• Title/Summary/Keyword: 기형교정

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A CASE OF DELAYED ERUPTION IN A CHILD WITH MONOSTOTIC FIBROUS DYSPLASIA (단골성 섬유성이형성증 환아에서 나타난 맹출지연)

  • Min, Soo-Young;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Byung-Jae;Choi, Hyung-Jun;Kim, Seung-Hye;Song, Je-Seon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.270-275
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    • 2011
  • Fibrous dysplasia is a developmental tumor-like condition that is characterized by replacement of normal bone by an excessive proliferation of cellular fibrous connective tissue intermixed with irregular bony trabeculae. Craniofacial lesions may cause facial pain, headache, cranial asymmetry, facial deformity, tooth displacement and visual or auditory impairment. In this case, a 2-year-9-month old boy who was diagnosed as the fibrous dysplasia showed delayed eruption on affected area. Teeth of left lateral dentition group have erupted completely but teeth of right lateral dentition group are erupting slowly. Eruption and maturation of affected teeth are in progress, so continuous observation is required presently. If the eruption state stops, surgical opening or forced eruption of the impacted teeth will be considered.

Late Results of Total Correction for Tetralogy of Fallot (활로 4징증의 완전교정술에 대한 장기 성적)

  • Lee, Yeon-Jae;Hwang, Sang-Won;Kim, Han-Yong;Yu, Byeong-Ha
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1184-1189
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    • 1997
  • Tetralogy of Falloff is the most common cyanotic congenital cardiac malformation. Between April 1984 and December 1993, we experinced with 39 cases of total correction for the tetralogy of Falloff at the department of Thoracic and Cardiovascular Surgery, Masan Samsung General Hospital. The results were as follows; There were 14 males and 25 females, and their ages ranged from 2 to 36 years, with an average age of 13.33 $\pm$7.40 years. There was type I VSD in 10 cases(25.6%), type II VSD in 19 cases(48.8%) and type 1+ II VSD in 10 cases(25.6%) Types of right ventricular outflow tract obstruction were valvar + infundibular stenosis in 19 cases(48.7%), valvar + infundibular + annular stenosis in 10 cases(25.6%), infundibular stenosis in 9 cases(23.1%)and pure valvar stenosis in 1 case(2.6%). Right ventricular outflow tract patch widening was necessary in 33 cases(84.6%) and a Iransannular patch including 2 cases of Monocusp-bearing outflow patch was used in 10 cases. n 36 hospital survivors, 23 patients were evaluated by 2 dimensional and doppler echocardiography. The most common complication was arrthymia, especially complete right bundle branch block, in 30 cases (76.9%). The operative mortality was 7.7%, and the cause of death was low cardiac output syndrome.

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평악곽씨정골전통약물적현대연구(平樂郭氏正骨傳統藥物的現代硏究) -평악곽씨(平樂郭氏) 정골(正骨)에 대한 전통약물의 현대적 연구-

  • Gwak Yeom-Haeng;Du Ji-Gyeom;Jo Gyeong-An;Gwak Yeom-Geum;Lee Mu-Eum
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.219-227
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    • 2001
  • 중국 낙양의 평악곽씨(平樂郭氏) 정골법은 중국의학의 골상과(骨傷科) 중에서 중요한 학술유파로 널리 알려져 있다. 그 치료법에 있어서 독특하고 체계적인 시술법을 갖추고 있는데, 교정 수기법, 고정방법, 기능훈련, 약물치료 등의 내용을 포함하고 있다. 창상(創傷)에 대한 약물요법에서 "파(破) 화(和) 보(補)" 3단계로 분류된 약물사용 원칙을 제시하였는데, 즉 골정손상의 초기에는 기혈어체(氣血瘀滯)의 병리기전에 입각하여 약물은 활혈화어제(活血化瘀劑)를 주로 사용하고, 중반에는 기혈부화(氣血不和) 경락부통(經絡不通)의 기전으로 파악하고 주로 활혈통락(活血通絡)시키는 약물을 사용하며, 말기에는 구병(久病)으로 기형(氣血)이 휴손(虧損)되므로 보기혈(補氣血) 및 장근골(壯筋骨)의 약물을 주로 사용한다. 이와 같은 평악곽씨(平樂郭氏)의 正骨(정골)에 관한 약물사용 원칙을 토대로 선조의 처방과 경험방 및 후세의 통용방(協定方)을 근간으로 심은 평악곽씨(平樂郭氏)의 正骨(정골)에 대한 전통약물시리즈가 형성되었다. 이러한 처방들은 장기간의 임상활용에서 그 효과가 뛰어나고 안전성이 확보된 것으로 입증되었다. 근골통소환(筋骨痛消丸)은 활혈행기(活血行氣), 온경통락(溫經通絡), 소종지통(消腫止痛)의 효능이 있어 근골의 퇴행성 질환이나 만성 노손(勞損)으로 일어나는 종창(腫脹), 통증, 관절활동의 제한, 목 어깨 허리 다리 등의 통증, 발꿈치 통증, 골절 후 지체(肢體)의 종통(腫痛), 어혈 등에 활용한다. 활혈접골지통고(活血接骨止痛膏)는 접골속근(接骨續筋), 통락지통(通絡止痛)의 효능이 있어 골상(骨傷)을 입은 후 지체(肢體)의 종창(腫脹)이나 통증 또는 골절 등에 사용한다. 이 약은 크림제와 고약제 두가지가 있다. 평악내복접골교양(平樂內服接骨膠襄)은 활혈소종(活血消腫), 접골속근(接骨續筋)의 효능이 있어 각종 근육의 손상이나 골정상에 활용된다. 평낙전근단(平樂展筋丹)은 활혈화어(活血化瘀), 서근지통(舒筋止痛), 통리관절(通利關節), 등의 효능이 있어 타박상으로 인한 지체(肢體)의 종통(腫痛), 관절강직, 활동제한 및 골관절 질환과 풍습비통(風濕痺痛) 등을 치료한다. 전통적으로 외용(外用)에 사용되는 산제(散劑)는 마사지에 주로 활용된다. 임상에서 다양한 제형(劑型)으로 개발되어 분무형태로 쓰이는 근상정(筋傷酊)과 마사지 크림으로 사용되는 평악낙전근접마유제(平樂展筋接摩乳劑)가 있다. 소종활혈(消腫活血) 대포제(袋泡劑)는 산제(散劑)를 티팩 형식으로 사용하는 외용제형(外用劑型)이며, 서근활혈(舒筋活血), 소종지통(消腫止痛)의 효능이 있어 타박상 말기에 근육이 굳어지고, 어반이 형성되면서 통증이 나타나며, 종창(腫脹) 등이 생길 때 사용한다. 사용방법은 따뜻한 물에 담가 우려낸 다음 상처부위를 씨어주면 된다. 특별히 제작된 접골환(接骨丸)은 배보간신(培補肝腎), 익기건비(益氣健脾), 활혈통락(活血通絡), 강근건골(强筋健骨) 등의 작용이 있어 파박상이나 골절이 잘 치유되지 않고 오래 지속되는 경우에 사용된다. 이와 같은 다양한 평악곽씨(平樂郭氏)의 전통적인 정골(正骨)에 관한 약물들은 약리학적 실험을 거쳐 그 독성반응이나 부작용 및 임상효과를 관찰한 결과 통제학적으로 p<0.05-0.01로 나타나 98%의 치료효과를 보였으며, 독성 및 부작용이 없어 안정성이 인정되었으므로 긍정적인 치료효과를 확인할 수 있었다.

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Clinical Study on the Dental Abnomalities of Number and Morphology in Cleft Alveolus Patients (치조열 환자에서 치아의 선천결손과 형태이상에 관한 연구)

  • Seo, Min-Gyo;Leem, Dae-Ho;Ko, Seung-O;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.1
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    • pp.1-10
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    • 2010
  • 구순구개열은 선천성 악안면 기형중에서 발생률이 가장 높은 질환이며 특히 동양인에게 높은 빈도로 발생된다. 그리고 순구개열에서는 파열부 조직의 선천적 상실과 파열부 봉합 수술 후 형성된 반흔에 의한 상악골의 열성장과 상악궁의 협착, 코의 형태 이상, 등과 함께 치아의 수, 크기와 형태 및 맹출 이상도 높은 빈도로 동반된다. 선천성 치아 발육 이상이 구순열 또는 구개열 가진 환자에게서 종종 보고되고 있다. 이런 치아 이상은 과잉치, 결손치, 크기, 형태, 맹출시기, 법랑질 광화 등의 많은 특징을 포함한다. 이번 연구의 목적은 다음과 같다. 1. 구순열 또는 구개열을 가진 환자의 선천성 치아 결손 발병률을 결정하여 정상인과 비교하는 것이다. 2. 상하악에서 파열이 있는 부위와 없는 부위의 제2소구치 결손가능성을 비교 하는 것이다. 구강악안면외과에서 구순구개열로 진단한 환자 중 2005년 1월~2009년 8월까지 전북대학교 구강악안면외과에서 치조열부위 자가골이식수술을 받은 32명의 환자로 초진시의 교정 chart, 구강악안면외과 chart, x-ray(파노라마, 치근단사진, 교합사진(상악), 석고 모델, 구강내 외 임상사진을 사용하여 순구개열군 별로 매복치, 과잉치, 결손치, 왜소치의 유무와 위치를 조사하여 다음과 같은 결론을 얻었다. 1. 결손치는 비교적 높은 발생빈도(53.1%)를 보였으며, 치아별 발생빈도는 상악 측절치와 상악 제2소구치, 하악 제2소구치 순이었다. 구순구개열군이 구순치조열군에 비해 발생률이 높게 나타났다. 그리고 구순구개열군 내에서 양측성이 편측성에 비해 결손치의 발생률이 높게 나타났다. 2. 왜소치는 71.6%에서 발견되었으며, 치아별 발생빈도는 상악측절치에서 가장 많았다. 구순치조열군이 구순구개열군에 비해 발생률이 높게 나타났다. 3. 치조열을 가진 환자에 있어 상/하악간 제2소구치의 선천적 결손에 유의한 차이가 있었다. 4. 구순구개열이 인접한 상악측절치의 발생중인 미성숙 조직에 영향을 미치며 파열부위와 좀 더 떨어져 있는 상악 제2소구치에도 일정한 영향을 미침을 이번 연구를 통해 다시 확인할 수 있었다.

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Treatment of Grade IV Medial Patellar Luxation by Femoral Shortening Osteotomy in Three Small-Breed Dogs (세 마리의 소형견에서 대퇴 단축 절골술에 의한 4단계 내측 슬개골 탈구의 치료 증례)

  • Kang, Byung-Jae;Rhew, Daeun;Kim, Yongsun;Lee, Seunghoon;Yoon, Daeyoung;Kim, Wan Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.421-424
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    • 2014
  • Three small-breed dogs with grade IV medial patellar luxation were presented. In all cases, patellar luxation could not be reduced by conventional surgical techniques. Femoral shortening osteotomy was performed in all dogs to correct patellar luxation. In all the dogs, the clinical condition was remarkably improved, and following surgical procedures, no complication or recurrence was presented. Femoral shortening osteotomy is an effective treatment in small-breed dogs with medial patellar luxation associated with severe skeletal deformity.

The ethnic difference of the prevalence of SfaN polymorphism in the nonsyndromic cleft palate (비증후군성 구개열에서 SfaN1 polymorphism발현빈도의 인종적 차이에 관한 연구)

  • Kim, Myung-Hee;Nahm, Dong-Seok;Rotaru, Horatiu;Hurubeanu, Lucia;Choi, Je-Yong;Chae, Chang-Hoon;Kim, Seong-Gon
    • The korean journal of orthodontics
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    • v.34 no.3 s.104
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    • pp.261-267
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    • 2004
  • Nonsyndromic cleft lip and/or palate (NSCLP) is one of the most common congenital deformities and its prevalence in Far East Asia, such as within Korean and Japanese populations, is relatively high. However, in the eastern part of Europe, clefts are relatively rare situations. These ethnic differences infer a genetic background of the disease. The objective of this study was to compare the frequency of single nucleotide polymorphism (SNP) in $TGF-{\beta}3$ between Korean and Romanian cleft families. Korean cleft families samples were collected from twenty-six families (n=78) and Romanian cleft families samples were collected from eighteen families (n=41). For sequencing, the blood or saliva of the subjects was sampled. A single nucleotide polymorphism was observed in the intron 5 of $TGF-{\beta}3$ (Al8141G). The frequency of each allele was significantly different between the Korean and Romanian samples. The Ah allele was present in 18 out of 78 Korean samples (23.1%) and in 27 out of 41 Romanian samples (65.9%). The AG was present in 27 (34.6%) out of 78 Koreans and in 13 (31.7%) out of 41 Romanians. The GG was found in 33 (42.3%) Koreans and in 1 (2.4%) Romanian. The difference between the groups was significant (p<0.001). In conclusion, the frequency of observed SNP was significantly different between the two countries. SNP in $TGF-{\beta}3$ in the Korean population seemed to have a higher possibility of occurrence for nonsyndromic cleft palate than the Romanian population.

Generation of a transgenic mouse model to study cranial suture development; Apert syndrome (두개봉합 발육 연구를 위한 형질변환 쥐의 개발 : 어퍼트 신드롬)

  • Lee, Kee-Joon;Ratisoontorn, Chootima;Baik, Hyoung-Seon;Park, Young-Chel;Park, Kwang-Kyun;Nah, Hyun-Duck
    • The korean journal of orthodontics
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    • v.33 no.6 s.101
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    • pp.485-497
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    • 2003
  • The form and function of the craniofacial structure critically depend on genetic information. With recent advances in the molecular technology, genes that are important for normal growth and morphogenesis of the craniofacial skeleton are being rapidly uncovered, shaping up modem craniofacial biology. One of them is fibroblast growth factor receptor 2 (FGFR2). Specific point mutations in the. FGFR2 gene have been linked to Apert syndrome, which is characterized by premature closure of cranial sutures and craniofacial anomalies as well as limb deformities. To study pathogenic mechanisms underlying craniosynostosis phenotype of Apert syndrome, we used a transgenic approach; an FGFR2 minigene construct containing an Apert mutation (a point mutation that substitute proline at the position 253 to arginine; P253R) was introduced into fertilized mouse germ cells by DNA microinjection. The injected cells were then allowed to develop into transgenic mice. We used a bone-specific promoter (a DNA fragment from the type I collagen gene) to confine the expression of mutant FGFR2 gene to the bone tissue, and asked whether expression of mutant FGFR2 in bone is sufficient to cause the craniosynostosis phenotype in mice. Initial characterization of these mice shows prematurely closed cranial sutures with facial deformities expected from Apert patients. We also demonstrate that the transgene produces mutant FGFR2 protein with increased functional activities. Having this useful mouse model, we now can ask questions regarding the role of FGFR2 in normal and abnormal development of cranial bones and sutures.

Changes of Ventricular Function and Mitral Regurgitation after Repair of Anomalous Origin of Coronary Artery from the Pulmonary Artery (관상동맥 폐동맥 이상 기시증의 외과적 치료 후 좌심실 및 승모판 기능의 변화)

  • Lee Jeong Ryul;Oh Sea Jin;Kim Woong Han;Kim Yong Jin;Rho Joon Ryang;Bae Eun Jung;Noh Chung II;Yun Yong Soo
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.523-528
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    • 2005
  • Background: Investigation of the change of ventricular function and mitral regurgitation after surgical repair of patient with anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is key issue for the better surgical outcome. Material and Method: From April 1986 to July 2002, 12 patients presented with ALCAPA. The median age at repair was 4 months. Surgical methods included left coronary artery transfer to the aorta (10), Takeuchi procedure (1), saphenous vein free graft bypass (1). Mitral valve was repaired in 1. Result: There were 2 hospital death $(16.7\%)$. The mean follow-up period was $7.1\pm4.1$ years (range, 7 months to 13 years). Four patients required postoperative circulatory assist for $2.2\pm1.1$ days and one needed left ventricular assist device (LVAD) for 1day. Postoperative echocardiography demonstrated significant improvements in mean fractional shortening $(33.4\pm9.1\%\;vs\;17.7\pm9.6\%,\;n=10,\;p<0.05);$ left ventricular end diastolic dimension $(33.4\pm7.3\;mm\;vs\;44.8\pm7.0\;mm,\;n=10,\;p<0.05)$ and systolic dimension $(22.2\pm7.5\;mm\;vs\;33.4\pm7.9\;mm,\;n=10,\;p<0.05)$. Severities of mitral regurgitation decreased in all survivors at 1st and 4th year follow-up echocardiography. There were 2 reoperation due to residual MR and right ventricular outflow obstruction (Takeuchi case). Conclusion: Anatomic repair of anomalous left coronary artery from the pulmonary artery offered an excellent surgical results, especially in terms of the recovery of left ventricle function and mitral regurgitation. However, preoperative indications for mitral procedure is to be evaluated.

Sequencing analysis of the OFC1 gene on the nonsyndromic cleft lip and palate patient in Korean (한국인 비증후군성 구순구개열 환자의 OFC1 유전자의 서열 분석)

  • Kim, Sung-Sik;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.33 no.3 s.98
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    • pp.185-197
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    • 2003
  • This study was performed to identify the characteristics of the OFC1 gene (locus: chromosome 6p24.3) in Korean patients, which is assumed to be the major gene behind the nonsyndromic cleft lip and palate. The sample consisted of 80 subjects: 40 nonsyndromic cleft lip and palate patients (proband, 20 males and females, mean age 14.2 years); and 40 normal adults (20 males and 20 females, mean age 25.6 years). Using PCR-based assay, the OFC1 gene was amplified, sequenced, and then searched for similar protein structures. Results were as follows: 1. The OFC1 gene contains the microsatellite marker 'CA' repeats. The number of the reference 'CA' repeats was 21 times, and formed as TA(CA)11TA(CA)10. But, in Koreans, the number of tandem 'CA' repeats was varied from 17 to 26 except 18, and 'CA' repeats consisted of TA(CA)n. 2. Nine allelic variants were found. Distribution of the OFC1 allele was similar between the patients and control group. 3. There was a replacement of the base 'T' to 'C' after 11 tandem 'CA' repeats in Koreans compared with Weissenbach's report. However, the difference did not seem to be the ORF prediction results between Koreans and Weissenbach's report. 4. The BLAST search results showed the Telomerase reverse transcriptase (TERT) and the Nucleotide binding protein 2 (NBP2) as similar proteins. The TERT was a protein product by the hTERT gene in the locus 5p15.33 (NCBI Genome Annotation; NT023089) The NBP2 was a protein product by the ABCC3 (ATP-binding cassette, sub-family C) gene in the locus 17q22 (NCBI Genome Annotation; NT010783). 5. In the Pedant-Pro database analysis, the predictable protein structure of the OFC1 gene had at least one transmembrane region and one non-globular region.

A STUDY ABOUT THE APOPTOSIS OF EPITHELIAL CELLS IN THE FUSING FETAL RAT PALATE (흰쥐 태아 구개융합부위 상피세포의 아포프토시스에 관한 연구)

  • Lee, Hong-Joo;Cha, Kyung-Suk;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.71-83
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    • 2001
  • The purpose of this study was to Prove that the medial edge epithelial cells covering the secondary palatal shelves were removed by apoptosis during palatal fusion. 12 mature female rats (Suprague-Dawley) were mated overnight with male rats and sacrificed on days 15.0, 16.5, 16.75, 17.0 of pregnancy. The embryos were removed from the uterus and the heads were embedded in paraffin. The paraffin blocks were sectioned and the sections were undergone H-E staining for general histologic feature and TdT staining for detection of apoptotic cells. The obtained results were as follows. k. In the section of 16.0 and 16.5 day embryos, the palatal shelves were prior to contact and no apoptotic cells wereobserved in the medial edge epithelium. At the initial contact of Palatal shelves, there was a few apoptotic cells in the fusing epithelium. 2. In the 16.75 day embryos, the samples that epithelial seams did not lost there continuity, apoptotic cells were rarely seen at the midline epithelial seam. In contrast, a lot of apoptotic cells were observed at epithelial triangles and the junction between palatal shelves and nasal septum. 3. In the 16,75 day embryos, the samples that epithelial seams lost their continuity and disrupted to epithelial islands, large number, of apoptotic cells were observed at epithelial islands and epithelial triangles. Some apoptotic cells were also observed at the oral, nasal epithelium near the midline. 4. In the 17.0 day embryos, most of epithelial islands were disappeared and mesenchymal confluence was achieved. Apoptotic cells were rarely observed in the mesenchymal tissue which replaced epithelial islands, but there were some apoptotic cells at the epithelial triangles, oral and nasal epithelium. From the results of the study, it was revealed that medial edge epithelial cells of fusing palate were removed by apoptosis. Apoptotic cells were found mainly in the disappearing midline epithelial seam and the oral and nasal epithelial triangles at some late stages of palatal fusion.

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