• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.321-340
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• 1995

The regeneration of destructed periodontal tissues is one of the ultimate objectives of periodontal therapy. Guided tissue regeneration technique was developed for the ideal regeneration of periodontal tissues. In order to investigate the role of fibronectin, laminin and tenascin in the regenerating process of periodontal tissues, the expanded PTFE barrier membranes(Gore Associates, USA) removed from the patients who had been treated by guided tissue regeneration(GTR) and guided bone regeneration(GBR) techniques were fixed in neutral formalin for 6-24 hours, embedded with paraffin, sectioned at $4-6{\mu}m$ in thickness, and immunohistochemically processed by Avidin-Biotin peroxidase complex method for detecting fibronectin, laminin and tenascin. Monoclonal mouse anti-human fibronectin antibody(Oncogene Science, USA., 1:100), monoclonal mouse anti-human laminin antibody(Oncogene Science, USA., 1:50) and mouse anti-human tenascin antibody(Oncogene Science, USA, 1:10) were used as primary antibodies. The light microscopic findings were as follows: (1) The distribution of fibronectin, laminin and tenascin was various according to the area of barrier membranes. (2) The distribution of fibronectin in case of GBR was extensive in the tissue on the outer surface of barrier membranes, and rare in the intervening space and on the inner surface. In case of GTR it was extensive on the outer surface and in the intervening space, and rare on the inner surface. (3) The distribution of laminin was rare in the tissue on the outer, the inner surface and intervening space of barrier membranes, regardless of GBR or GTR. (4) In case 'of GBR rare distribution of tenascin was observed on the outer surface only, except the inner surface and the intervening space of barrier membranes. In case of GTR the distribution of tenascin was extensive in the tissue on the outer surface, rare in intervening space and the inner surface. The results suggest that fibronectin, laminin and tenascin may play a important role in the regenerating process of periodontal tissue, and they may affect the outcome of healing.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.273-278
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• 2011

Purpose: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. Methods: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. Results: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. Conclusion: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.339-343
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• 2012

Three dogs were presented with diaphyseal fracture of the tibia following separate motor vehicle accidents. On physical and orthopedic examinations, the dogs were noted to have soft-tissue swelling and a closed fracture in these tibia sites. Radiographs revealed a simple, short oblique fracture (case 1), a comminuted, spiral fracture (case 2), and a simple, spiral fracture (case 3) in tibia. Minimally invasive percutaneous plate osteosynthesis (MIPO) using a veterinary cuttable plate or locking plate was applied for the treatment of these fractures. The surgery was successful, and the fractures healed without any complications by 7 weeks (case 1), 10 weeks (case 2) and 8 weeks (case 3) after surgery. Our patients showed fast bone healing times and early weight-bearing during the treatment of their tibia fractures. Therefore, MIPO was a useful procedure for diaphyseal fracture of the tibia in veterinary orthopedics.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.631-639
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• 1996

Electrosurgical technique have been used in dentistry as an aid to soft tissue management for nearly 60 years. However, it was not until the late 1960s that the principles of electrosurgery were understood and improved equipment became available. Electrosurgery is a surgical procedure performed on soft tissue utilizing controlled high frequency electricaI(radio-frequency) currents in the range of 1,500,000 to 7,500,000 cyclesper second. The radio-frequency energy used in electrosurgery is able to cut and coagulate tissue because it focuses the energy at the small, active electrode. Advantages of electrosurgery for soft-tissue management during dental procedures include improved hemostasis, ease of tissue modification, improved visibility and so on, but adverse healing responses-including necrosis of soft tissue and sequestration of alveolar bone-have been reported. The present report provides examples of treatment of soft tissue and pulp tissue of primary teeth by electrosurgery. The results are as follows; 1. Electrosurgical techniques can be used for various procedures in pedodontics. 2. Electrosurgical procedures provide improved hemostasis and visibility in the operating field, which enable to remove, reshape, and contour soft tissues easily. 3. In pulpotomy technique, it was difficult to expect the variable pulpal response based on the degree of heat accumulation and the conditions of pulp tissues. Therefore, electrosurgical pulpotomy could not be considered as a method superior to formocresol pulpotomy. 4. A greater degree of dexterity and experiences in manipulation of the electrode is required compared with the conventional scalpel surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.150-157
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• 2008

This study evaluated the influence of smooth and brushite-coated implant surfaces in dogs. The first through fourth mandibular premolars were extracted from eight young adult dogs. Twelve weeks after extraction. implantation was performed at the extraction sites. In total, 40 implant fixtures were implanted in the dog mandibles. Twenty machined implants served as controls and twenty brushite-coated surfaces served as tests. Dogs were sacrificed 2 and 4 weeks after implantation. The hemi-mandibles were obtained and processed histologically to obtain non-decalcified sections. Longitudinal sections of each implant were made and analyzed using light microscopy. The overall implant success rate was 83.3%. Histomorphometrically. the experimental group had a better percentage of bone-implant contact than the control group (p<0.05) and there was a significant difference between the 2- and 4-week groups after implantation (p<0.05) Our results suggest that the implant surface morphology influences the increase in peri-implant osteogenesis in the early period of peri-implant healing.

• Journal of Korean Foot and Ankle Society
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• v.1 no.2
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• pp.95-101
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• 1997

Hallux valgus has been characterized by a valgus deformity of the great toe at the metatarsophalangeal joint, along with medial deviation of the first metatarsal, and by three components. First, there is a valgus angle more than $20^{\circ}$ at the first, metatarsophalangeal joint. Second, there is a greater angle than $9^{\circ}$ between the first. and second metatarsals. Third, there is bursal hypertrophy at the medial eminence of the first metatarsals head. The etiology is multifactorial and many procedures have been reported in the treatment of hallux valgus. Most of the procedures are directed towards pain relief, correction of deformity, and preservation of dorsiflexion in the first metatarsophalangeal joint. One such treatment is the Modified chevron osteotomy. It is technically simple, and provides greater stability than a standard osteotomy, and allows early ambulation after surgery. We a reviewed 19 cases with 13 patients of hallux valgus deformity. They were all treated with the Modified chevron osteotomy at the Department of Orthopedic Surgery, Choong ang Gil Hospital, between June 1988 and May 1994. The results of the study were as follows; 1. The mean age was 36 years. Three patients(5 case) were male and ten patients(14 cases) were female. 2. The mean value of the hallux valgus angle was $34.1^{\circ}$, and the first to second intermetatarsal angle was $12.1^{\circ}$, preoperatively. These angles were corrected to $15.8^{\circ}$ and $8.5^{\circ}$, respectively. 3. The metatarsalgia subsided in 17 cases (89.5%). avascular necrosis, non union, and dorsal angulation complicatious were nonexistant. Early bone healing occurred in all cases. 4. The Modified chevron osteotomy is technically simple. It provides excellent pain relief, early ambulation, increased mechanical stability, and many avoids many complications such as AVN, non-union, and dorsal angulation.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.174-180
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• 2008

Purpose: While radiotherapy remains an essential part of the multidisciplinary treatment of cancers, it may cause unwanted consequences such as tissue break down and chronic non-healing wounds as a result of hypoxia, hypovascularity, and hypocellularity. The conservative treatment of osteoradionecrosis was effective only in the early stages or has a limited result. The surgical treatment of osteoradionecrosis includes various local fasciocutaneous flaps, local myocutaneous flaps and different kinds of free flaps with cancellous bone graft or alloplastic material after removal of all devitalized tissue. This study reviews recent cases of osteoradionecrosis in Severance hospital and investigates the use of various flaps for reconstruction of osteoradionecrosis. Methods: From 2000 to 2006, a total of 29 patients, nine men and twenty women with a mean age of 60.4 years were identified and included in the study. Fasciocutaneous flaps were used on 7 patients and myocutaneous flaps were used on the remaining patients. Mean follow-up period was 10.4 months. Results: In the fasciocutaneous flap group, we noted two complications including total flap failure and a partial flap necrosis. In the myocutaneous flap group, four complications were noted including a partial flap necrosis and 3 cases of wound dehiscence. Considering the complications noted in this study, the natural history of progression to flap necrosis appeared to follow the following sequence of events: marginal flap necrosis, infection, wound dehiscence, flap floating and partial flap necrosis, serially. Conclusion: Successful surgical treatment of osteoradionecrosis includes wide radical debridement and reconstruction with a well vascularized flap like myocutaneous flap or fasciocutaneous flap.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.1-6
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• 2010

Purpose: Diabetic foot infection is one of the most common and severe complications of diabetes mellitus that delays healing of the wound. Deep tissue biopsy is considered to be the gold standard method for antibiotic selection in treating infected chronic diabetic ulcers. However, swab culture or superficial tissue biopsy is often performed for a microbiologic test since deep tissue biopsy has limitations in application. The purpose of this study is to find out whether microbiologic results of swab culture or superficial tissue biopsy could be used for selection of antibiotics in treating diabetic ulcers. Methods: This study involved 42 patients with diabetic foot ulcers with negative results in bone probing test. Tissue samples for microbiologic tests were collected from all the patients by using superficial cotton swab, superficial tissue, and deep tissue. The microbiologic results of deep tissue biopsy were compared with swab culture and superficial tissue biopsy statistically. Results: Microbiology of the deep tissue showed the same results with those of the swab culture and superficial tissue in 67% and 71%, respectively. Statistical analysis demonstrated that the microbiology of the swab culture and superficial tissue does not coincide with that of the deep tissue. Conclusion: These results suggest that the microbiology of the swab culture and superficial tissue is not concordant with that of the deep tissue in infected chronic diabetic ulcers. To select appropriate antibiotic regimen, the speci specimen for the microbiologic test should be obtained from deep tissue.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.28-35
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• 2008

The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

• Proceedings of the Korean Vacuum Society Conference
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• 2011.02a
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• pp.20-20
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• 2011

It has been known that, under certain conditions, application of low-temperature atmospheric-pressure plasmas can enhance proliferation of cells. In this study, conditions for optimal cell proliferation were examined for various cells relevant for orthopaedic applications. Plasmas used in our experiments were generated by dielectric barrier discharge (DBD) with a helium flow (of approximately 3 litter/min) into ambient air at atmospheric pressure by a 10 kV~20 kHz power supply. Such plasmas were directly applied to a medium, in which cells of interest were cultured. The cells examined in this study were human synoviocytes, rat mesenchymal stem cells derived from bone marrow or adipose tissue, a mouse osteoblastic cell line (MC3T3-E1), a mouse embryonic mesenchymal cell line (C3H-10T1/2), human osteosarcoma cells (HOS), a mouse myoblast cell line (C2C12), and rat Schwann cells. Since cell proliferation can be enhanced even if the cells are not directly exposed to plasmas but cultured in a medium that is pre-treated by plasma application, it is surmised that long-life free radicals generated in the medium by plasma application stimulate cell proliferation if their densities are appropriate. The level of free radical generation in the medium was examined by dROMs tests and correlation between cell proliferation and oxidative stress was observed. Other applications of plasma medicine in orthopaedics, such as plasma modification of artificial bones and wound healing effects by direct plasma application for mouse models, will be also discussed. The work has been done in collaboration with Prof. H. Yoshikawa and his group members at the School of Medicine, Osaka University.