• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.112-117
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• 2007

Objective : Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. Methods : Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. Results : The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. Conclusion : Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.346-349
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• 1996

This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.21-28
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• 2010

Purpose: To report the clinical results of the use of arterialized venous free flaps in reconstruction in soft tissue defects of the finger and to extend indications for the use of such flaps based on the clinical experiences of the authors. Materials and Methods: Eighteen patients who underwent arterialized venous free flaps for finger reconstruction, between May 2007 and July 2009 were reviewed retrospectively. The mean flap size was 4.7${\times}3.2$ cm. The donor site was the ipsilateral volar aspect of the distal forearm in all cases. There were 8 cases of venous skin flaps, 5 cases of neurocutaneous flaps, 4 cases of tendocutaneous flaps, 1 case of innervated tendocutaneous flap. The vascuality of recipient beds was good except in 4 cases (partial devascuality in 2, more than 50% avascuality (bone cement) in 2). Results: All flaps were survived. The mean number of included veins was 2.27 per flap. Mean static two-point discrimination was 10.5 mm in neurocutaneous flaps. In 3 of 5 cases where tendocutaneous flaps were used, active ROM at the PIP joint was 60 degrees, 30 degrees at the DIP joint and 40 degrees at the IP joint of thumb. There were no specific complications except partial necrosis in 3 cases. Conclusions: An arterialized venous free flap is a useful procedure for single-stage reconstruction in soft tissue or combined defect of the finger; we consider that this technique could be applied to fingers despite avascular recipient beds if the periphery of recipient bed vascularity is good.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.177-194
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• 1991

The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from a distal extension removable partial dentures with three kinds of mandibular major connectors, that is, lingual bar, linguoplate, and swing-lock attachment. A photoelastic model was made of the epoxy resin(PC-1) and hardener(PCH-1) and coated with plastic cement-1 (PC-1) at the lingual surface of the epoxy model and set with three kinds of chrome-cobalt removable partial dentures. A bilateral vertical load of 15kg to the middle portion of the metal bar crossing both the first molars of the right and the left, and a unilateral vertical load of 12.5kg to the right first molar were applied with the use of specially designed loading device and the reflective circular polariscope was used to analyze the photoelastic model under each condition. The following results were obtained : 1. When the bilateral vertical load was applied, the magnitude and distribution of the stress concentration of the edentulous area and the terminal abutment or adjacent teeth was in the order of lingual bar, linguoplate, swing-lock attachment. 2. When the unilateral vertical load was applied, the magnitude and distribution of the stress concentration of the edentulous area and the terminal abutment or adjacent teeth was in the order of lingual bar, linguoplate, swing-lock attachment. 3. When the unilateral vertical load was applied, the magnitude and distribution of the stress concentration of the termial abutment or adjacent teeth on the non-loaded side showed the least stress distribution in case of swing-lock attachment. 4. When the bilateral vertical load and the unilateral vertical load were applied the swing-lock attachment showed the mildest uniform stress distribution on the edentulous area and the alveolar bone around the abutment teeth.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.305-311
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• 2009

Objective : The purpose of this study was to determine the efficacy, radiological findings, clinical outcomes and complications in patients with lumbar stenosis and osteoporosis after the use of polymethylmethacrylate (PMMA) augmentation of a cannulated pedicle screw. Methods : Thirty-seven patients with degenerative spinal stenosis and osteoporosis (T-score < -2.5) underwent lumbar fusion using the Dream Technology Pedicle Screw ($DTPS^{TM}$, Dream Spine Total Solutions, Dream STS, Seoul. Korea) between 2005 and 2007. The clinical outcomes were evaluated by using the visual analog scale (VAS) and the Prolo scale. Radiologic findings were documented through computed tomography (CT) and plain films. Results : Thirty-seven patients were evaluated and included, 2 males and 35 females with an average bone mineral density (BMD) of $0.47g/cm^2$. The average age of the patients was 68.7 (range, 57-88). The preoperative VAS for low back and leg pain ($7.87{\pm}0.95$ and $8.82{\pm}0.83$) were higher as compared with postoperative VAS ($2.30{\pm}1.61$ and $1.42{\pm}0.73$) with statistical significance (p = 0.006, p = 0.003). According to the Prolo scale, 11, 22, one and three patients were in excellent, good, fair and poor conditions, respectively. The average amount of the injected cement per one cannulated screw was $1.83{\pm}0.11\;mL$. Conclusion : The results show favorable outcome both clinically and radiographically for 37 patients who underwent lumbar fusion using $DTPS^{TM}$ and PMMA. Based on the results, the use of this surgical method can be a safe and effective option for the operation on the osteoporotic spine.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.24.1-24.12
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• 2018

Objectives: The aim of this in vitro study was to evaluate the biocompatibility of newly proposed root-end filling materials, Biodentine, Micro-Mega mineral trioxide aggregate (MM-MTA), polymethylmethacrylate (PMMA) bone cement, and Smart Dentin Replacement (SDR), in comparison with contemporary root-end filling materials, intermediate restorative material (IRM), Dyract compomer, ProRoot MTA (PMTA), and Vitrebond, using human periodontal ligament (hPDL) fibroblasts. Materials and Methods: Ten discs from each material were fabricated in sterile Teflon molds and 24-hour eluates were obtained from each root-end filling material in cell culture media after 1- or 3-day setting. hPDL fibroblasts were plated at a density of $5{\times}10^3/well$, and were incubated for 24 hours with 1:1, 1:2, 1:4, and 1:8 dilutions of eluates. Cell viability was evaluated by XTT assay. Data was statistically analysed. Apoptotic/necrotic activity of PDL cells exposed to material eluates was established by flow cytometry. Results: The Vitrebond and IRM were significantly more cytotoxic than the other root-end filling materials (p < 0.05). Those cells exposed to the Biodentine and Dyract compomer eluates showed the highest survival rates (p < 0.05), while the PMTA, MM-MTA, SDR, and PMMA groups exhibited similar cell viabilities. Three-day samples were more cytotoxic than 1-day samples (p < 0.05). Eluates from the cements at 1:1 dilution were significantly more cytotoxic (p < 0.05). Vitrebond induced cell necrosis as indicated by flow cytometry. Conclusions: This in vitro study demonstrated that Biodentine and Compomer were more biocompatible than the other root-end filling materials. Vitrebond eluate caused necrotic cell death.

• Journal of Veterinary Clinics
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• v.39 no.4
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• pp.185-191
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• 2022

An Amur softshell turtle with multiple shell injuries was admitted to the Seoul Wildlife Center on 19 May 2021. The most severe lesion was a puncture wound requiring urgent closure. In addition to routine supportive therapy, the damaged shell was patched with biocompatible polymethyl methacrylate (PMMA) materials (bone cement and dental acrylic) and fiberglass. Despite a few methods to repair the carapace or plastron of hard-shelled turtles, shell repair in the Amur softshell turtle has rarely been reported. This paper reports the repair process of a puncture wound in the carapace of a softshell turtle using polymethyl methacrylate (PMMA). PMMA is a biocompatible acrylic polymer that forms a tight structure that holds the implant against tissue defects, such as skin, bones, and dentures. Fiberglass, a preferred fiber in various medical fields, was used with PMMA to provide extra strength and waterproof capability. After the procedure, there were no signs of edema, inflammation, bleeding, skin discoloration, or any other complications. Accordingly, this can be a method of choice in softshell turtles using biocompatible materials to cover the lesion in the carapace and provide appropriate wound management, supportive therapy, and a suitable course of antibiotics considering all other circumstances.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.24-34
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• 2010

The aim of this study was to evaluate the effect of incorporated nano HA on the demineralization resistance and bonding strength of LC GIC in comparison with micro HA. Fuji II LC GIC was used as the control group and a base material for experimental groups. Two experimental groups were prepared. One was prepared by adding 15% micro HA to LC GIC by weight ratio (Exp. 1), and the other was prepared by adding 15% nano HA instead (Exp. 2). According to the results, the following conclusions could be obtained. 1. Observing under the CLSM, the control group showed thicker enamel demineralization layer than in the experimental groups, and the Exp. 2 group showed the thinnest demineralization layer. 2. In SEM analysis, there was greater enamel demineralization in the control group. The Exp. 2 group was more resistant to demineralization compared to the Exp. 1 group. 3. The bonding strength was found to be in the increasing order of control, Exp. 1, and Exp. 2 group (p < 0.05). 4. Observing the fractured surfaces under SEM after the bonding strength test was performed, there were bone-like apatite particles formed in HA-added experimental groups, and a greater number of bone-like apatite particles were formed in the Exp. 2 group compared to the Exp. 1 group.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.1
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• pp.73-82
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• 2009

Injectable calcium phosphate cement (CPC) has been used as bone substitute successfully due to good biocompatibility and osteoconductivity. One of the important mechanical characteristics of CPC is flowablility, which can be evaluated by measuring rheological parameters. However, there have been few studies that measured rheological properties of CPC. The purpose of this study was to evaluate the effects of temperature and concentrations of 2 kinds of setting solutions, hydroxyprophyl methylcellulose (HPMC) and polyacrylic acid (PAA), on rheological properties of CPC. The CPC used was dicalcium phosphate dihydrate (DCPD). Rheological properties of CPC paste were measured using rheometer. The effect of concentrations of each solution (2% and 1% HPMC and 35% and 17.5% PAA) was evaluated. The effect of temperature ($25^{\circ}C$ and $37^{\circ}C$) on the rheological properties of CPC was also investigated. The statistical analysis was carried out with Mann-whitney test with Bonferronis collection. CPC with both setting solutions showed shear thinning behavior. Higher concentrations of setting solution (2% HPMC and 35% PAA) produced significantly higher viscosity than lower concentrations of setting solution (1% HPMC and 17.5% PAA). CPC with HPMC showed significantly higher viscosity at $37^{\circ}C$ that at $25^{\circ}C$. CPC with PAA showed lower viscosity at $37^{\circ}C$ than at $25^{\circ}C$, although the difference was not statistically significant. The results showed that CPC with HPMC or PAA solutions are pseudoplastic and the concentrations of setting solutions and temperature may have an effect on the rheological properties of CPC paste. These results showed that the flowability of injectable CPC could be improved by use of increasing frequency of oscillation. In clinical practice, the use of ultrasonic vibration would be helpful in application of injectable CPC. CPC with HPMC could be more easily applicated at $25^{\circ}C$ than $37^{\circ}C$. The use of lower concentrations of HPMC and PAA solution would be beneficial in terms of flowability.

• Journal of Biomedical Engineering Research
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• v.25 no.3
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• pp.171-182
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• 2004

This study investigates the biomechanical efficacies of vertebroplasty which is used to treat vertebral body fracture with bone cement augmentation for osteoporotic patients using image and finite element analysis. Simulated models were divided into two groups: (a) a vertebral body, (b) a functional spinal unit(FSU). For a vertebral body model, the maximum axial displacement was investigated under axial compression to evaluate the effect of structural integrity. The stiffness of each FE model simulated was normalized by the stiffness of intact model. In the case of FSU model, 3 types of compression fractures were formulated to assess the influence on spinal curvature changes. The FSU models were loaded under compressive pressure to calculate the change of spinal curvature. The results according to the various factors suggest that vertebroplasty has the biomechanical efficacy of the increment of structural reinforcement in a patient who has relatively high level of BMD and a patient with the amount of 15％, PMMA injection of the cancellous bone volume. The spinal curvatures after compression fracture simulation vary from 9$^{\circ}$ to 17$^{\circ}$ of kyphosis compared to that the spinal curvature of normal model was -2.8$^{\circ}$ of lordosis. These spinal curvature changes cause the severe spinal deformity under the same loading. As the degree of compressive fracture increases the spinal deformity also increases. The results indicate that vertebroplasty has the increasing effect of the structural integrity regardless of the amount of PMMA or BMD and the restoration of decreased vertebral body height may be an important factor when the compressive fracture caused the significant height loss of vertebral body.