• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.163-169
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• 1999

Purpose : To evaluate the efficacy of free musculocutaneous flap in the treatment of chronic osteomyelitis with drain sinus. Materials and Methods : Eighteen patients (sixteen male and two female) whose average age was 42.6 years were followed for an average of 3.5 years after free musculocutaneous flap for chronic osteomyelitis with drain sinus tract. The period of time between the initial injury and this procedure was average 10.6 years. The patients had an average of 4.1 prior surgical procedure before it. Results : Sixteen(88.9%) of the eighteen free musculocutaneous flap survived, including thirteen of latisimus dorsi flap, three of scapular free flap with muscle, two of medial plantar flap with abductor muscle. Sixteen cases had no evidence of recurrence at follow up. Conclusion : Free musculocutaneous flap is an extremely successful and reliable procedure for the treatment of chronic osteomyelitis with drain sinus. This flap with microvascular anastomses is highly vascularized through its own intrinsic blood vessels, which has the advantage of obliterating dead space and providing improved vascularity to the relatively ischemic recipient site and covering the skin defect.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.745-752
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• 2002

Osteomyelitis is an exhaustive disease whose main feature is an inflammation of inner part of bone, bone marrow. In oral and maxillofacial area, we have maxillary and mandibular osteomyelitis and the latter is dominant because of its impaired blood supply. The main cause of osteomyelitis is a bacterial infection and the ways of infections are by periapical odontogenic infection, fracture, post-operative complication, and periodontal disease. The predominant etiologic factor is periapical odontogenic infection mostly caused by advanced dental caries. It is generally believed that periodontal disease could be a cause of osteomyelitis. But periodontal disease is usually confined to the alveolar bone area and not extends to the underlying bone marrow. Accordingly periodontal infection per se rarely cause produce oseomyelitis. Even though osteomyeltis could be occurred by periodontal disease, its virulence of infection is milder than periapical odontogenic infection. So it usually provokes sclerosing or hyperplastic osteomyelitis rather than suppurative type. We had a case of suppurative osteomyelitis caused by periodontal disease and treated it with periodontal and oral and maxillofacial surgical method.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.53-57
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• 2008

Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.58-60
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• 2011

Chronic graft-versus-host disease (GVHD) is a well-known complication of allogeneic bone marrow transplantation (BMT) and has heterogeneous manifestations, with multi-organ involvement. Recently, polymyositis (PM) was reported to be a rare manifestation of chronic GVHD. Here, we report a 30-year-old woman who was diagnosed with PM after allogeneic BMT.

• The Korean Journal of Nuclear Medicine
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• v.36 no.2
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• pp.143-145
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• 2002

A 49-year-old male patient with a carcinoma of the right pyriform sinus had a whole-body bone scan and gamma camera based F-18 FDG-PET for staging. Tc-99m MDP bone scan depicted diffuse increased uptake in the left femur due to chronic osteomyelitis but no skeletal metastasis. F-18-FDG-PET revealed increased focal bone uptake and uptake in the draining sinus due to chronic osteomyelitis in addition to visualization of the right pyriform sinus carcinoma and right neck nodal uptake. Fluorine-18 fluorodeoxyglucose-positron emission tomography is significantly more accurate than the bone scan in pinpointing chronic osteomyelitis focus and draining soft tissue infection.

• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.53-59
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• 2021

High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis. Repetitive debridements and rich-vascularized flap coverage of the cranium are required. However, despite successful flap coverage, chronic osteomyelitis of cranial bones may occur. Treatment of chronic osteomyelitis of cranial bones is surgical debridement of the necrotic bone with re-coverage by a well-vascularized flap. The latissimus dorsi musculocutaneous flap is suitable not only for coverage of the cranium after the burn injury, but also for treatment of chronic osteomyelitis of the skull.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.465-472
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• 2008

We experienced a rare case of oral squamous cell carcinoma arisen from gingival tissues overlying prolonged chronic osteomyelitis of the mandible. A 66 years old man complained of unhealed extraction sockets of left mandibular second premolar and first molar, and showed extensive leukoplakia in the gingival tissues of the same area. The inflammation of the socket granuloma became severe and extended into adjacent mandibular proper, resulted in diffuse suppurative chronic osteomyelitis of mandibular body, exhibiting irregular osteolytic changes of mandibular trabecular patterns in mottled radiolucent appearance. The leukoplakia was initially diagnosed under microscope, and the involved gingival tissues were radically removed. Thereafter, the gingival soft tissue inflammation involving the mandibular osteomyelitis was hardly healed for two years. During the period of repeated surgical treatments for the inflamed lesion, nine biopsies were taken sequentially. Until the eighth biopsy, there consistently showed the suppurative osteomyelitis with ingrowing gingival tissues into the bony inflammatory lesion. The gingival epithelium showed the features of leukoplakia but no evidence of malignant changes. However, the ninth biopsy, taken about 2 years after initial diagnosis, showed the early carcinomatous changes of the gingival epithelium. The neoplastic epithelial cells were relatively well differentiated with many keratin pearls, and infiltrated only into underlying connective tissues. So, we presumed that the present case of squamous cell carcinoma was caused by the persistent inflammatory condition of the mandibular osteomyelitis, and also suggest that the leukoplakia should be carefully removed in the beginning to prevent the neoplatic promotion of the chronic inflammation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.514-518
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• 2000

Chronic osteomyelitis is often considered difficult to treat and may lead to refratory condition in oral and maxillofacial region. Clinical features of chronic osteomyelitis includes pain, swelling, pus discharge, and radiographic change. There are many kinds of treatment of chronic osteomyelitis. One of the most important factors in treating osteomyelitis are removal of infectious foci and administration of massive antibiotics. Recently we reviewed 29 patients with chronic osteomyelitis who visited in our department and treated successfully with our treatment protocols, consisting of surgical intervention and intravenous antibiotics for 2 weeks, and followed by oral antibiotics for 6 weeks. It is concluded that combination of surgical intervention and antibiotic therapy are sufficient to treat the chronic osteomyelitis in oral and maxillofacial region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.672-676
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• 2000

One of the current treatment methods for chronic osteomyelitis is removal of the infected and necrotic tissue to reduce the bacterial concentration as much as possible. This is performed concomitantly with antibiotic therapy. Chronic osteomyelitis(C.O.) implies chronic ischemia of the diseased bone. Thus, the treatment for C.O. requires high systemic level of antibiotics. In some cases, however, inherent undesirable adverse effects(for example, nephrotoxicity, ototoxicity, and others) may render this course of treatment difficult. Knowing that residual monomers are released from hardened bone cement, installation of antibiotic-impregnated PMMA(polymethyl-methacrylate) beads in situ have been one of treatment methods of C.O. When introduced into the wound, they established an exceedingly high level of local antibiotics for prolonged period without high systemic level of antibiotics. We experienced favorable results with vancomycin-impregnated PMMA beads for the treatment of C.O. of the mandible. So, we report it with literature reviews.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.293-297
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• 2003

Florid cemento-osseous dysplasia (FCOD) is a benign, non-neoplastic lesion characterized by multiple sclerosing masses only within jawbones. It is frequently confused with chronic diffuse sclerosing osteomyelitis (CDSO) in previous literatures. In our study, two cases of FCOD were examined to know the characteristics of their calcifying tissues. The first case was non-infected, while the second case was severely infected, displaying the typical features of CDSO in clinico-radiologic findings. The infected FCOD case showed a lot of bacterial colonies in the main lesion with relatively rare inflammatory reaction. The globular cementum-like materials of FCOD showed woven bone pattern and was positive for Alcian blue stain, and also positive for the antibodies of ameloblastin, bone morphogenetic protein (BMP) -2 and -4. On the other hands, in the immunostains of matrix metalloproteinase (MMP) -3, -9, -10, and $TNF-{\alpha}$, macrophage infiltrated in the FCOD lesion was rarely observed. These data suggest that the cementum-like materials of FCOD contain various matrix proteins, and that the cementum-like materials are relevant to the overgrowth of the bacterial colonies by inhibition of the regional inflammatory reactions.