• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권5호
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• pp.543-549
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• 2008

Distraction osteogenesis is a commonly used technique for mandibular lengthening, but changes in the temporomandibular joint(TMJ) have not been well documented. The TMJ is one of the most complex joint in the body and is composed of a fibrous surface layer, a proliferative zone, hypertrophic cartilage, and bone. The shape and role of the TMJ change and modify during a person's life-time. Possible complications that can arise after mandibular distraction include failure of the formation, failure of callus, infection, disturbance of TMJ and of occlusion. However, there are only a few reports on changes in the TMJ as a result of distraction osteogenesis. Hence, the goal of this study was to evaluate the change of the TMJ after experimental distraction of mandibular ramus in rabbit. We studied histological changes of mandibular condyle, articular disk and retrodiscal tissue, and also examined the collagen I gene expression and MMP-1 gene expression. The results were as follows. 1. In the histological staining, experimental condylar surface showed more thick fibrous articular layer and proliferative layer, compared with the control condyle and experimental articular disc showed thick and dense collagen fibers compared with the control disc. 2. In the collagen I and MMP-1 gene RT-PCR analysis, experimental discs showed increased collagen I expression compared with the control disc, while MMP-1 gene expression was decreased compared with the control disc. The retrodiscal tissue was almost equal expressions of the collagen I and MMP-1 genes compared with the control retrodiscal tissue. These findings suggest that histological and biomolecular changes occur in condyles and discs after unilateral mandibular distraction osteogenesis.

• 척추신경추나의학회지
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• 제2권1호
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• pp.99-114
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• 2007

Objectives : The purpose of this study was to introduce the Chuna Manual Therapy (CMT) using Bong (a type of stick which is called 'bong') as a part of Oriental Medicine. Methods : We searched several traditional methods of CMT using Bong, either individual contact to specialist of CMT using Bong or referred to publications, and summarized briefly for introduction. Authors also made a comparative study between existing CMT and CMT using the bong. Results & Conclusions : The indications of Bong CMT are regarded as acute or chronic pain syndrome, whiplash associated disorders, facet syndrome, vertebral misalignment, chronic fatigue syndrome, obesity and also lower extremity length difference caused by malalignment of vertebrae and pelvic bone. The Meridian Muscle Therapy by pressing down using the Bong can be carried out on the imbalances of the muscle by shortening and lengthening contraction. CMT with Bong is considered more effective than other existing CMT in terms of effectiveness. In the case of pelvic correction which needs a tremendous amount of force, it can reduce the force required effectively. This fact can be inferred by the theory of composition and decomposition of force during the transmission of power. We can perform Bong CMT feeling less fatigued subsequently than general CMT. Pressing down with flexed fingers to grip bong acts on the contraction of flexor digiti and extensor digiti muscle, this protects the $doctor^{\circ}{\emptyset}s$ wrist joints from injury. The bong which acts as a tool between the doctor and the patient, while being given treatment, absorbs and spreads out the direct impact from the patient to the doctor. CMT with Bong is able to apply to both existing massage therapies with the hand. The bong appliance can be used in all applications, particularly, but not limited to; Orthopedic and Manual Correction Therapy, Meridian Muscle Pressing, Exercise Therapy, and Meridian Point Manual Pressing Therapy. CMT with Bong belongs to the category of oriental rehabilitation and Chuna manual medicine.

• 대한구순구개열학회지
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• 제8권1호
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• pp.11-22
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• 2005

상악골의 열성장과 횡적 부조화, 그리고 광범위한 치조열 및 구강상악동 누공의 치료에 있어서 기존의 방법에 비해 골신장술을 사용하였을 경우, 본 증례들과 관련 문헌 고찰을 통하여, 견인량의 충분한 확보 및 회귀율의 최소화를 얻을 수 있으며, 또한 입원가료기간의 감소와 연조직 부조화의 해결을 볼 수 있어 구순구개열에 관련된 상악골 변형의 치료에 골신장술이 유용한 치료법이라 생각되어 보고한다.

• The Korean Journal of Pain
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• 제19권2호
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• pp.288-291
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• 2006

Epidural analgesia using an epidural catheter is an effective method to relieve the pain during the rehabilitating procedure for postoperative orthopedic patients. Total spinal anesthesia is one of the possible complications of epidural catheterization which can lead to a life-threatening condition. Achondroplasia is the most common form of short-limbed dwarfism resulting from a failure of endochondral bone formation. In patients suffering with short stature syndrome like achondroplasia, the incidence and risk of total spinal anesthesia during epidural anesthesia may increase because of the technical difficulty and structural anomaly of the spine. We report here on a 35-year old female patient with a height of a 115 cm. She was diagnosed as achondroplasia and she had a previous Ilizarov operation; both tibial lengthening and correction of valgus were done. No specific event occurred during epidural catheterization. Immediately after the injection of a test dose via epidural catheter, the patient became hypotensive, drowsy and showed weakness of both her upper and lower extremities. The symptoms were disappeared after 40 minutes. The catheter was removed on the next day. We concluded that the total spinal anesthesia was caused by intrathecal injection of local anesthetics through the epidural catheter, and the anesthesia then migrated into the subarachonoid space.

• Journal of Periodontal and Implant Science
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• 제41권3호
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• pp.109-116
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• 2011

Purpose: The purpose of this study was to compare and quantify the expression of C-reactive protein (CRP), matrix metalloproteinase (MMP)-14, and tissue inhibitor of metalioproteinases (TIMP)-2 in gingival tissues of patients with chronic periodontitis accompanied with inflammatory reaction related to alveolar bone resorption with or without type 2 diabetes mellitus (DM). Methods: Twelve patients with type 2 DM and chronic periodontitis (group 3), twelve patients with chronic periodontitis (group 2), and twelve healthy individuals (group 1) were included in the study. Gingival tissue biopsies were collected from each patient and from healthy individuals at the time of periodontal surgery (including surgical crown lengthening) or tooth extraction. The concentrations of cytokines were determined by a western blot analysis. Results: The expression levels of CRP and MMP-14 increased in group 2 and 3, and they were highest in group 3. The expressions of TIMP-2 also increased in group 2 and 3. Conclusions: This study demonstrated that the expression levels of CRP, MMP-14, and TIMP-2 might be inflammatory markers in periodontal inflamed tissue. It can be assumed that CRP, MMP-14, and TIMP-2 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.

• Journal of Periodontal and Implant Science
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• 제37권2호
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.125-134
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• 2021

Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

• Childhood Kidney Diseases
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• 제8권2호
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• pp.195-204
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• 2004

목적: 저인산혈성 구루병 환아의 임상상, 각종 혈액화학 검사 수치 및 방사선 검사 소견, 치료에 대한 반응 등을 살피고 효과적인 치료에 도움이 되는 정보를 얻고자 본 연구를 시행하였다. 방법: 1983년 7월부터 2004년 2월까지 서울대학교병원 소아과에서 저인산혈성 구루병으로 진단받고 내과적인 치료를 받은 환아들의 의무기록지를 후향적으로 분석하였다. 결과: 대상환자는 56명이었고, 남녀의 비는 1:3 이었다 주소는 대부분 하지만곡과 저신장이었고, 혼자 걷기 시작하면서 발견된 경우가 가장 많았다. 진단시 평균연령은 5년 2개월 이었으며 12개월 이전에 진단 받은 경우는 없었다. 14명(25%)에서 가족력이 있었다. 진단받은 연령과 신장의 표준편차 점수는 통계적으로 의미있는 음의 상관관계가 있었다(r=-0.47, p=0.005). 생화학적 검사에서 정상 혈청 칼슘, 혈청 인의 저하, alkaline phosphatase의 상승, 세뇨관에서 인산 재흡수의 감소 및 정상 범위의 $1,25(OH)_2D_3$ 치를 보였다. 방사선 검사는 구루병에 합당하였다. 치료제로 Joulie 용액과 비타민 D 대사체를 복용하였다. 치료를 시작한 후 혈청 인과 alkaline phosphatase는 통계적으로 의미있는(P<0.05) 호전을 보였고, 방사선 검사는 구루병의 치유를 보였으나, 신장 표준편차 점수는 의미있는 변화를 보이지 않았다(.p=0.224). 치료의 부작용으로 신석회화(34%), 부갑상선호르몬의 상승(77%), 고칼슘뇨증(45%) 등이 발생하였다. 16명이 절골술을 통한 변형의 교정을 시행하였고, 그 중 4명은 하지연장을 함께 시행하였다. 결론: 증상의 시작과 진단 사이에는 수 년간의 지연이 있었다 조기치료가 환자의 예후에 가장 중요하므로, 가족력이 있는 경우 증상 발현 이전에 생화학적 검사로 조기 진단 및 치료를 하도록 해야 한다. 치료 중에는 정기적인 모니터링과 용량의 조절을 통해 합병증에 대처해야 한다.