament cells (사람의 치수, 치은, 치주인대 세포에 tumor necrosis factor (TNF)-α로 자극 시 matrix metalloproteinase (MMPs)의 분비에 관한 연구)

  • Rhim, Eun-Mi;Park, Sang-Hyuk;Kim, Duck-Su;Kim, Sun-Young;Choi, Kyoung-Kyu;Choi, Gi-Woon
    • Restorative Dentistry and Endodontics
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    • v.36 no.1
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    • pp.26-36
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    • 2011
  • Objectives: In the present study, three kinds of tissues cells (pulp, gingiva, and periodontal ligament) were investigated if those cells express MMP and TIMP when they were stimulated with neuropeptides (substance P, CGRP) or proinflammatory cytokine, TNF-$\alpha$. Materials and Methods: The cells cultured from human dental pulp (PF), gingiva (GF) and periodontal ligament were (PDLF) stimulated with Mock, SP, TNF-$\alpha$, and CGRP for 24 hrs and 48 hrs. for an RNase protection assay and Enzyme Linked Immunosorbent Assay. Cells (PF, GF and PDLF) seeded in 100 mm culture dish were stimulated with SP ($10^{-5}$, $10^{-8}\;M$) or only with medium (Mock stimulation) for 4hrs and for 24 hrs for RNase Protection Assay, and they were stimulated with CGRP ($10^{-5}\;M$) and TNF-$\alpha$(2 ng/mL) for 24 hrs and with various concentraion of TNF-$\alpha$(2, 10, and 100 ng/mL) for Rnase Protection Assay with a human MMP-1 probe set including MMP 1, 2, 8, 7, 8, 9, 12, and TIMP 2, 3. In addition, cells (PF, GF and PDLF) were stimulated with Mock and various concentraion of TNF-$\alpha$(2, 10, and 100 ng/mL) for 24 hrs and with TNF-$\alpha$(10 ng/mL) for 48 hrs, and the supernatents from the cells were collected for Enzyme Linked Immunosorbent Assay (ELISA) for MMP-1 and MMP-13. Results: The expression of MMPs in PF, GF, PDLF after stimulation with SP and CGRP were not changed compared with Mock stimulation for 4 hrs and 24 hrs. The expression of MMP-1, -12, -13 24 hrs after stimulation with TNF-$\alpha$ were upregulated, however the expression of TIMP-3 in PF, GF, PDLF after stimulation with TNF-$\alpha$ were downregulated. TNF-$\alpha$(2 ng/mL, 10 ng/mL, 100 ng/mL) increased MMP-1 and MMP-12 expression in PF dose dependently for 24 hrs. Conclusions: TNF-$\alpha$ in the area of inflammation may play an important role in regulating the remodeling of dentin, cementum, and alveolar bone.

Three dimensional photoelastic study on the initial stress distributions of alveolar bone when retracted by lingual K-loop archwire (Lingual K-loop archwire를 이용한 발치공간 폐쇄시 초기응력 분포에 대한 3차원 광탄성학적 연구)

  • Byun, Bo-Ram;Kim, Sik-Sung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.32 no.5 s.94
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    • pp.343-353
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    • 2002
  • This study was designed to investigate the stress distribution of alveolar bone in case of on masse retraction with lingual K-loop archwire using the 3-dimensional photoelastic stress analysis followed by stress freezing process. Lingual K-loop archwire which had loop in 15mm height was used and activated by retraction force of 350gm per each side. The results were as follows 1. Central incisor : As the closer side to crown, the larger tensile stress was distributed at both mesial and labial surfaces and the larger compressive stress was distributed at distal surface. As the closer side to root apex, the larger compressive stress was distributed at lingual surface. The compressive stress was distributed at root apex. 2. Lateral incisor : The tensile stress was distributed at the coronal side of mesial surface. The compressive stress was distributed at distal surface. As the closer side to crown, the larger tensile stress was distributed at labial surface. The tensile stress was distributed at coronal side and the compressive stress was distributed at apical side of lingual surface. The compressive stress was distributed at root apex. 3. Canine The tensile stress was distributed at coronal side and the compressive stress was distributed at apical side of mesial surface. The tensile stress was distributed at distal surface. As the closer side to crown, the larger tensile stress was distributed at both mesial and distal surfaces. The compressive stress was distributed at root apex. 4. Second premolar : The tensile stress was distributed at mesial surface. The compressive stress was distributed at coronal side and the tensile stress was distributed at apical side of distal surface. The compressive stress was distributed at coronal side of buccal surface. As the closer side to crown, the larger tensile stress was distributed at lingual surface. The compressive stress was distributed at root apex. 5. First molar . As the closer side to crown, the larger tensile stress was distributed at both mesial and distal surfaces. No stress was distributed at buccal surface and palatal root apex. As the closer side to crown, the larger tensile stress was distributed at both lingual surfaces. The compressive stress was distributed a4 buccal root apexes. 6. Second molar The compressive stress was distributed at all root apexes. As the closer side to crown, the larger compressive stress was distributed at both mesial and lingual surfaces, and the larger tensile stress at both distal and buccal surfaces. Transverse bowing effect was observed in on-masse retraction with lingual K-loop archwire, however vertical towing effect was not. Rather, reverse vortical bowing effect was developed.