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Limb Salvage Surgery after Removal of Infected Tumor Prosthesis with Equalization of Leg Length (감염된 종양 대치물 제거와 하지 단축 보정 후 시행한 사지 구제술 - 증례 보고 -)

  • Kwon, Young-Ho;Kim, Jae-Do;Chung, So-Hak;Cho, Yool
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.141-147
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    • 2006
  • In 1996, a nine-year-old girl was treated with recycling autograft after wide resection of the distal femoral osteosarcoma. The leg lengthening and revision with growing tumor prosthesis were performed due to limb leg discrepancy and epiphyseal problem. However, deep infection developed after operation, and a temporary spacer with cement and Ender nail was inserted. After infection was controlled completely, the final leg lengthening was performed with mono-external fixator for limb length discrepancy (10 cm). Lastly, Tumor prosthesis was reinserted to preserve the joint function.

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Trial of a Synthetic Absorbable Staple Line Reinforcement for Preventing Recurrence after Performing Video-assisted Thoracoscopic Bullectomy for the Treatment of Primary Pneumothorax (일차성 기흉 치료에서 흉강경 기포 절제술 시 재발 방지를 위한 Staple Line 보강재 사용)

  • Park, Jae-Hong;Yoo, Byung-Ha;Kim, Han-Yong;Hwang, Sang-Won;Kim, Myoung-Young
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.337-343
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    • 2009
  • Background: Postoperative recurrence is a major problem after performing video-assisted thoracic surgery for the treatment of primary pneumothorax. This study was designed to evaluate the efficacy and safety of a bioabsorbable staple line reinforcement (GORE $SEAMGUARD^{(R)}$) for preventing recurrence after bullectomy. Material and Method: From January 2000 to December 2004, 300 patients underwent video assisted thoracoscopic surgery for the treatment of primary penumothorax. 143 patients were treated with bioabsorbable staple line reinforcement (Group A) and 142 patients were treated with stapling of the bullae (Group B). Mechanical pleural abrasion was performed in all the patients. The operating time, the duration of the indwelling chest tube, the length of the hospital stay and the number of recurrences after operation were compared between the groups. Result: No operative deaths occurred. The conversion rate to an open procedure was 5% (15/300). Comparison with these groups (Group A versus Group B) showed the following results: the operating time ($49.6{\pm}25.6$ vs $51.8{\pm}30.4$ minutes, respectively, p=0.514), the duration of an indwelling chest tube ($5.8{\pm}2.5$ vs $7.2{\pm}3.3$ days, respectively, p<0.005), the hospital stay ($10.9{\pm}4.3$ vs $12.5{\pm}4.3$ days, respectively, p<0.005) and the number of recurrences (14 (9.8%) vs 10 (7.0%), respectively, the over all rate: 8.4% p=0.523), and the mean follow up period. ($48.1{\pm}36.6$ vs $36.5{\pm}24.4$ months, respectively). Conclusion: There were advantages to use synthetic absorbable staple line reinforcement over the usual method for the treatment of primary pneumothorax in regard to the duration of an indwelling chest tube and the hospital stay, but here was no significant difference between the groups for postoperative recurrence.

Arthroscopic Management for Pyogenic Arthritis with Positive Culture in the Knee Joint (배양 검사로 증명된 화농성 슬관절염의 관절경적 치료)

  • Baek, Seung-Hoon;Kim, Se Sik
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.167-174
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    • 2012
  • Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

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The effect of enamel matrix derivative (EMD) in combination with deproteinized bovine bone material (DBBM) on the early wound healing of rabbit calvarial defects (법랑기질 단백질 유도체와 혼합된 이종골 이식재가 토끼 두개골 결손부 초기 치유에 미치는 영향)

  • Kim, You-Seok;Jang, Hyun-Seon;Park, Ju-Chol;Kim, Heoung-Jung;Lee, Jong-Woo;Kim, Chong-Kwan;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.199-216
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    • 2005
  • 치주치료의 가장 중요한 목적은 상실된 치주조직의 형태적, 기능적 재건이다. 법랑기칠 단백질 유도체(enamel matrix derivative: EMD)는 치주 병소에 사용시 상피세포의 증식을 억제하며 치주인대 및 백악아세포를 활성화시켜 무세포성 백악질 및 치주인대와 골조직의 생성을 유도한다고 보고되고 있다. 또한 법랑기질 단백칠 유도체는 골모세포의 증식 및 분화를 촉진시키며 alkaline phosphatase의 활성 및 mineralized nodule의 형성을 촉진시킨다고 보고되고 있다. 이에 본 연구에서는 토끼 두개골 결손부에 법랑기질 단백질 유도체와 이종골 이식재를 이식한 후 골밀도를 방사선학적으로 분석하고, 신생골 형성 및 주변 조직 반응을 조직학적으로 관찰, 평가하고자 하였다. 토끼 두개골에 6mm trephine bur(외경 8mm)를 이용하여 경뇌막에 손상을 주지 않도록 하면서 4개의 결손부를 형성하였다. 아무것도 이식하지 않은 군을 음성 대조군으로, 이종골 이식재 ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland)을 이식한 군을 양성 대조군으로 설정하였다. 법랑기질 단백질 유도체 ($Emdogain^{(R)}$, Biora, Inc., Sweden)만 이식한 군과 법랑기질 단백질 유도체와 이종골 이식재를 혼합하여 이식한 군을 설험군으로 설정하였다. 각각의 재료를 이식한 후 비흡수성 차폐막 ($Tefgen^{(R)}$, Lifecore Biomedical, Inc., U.S.A.)을 위치시키고 흡수성 봉합사로 일차봉합을 시행하였다. 각 군당 술 후 1, 2, 4주의 치유기간을 설정하였다. 동물을 희생시킨 후 두개골을 절제하여 먼저 방사선학적인 골밀도측정을 시행한 후 10% formalin에 고정한 후 통법에 따라 조직표본을 제작하여 광학현미경으로 관찰하였다. 1. 방사선학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군에서 더 큰 골의 밀도를 보이고 있었다 (P<0.01). 하지만, 동일한 시기에 대조군과 법랑기질 단백질 유도체만 이식한 군과의 차이는 발견할 수 없었으며 (P>0.05), 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군의 차이 또한 발견할 수 없었다 (P>0.05). 2. 조직학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한군에서 골의 형성이 더 진행됨을 알 수 있었다. 법랑기질 단백질 유도체만 이식한 군이 대조군보다 2주에서 더 많은 신생골을 볼 수 있었으며, 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군이 이종골 이식재만 이식한 군보다 1, 2주에서 더 많은 신생골을 관찰할 수 있었다. 이상의 결과에서 법랑기질 단백질 유도체는 토끼 두개골 결손부 치유단계에서 초기 골 형성을 촉진하는 것으로 사료되며 골 이식시에 법랑기질 단백질 유도체를 적용하는 것은 유용한 술식으로 사료된다.

Survival and Compliance with the Use of Radiation Therapy for Anaplastic Thyroid Carcinoma (미분화 갑상선암에서 방사선치료 순응도와 생존기간)

  • Oh, Yoon-Kyeong;Jang, Ji-Young;Chung, Woong-Ki
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.229-236
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    • 2008
  • Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.

Plant Regeneration from Cotyledon and Hypocotyl Tissues of Chinese Cabbage (배추의 자엽과 배축 절편체로부터의 식물체 재분화)

  • Kang, Byung-Kook;Lim, Chae-Wan;Chung, Kyu-Hwan;Park, Young-Doo
    • Horticultural Science & Technology
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    • v.19 no.3
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    • pp.315-319
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    • 2001
  • The study was carried out to develop a simple and efficient system to regenerate plants from cotyledon and hypocotyl tissues of Chinese cabbage (Brassica campestris L. ssp. pekinensis cv Seoul). Among the various combinations of naphthalene acetic acid (NAA) and 6-benzyladenine (BA) tested, the best shoot induction medium for cotyledon, with 2.67 shoots per explants, contained $2.0mg{\cdot}L^{-1}$ NAA, $1.0mg{\cdot}L^{-1}$ BA and $16.7mg{\cdot}L^{-1}$ $AgNO_3$. The shoot induction medium with $1.0mg{\cdot}L^{-1}$ NAA, $5.0mg{\cdot}L^{-1}$ BA and $16.7mg{\cdot}L^{-1}$ $AgNO_3$, was best for shoot induction from hypocotyl explants, with 1.87 shoots per explants. After shoot induction, regenerated shoots were excised and rooted on rooting medium. Rooted plantlets were then hardened in the high humidity growth chamber and transplanted to pots, and then grown in the greenhouse. Regenerated plants appeared phenotypically normal and there were no changes in chromosome number.

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Mass Production of Calla Lily(Zantedeschia spp. Southern Light) by the Immature Zygotic Embryo Culture (유색칼라(Zantedeschia spp. Southern Light) 미숙배 배양에 의한 다량증식)

  • 고정애;최소라;김현순
    • Korean Journal of Plant Resources
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    • v.16 no.2
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    • pp.160-167
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    • 2003
  • In order to investigate the effects of developmental stage of embryos and plant growth regulators on mass production of Zantedeschia spp. Southern Light, immature zygotic embryos of Zantedeschia spp. Southern Light were cultured on Murashige and Skoog(1962) basal media or containing 2,4-D, NAA and BA. Globular embryos did not grow on any of the 2,4-D, NAA and BA combinations. The most suitable stage of immature zygotic embryo culture on the induction callus and multiple shoot was at early cotyledonary embryo stage, and at this stage of embryos were germinated up to 87.5%. The whitish watery callus and yellowish compact nodular callus produced on all 2,4-D, NAA and BA media. The best combination for inducing embryogenic callus was 0.5 mgL NAA and 1.0 mg/L BA. Whitish watery calli have been subcultured for more than 8 months and have retained their producing ability, Plant regeneration was only obtained by direct shoot development and yellowish compact nodular calli. Abundant plantlets were regenerated from cotyledonary stage of embryo culture on MS medium supplemented with 0.5 mg/L NAA and 1.0 mg/L BA. Supplementation of the media with 10% coconut water showed as the best concentration for plant differentiation from direct developed of shoots. The number of regenerated plants from one embryo could be seperated 25-35s plantlets. All yellowish compact callus-derived plantlets were transferred to pots containing a mixture of vermiculite, perlite and sand(1:1;1 v/v) and 100% of divided plantlets were phenotypically normal.

The Verification Of Green Soil Material Characteristics For Slope Protection (사면 보호를 위한 녹생토 재료 특성 검증)

  • Lee, Byung-Jae;Heo, Hyung-Seok;Noh, Jae-Ho;Jang, Young-Il
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.7 no.6
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    • pp.681-692
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    • 2017
  • In recent years, large-scale construction projects such as road pavement construction and new city construction have been carried out nationwide with by the expansion of social overhead facilities and base on the economic development planning, resulting in a rapid increase in artificial slope damage. The existing vegetation-based re-installation method of the slope surface greening method reveals various problems such as lack of bonding force, drying, and lack of organic matter. In this study, research was carried out using vegetation-based material and environmentally friendly soil additives, were are used in combination with natural humus, Bark compost, coco peat, and vermiculite. Uniaxial compressive strength was measured according to the mixing ratio of soil additives and the strength was analyzed. Experiments were carried out on the characteristics of the soil material to gauge the slope protection properties by using the soil compaction test method wherein the soil and the soil additive materials are mixed in relation to the soil height, the number of compaction, the compaction method (layer) and the curing condition. As a result of the experiment, excellent strength performance was demonstrated in soil additives using gypsum cement, and it satisfied vegetation growth standards by using performance enhancer and pH regulator. It was confirmed that the strength increases with the mixing of soil and soil additive, and the stability of slope protection can be improved.

Operative Treatment of the Displaced Bucket Handle Tear of the Medial Meniscus (내측 반월상 연골의 전위된 양동이 손잡이형 파열의 수술적 치료)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Lee Dong-Ho;Kim Min-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.142-149
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    • 2002
  • Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.

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A Comparative Study of Initial Healing Process in White Rats after Gingivectomy using $CO_2$ Laser of different watts (($CO_2$)레이저를 이용한 백서의 치은절제술시 출력에 따른 초기 치유과정의 비교)

  • Cho, Kyoo-Sung;Hong, Sung-Jae;Choi, Seong-Ho;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.27 no.3
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    • pp.603-619
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    • 1997
  • The use of laser in the treatment of soft tissue minimizes hemorrhage, provides better view of the operating field, and thereby minimizes operating time. Also, there will be far less post-operative swelling, pain and scar formation, and sterilizing effect are shown in some portions of the wound site. All these advantages of laser therapy contribute to its widespread use in the field of medicine and dentistry. Regarding such facts, we used CO2 laser of different watts in gingivectomy for white rats to compare initial healing process. For the control group, the least amount of output in performing gingivectomy(4watts) was offered, and for the experimental group, 6watts was given. Animals were sacrificed on the second, third days, 1 weeks, 2 weeks, and 3 weeks after operation, and their specimens were histologically analyzed. The following results were obtained: 1. Blood clot of small size was observed in both the control and experimental groups after two days, and no more thereafter. 2. In both the control and experimental groups, the inflammation zone size was the greatest after two days, and it decreased gradually to become almost invisble by the second week. The experimental group showed larger size of inflammation zone during second and third days: however, there was no difference after one week. 3. Granulation tissue in both the control and experimental groups showed gradual maturation with time, and by the second week, it was almost replaced by normal connective tissue. By the third week, complete healing pattern was observed. The experimental group showed larger granulation tissue than the control group until the third day, but there was no significant difference after one week. 4. In both the control and experimental groups, gingival epithelialization began on the second day. After one week, regeneration of rete peg and partial formation of junctional epithelium were observed: by the second week, keratinization of oral sulcular epithelium began, and it was completed by the third week.

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