• Title/Summary/Keyword: 피질골

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Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

The pattern of movement and stress distribution during retraction of maxillary incisors using a 3-D finite element method (상악 전치부 후방 견인 시 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구)

  • Chung, Ae-Jin;Kim, Un-Su;Lee, Soo-Haeng;Kang, Seong-Soo;Choi, Hee-In;Jo, Jin-Hyung;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.37 no.2 s.121
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    • pp.98-113
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    • 2007
  • Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini Implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

The effect of steroid for fibrous dysplasia of the humerus combined with multiple cystic lesion (낭종성 병변을 동반한 상완골의 섬유성 골이형성증에서 steroid의 효과 - 증례 보고 -)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bo-Hyun;Won, Jung-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.20-26
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    • 2002
  • Fibrous dysplasia is a benign pathologic condition in which the normal cancellous bone is replaced by the fibro-osseous tissue. It is found mostly in the femur, tibia, skull, rib, and humerus. Clinically it may develops pain, progressive deformity, and pathologic fracture. Curettage with bone graft has been the most popular treatment method thesedays. A 17-year-old female who had fibrous dysplasia of the humerus combined with multiple cystic lesion was treated by intralesional steroid injection into the lesion total 2 times. The follow-up plain X-ray which was taken 11 months after steroid injection reveals decrease in size and increase in bone density and cortex thickness. The follow-up MRI reveals significant decrease in size and signal intensity. The signal intensity was decreased to that of normal bone marrow in T2 weighted image. She complains no pain and lives symptom free in last follow-up at 2 years and 8 months after steroid injection.

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A clinical study on the alveolar crest height after secondary alveolar bone graft in the cleft alveolus patients : Preliminary Study (치조 파열 환자에 있어서 이차성 골이식술 후의 치조정 높이 변화에 관한 임상적 연구 : 예비적 연구)

  • Choi, Jin-Young;Kim, Myung-Jin;Kim, Su-Gon;Eune, Jung-Ju;Choung, Pill-Hoon
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.1
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    • pp.1-9
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    • 2000
  • 목적 : 치조파열 환자에 있어서 이차 치조골 이식술을 시행한 후 그 결과를 알아보고자 방사선학적 분석을 통하여 평가하였다. 본 연구의 목적은 수술전 골결손부 인접치아의 치조정 높이와 수술후 골결손부 인접치아의 치조정 높이를 근심측과 원심측에서 각각 측정함으로써 치조정의 높이가 과연 통계적으로 유의성 있게 증가하는지와 치조골 이식술의 성공률이 치조열의 너비와 상관관계가 있는지의 여부를 알아보는 것이다. 환자 및 방법 : 1991년부터 1999년까지 서울대학교병원 구강악안면외과에서 자가장골 채취 후 분쇄피질망사골 형태 또는 block 피질망상골 형태로 이식한 편측성 치조열을 가진 환자 중 최소한 6개월이 경과한 환자 56명을 연구대상으로 하였고 두 술자에 의해 시술되었다. 수술전 골결손부 인접치아의 치조정의 높이와 치조열의 너비 및 수술후 이식한 골의 높이와 절흔의 양은 치과용 파노라마 방사선 사진을 이용하여 측정하였고, 치조열의 너비는 모델이나 환자의 골결손부 근심치아의 근원심 폭경을 이용하여 환산하였다. 그리고 이식한 골의 높이와 절흔의 양을 1995년 Long이 제시한 방법으로 측정하여 술전의 측정치와 비교하였다. 결과 : 치조열의 너비는 평균 6.9mm(1.9mm-12.1mm) 였다. 근심에서의 치아는 골이식 당시 중절치가 52개(92.9%), 측절치가 4개(7.1%)였고, 49명의 환자에서 완전맹출을, 6명의 환자에서 부분맹출(측절치 2개, 중절치 4개)을 보였다. 원심측에서의 치아는 골이식 당시 측절치가 25개(44.6%), 견치가 29개(51.8%), 소구치가 2개(3.6%)였고, 완전 맹출이 32.1%, 부분 맹출이 57.2%, 미맹출이 10.7%로서 완전히 맹출하기 전에 골이식한 경우가 67.9%였다. 모든 환자에 있어서 bony bridge가 나타났고, 절흔이 인접치 아래로 연장되지 않았으며, 치조골 이식술 후 oronasal fistula를 보인 환자는 한 명도 없었으므로 성공률은 100%였다. 술후 근심측에서의 치조정의 높이는 근심측 치아 치근길이의 79%(평균), 원심측에서의 치조정의 높이는 원심측 치아 치근길이의 87%(평균)로서 통계적으로 유의성 있게 증가하였다. 결론: 이차 치조골 이식술을 시행한 후 치조정의 높이는 골결손부 근심측과 원심측에서 모두 유의성있게 증가하였고, 근심측에서보다 원심측에서 통계학적으로 더 유의성 있게 증가하였다. 치조열의 너비와 절흔의 양, 치조정의 높이 및 치조골이식 성공률과는 유의성 있는 관련성이 없었다.

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Bizzare Parosteal Osteochondromatous Proliferation (Nora's lesion) which affects Humeral Shaft -A Case Report- (상완골 간부에 발생한 기괴 방골성 골연골성 증식증 - 1례 보고-)

  • Kim, Kyung-Tae;Lee, Song;Kim, Jin-Hak;Ji, Mi-Kyung;Park, Joon-Seong;Park, Kwan-Young
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.142-146
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    • 2004
  • Bizzare parosteal osteochondromatous proliferation is a rare lesion, tends to frequently recur. It was first described in 1983, when Nora and his colleagues reported 35 examples of a proliferative lesion involving small bones of the hand and the feet. It was regarded as occurring only in the small bones of the hand and the feet initially, but from then on, other authors have been reported cases including those involving long bones, skull and maxilla. We experienced a case of bizzare parosteal osteochondromatous proliferation which affects the humeral shaft in a 14-year-old male patient. Radiographs showed calcified mass measuring $4{\times}3$ cm in size and attached to the underlying cortex, which had a broad stalk base. Histologically, it showed hypercellular cartilage maturation to the trabecular bone and plump amount of fibrous stroma in the spaces around the bony trabeculae. Bizzare parosteal osteochondromatous proliferation is a relatively rare lesion, but has a recurrent behavior and histologically tends to be mistaken for malignancy. It can be treated by excision.

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Intraosseous Epidermal Cyst of the Distal Phalanx: A Case Report (원위 지골에서 발생한 골내 표피낭종: 증례 보고)

  • Kong, Gyu-Min;Kim, Joo Yong;Kim, Jung-Han;Park, Dae-Hyun;An, Kwang Hun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.22-26
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    • 2014
  • An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.

Detecting and Tracking Changes of Mechanical Characteristics of the Trabecular and Cortical Bone in the Lumbar Vertebrae of an OVX Rat - Use of In-Vivo Micro-CT and Micro-FE Analysis - (난소 절제술을 시행한 흰쥐 등뼈의 해면골과 피질골의 구조적 특성 추적관찰 및 기계적 특성 분석 - 생체 내 미세단층촬영 시스템과 미세 유한요소법 적용 -)

  • Ko, Chang-Yong;Woo, Dae-Gon;Lee, Tae-Woo;Lee, Beob-Yi;Tack, Gye-Rae;Kim, Han-Sung
    • Journal of the Korean Society for Precision Engineering
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    • v.24 no.1 s.190
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    • pp.110-117
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    • 2007
  • This study investigated changes of mechanical characteristics of the trabecular and cortical bone in the lumbar vertebrae of the ovariectomised (OVX) rat. In previous researches, there were many studies for morphology of osteoporotic bones based on Micro-Computed Tomography (Micro-CT). However, there were few studies for detecting and tracking changes of mechanical characteristics of the trabecular and cortical bone in the lumbar vertebrae of the OVX rat. For this study, the 4th lumbar of the OVX rat (female Sprague-Dawley) was utilized as a specimen. An OVX rat was scanned at week 0 (just before surgery), at week 4, and week 8 after surgery. Micro-finite element (${\mu}-FE$) analysis was used to investigate mechanical characteristics of the trabecular and cortical bone in the lumbar vertebrae for an OVX rat. When the OVX rat (at week 8) was compared with the OVX rat (at week 0), the structural modulus of cortical and trabecualr bone was decreased by 52% and 99%, respectively. This study showed the change of mechanical characteristics of cortical bone as well as trabecular bone of an OVX rat. Detecting and tracking changes of mechanical characteristics could greatly contribute to an experiment test for the trabecular and cortical bone in the lumbar vertebrae of an OVX rat by using In-vivo Micro-CT.

CORTICOTOMY IN PATIENT WITH NARROW PALATAL ARCH (피질골절단술을 이용한 상악협소증환자의 치험례)

  • Kim, Eun-Cheol;Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.371-374
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    • 1999
  • The treatment of adults with dentofacial deformities is frequently complicated by existence of discrepancies in transverse dimension. Control of the transverse dimension through surgical technique is now a valuable treatment consideration in non-growing patients. Proper diagnosis of relative and absolute maxillary transverse deficiency is imperative prior to surgical intervention. Therapeutic purpose should be implemented accordingly to facilitate correction of transverse discrepancies concomitant with treatment objectives in sagittal dimension in order to provide the patient with the most stable and functional result possible. Concomitant surgical correction of narrow palate require less treatment time, treatment cost and post-treatment relapse is less than to do only orthodontic therapy. This report is concerned with rapid palatal expansion by a combination of corticotomy and orthodontic treatment.

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Chondrosarcoma of the Calcaneus in 13 year old Aged Patient - A Case Report - (13세 환자의 종골에 발생한 연골육종 - 증례 보고 -)

  • Hong, Ki-Do;Ha, Sung-Sik;Park, Young-Keun;Lee, Hyo-Jin;Cha, Hyun-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.59-63
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    • 2001
  • Chondosarcoma of the calcaneus in young child is extremely rare. A thirteen-year old male patient has suffered from right heel pain for several months before. Dominant gross feature was hard mass and swelling on one entire right heel, and increased density and calcification on entire calcaneus with cortical destruction, and calcific densities on soft tissues around calcaneus were seen on roentgenogram of right ankle. It was diagnosed to be chondrosarcoma by bone biopsy. It was treated by below knee amputation and chemotherapy, and no recur and distant metastsis during 12 months after operation.

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TUMOR-INDUCED HYPOPHOSPHATEMIC OSTEOMALACIA : Report of Three Cases (종양유발성 골연화증의 3예)

  • Kim Soh-Hyun;Oh Bong-Hyun;Hang Eui-Hwan;Lee Sang-Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.1
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    • pp.141-150
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    • 1995
  • 종양유발성 골연화증은 종양에 의하여 생성된 활동성 펩티드호르몬과 유사한 물질이 골이나 위장관에 작용하여 칼슘대사와 인대사의 변화를 일으키거나, 정상적인 비타민 D대사에 장애를 일으킴으로써 2차적으로 발생되는 대사성 질환으로 알려져 있다. 이의 발생빈도는 매우 낮으며, 임상적으로는 체중과 신장의 감소, 전신적인 골격의 동통 및 근무력증과 병적 골절이 동반되어 나타난다. 방사선사진에서는 골소주의 전반적인 소실, 피질골의 비박, 위골절, 치조백선의 소실 등을 보이고, 실험실 소견에서는 혈청인의 농도와 신세뇨관에서 인의 재흡수율의 감소 및 혈청 알칼리성 인산화효소 농도의 상승이 관찰된다. 본질환은 종양이 제거되면 별도의 부가적인 치료 없이도 임상적, 방사선학적 소견 및 실험실 소견의 뚜렷한 개선을 보이므로 이의 치료에 있어서 정확한 진단이 매우 중요하다. 저자들은 전신적인 동통과 근무력증을 주소로 내원한 환자들에게서 발생된 종양유발성 골연화증 3예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.

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