• Journal of Chest Surgery
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• v.49 no.5
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• pp.361-365
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• 2016

Background: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. Methods: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. Results: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. Conclusion: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.

• The korean journal of orthodontics
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• v.51 no.5
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• pp.321-328
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• 2021

Objective: To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome. Methods: The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Real-time Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated. Results: The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases. Conclusions: This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.227-233
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• 2018

Background: The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures. Methods: Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard anteroposterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked. Results: Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p<0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group. Conclusions: Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acromioclavicular subluxation or dislocation.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.75-82
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• 2022

Purpose: This cross-sectional study evaluated and categorized the tomographic sagittal root position (SRP) of the maxillary anterior teeth in a Brazilian population. Materials and Methods: Cone-beam computed tomographic scans of 420 maxillary anterior teeth of 70 patients (35 men and 35 women, mean age 25.2±5.9 years) were evaluated. The SRP was classified as class I, II, III, or IV. In class I, the root is positioned against the buccal cortical plate; in class II, the root is centered in the middle of the alveolar housing; in class III, the root is positioned against the palatal cortical plate; and in class IV, at least two-thirds of the root engage both the buccal and palatal cortical plates. Results: In total, 274 teeth (65.2%) were class I, 39 (9.3%) were class II, 3 (0.7%) were class III, and 104 (24.8%) were class IV. The frequency distribution over the teeth groups was different from the overall analysis. Important differences were found in the frequencies of classes I, II, and IV compared to other populations. Sex was not associated with the SRP classes (P=0.307). Age distribution was significantly different over the classes (P=0.004). Conclusion: The findings of this study on the distribution of SRP classes among the Brazilian population compared to other populations demonstrate that the SRP should be analyzed on a case-by-case basis for an accurate treatment plan in the maxillary anterior area.

• Journal of Haehwa Medicine
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• v.7 no.2
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• pp.609-620
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• 1999

Over the period between January 1997 and December 1998, herbal medicine was more than three times administered to the patients coming to Na dong gyu's Oriental Medical Clinic on account of the symptom of growth deficiency. According to radiological opinions about the patients providing cooperation for measuring their height and weight as well as their bone age every three months, it was found that the growth plates were not closed. A research was conducted for 200 children randomly selected of patients in prepuberty (they grew by less than 5cm a year before treatment at a age of 12years for female children and 14years for male children). As a result, the following conclusion was drawn: 1. The randomly selected subjects were made up of 116 male and 84 female children in terms of gender. The age direstribution was most 10 to 12 years in 86 children(34.00%), followed by 8-10 years(27.50%) and 12 to 14 years(19.50%). 2. Considering the distribution of sick children's parental height, the fathers of 141 children(70.50%) measured less than 170cm high, the subaverage height, while the mothers of 172 children(86%) measured less than 160cm high, the subaverage height. It was shown that sick childen's height was genetically influenced by their parents. 3. Children patients's weight at a time of birth was most 3.1-3.5kg for 85 children(44%) and less than 2.5kg which came under the range of growth dificiency for 19 children(9.5%). 4. The highest proportian of the children patients with growth dificiency(56.33%) had the symptom of digestive disorders, of which 77 children patients(18.78%) had anorexia, 16.59% of children patients had the high level of respiratory disorders. Both the digestive disorder and the respiratory disorder put together, they had the high rate of 72.92%. Therefore, this indicates that both the digestive disorder and the respiratory disorder have a great effect on children's growth dificiency. 10.74% of chilren patients were shown to have allergic disorders, which indicates that they also exert an effect on growth deficiency. Specifically, 7.07% of the children patients had the high level of obesity, which shows that an excessive uptake of nutrition may rather induce children to have growth dificiency though an appropriate amount of nutritional uptake is necessary. 5. Comparing their bone age and their chronological age, 58 children patients(29.00%) showed that they were the same at the highest percent. 79 children patients(39.50%) showed that thier bone age was lower than their chronological age. And 63 children patients(31.50%) showed that their bone age was higher than their chronological age. 6. As regards the prescription administered to children patients for treating their growth dificiency, Growth tang A related to the kidney, the congenital factor, of the causes for growth dificiency in traditional Oriental Medicine was administered to 108 children patients(54%), whereas the Growth tang B related to the spleen, the acquired factor, was administered to 92 children patients(46%). 7. 116 male children patients with growth dificiency had the average value of growth for one year before treatment, 4.39cm, while 84 female children patients had the average value of growth for one year before treatment, 4.24cm. A total of 200 children had the average value of growth for one year before treatment, 4.33cm. The annual average value of growth in growth curve surveyed by the Korea Pediatrics Society was 5.79cm. Compared to this value, the one year average value of growth for 108 male and female children patients taking Growth tang A was shown be 8.44cm, which indicates a greater growth by 4.12cm(95.37%) in comparison with the average value of growth before treatment, 4.32cm, and a greater growth by 2.65cm(45.77%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Also, the average value of growth before treatment for 92 male and female children patients taking Growth tang B was shown to be 8.47cm, which indicates a greater increase by 4.15cm(96.06%) compared to 4.32cm, the average value of growth before treatment and a greater increase by 2.67cm(46.29%) in comparison with 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Considering the average value of growth for male and female children patients taking Growth tang A and B, it was shown to be 8.46cm, which indicates a greater increase by 4.14cm(95.81%) compared to 4.32cm, the average value of growth before treatment, and a greater increase by 2.67cm(46.11%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.2
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• pp.88-94
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• 2020

Purpose: The purpose of this study was to analyze the sagittal root position of maxillary anterior teeth and report the frequency of each classification in Korean for immediate implant placement. Materials and Methods: A retrospective review of cone-beam computed tomography (cone-beam CT) images was conducted on 120 patients (60 male and 60 female) who fulfilled the inclusion criteria. After reorientation of the axis, cone-beam CT images were evaluated and the relationship of the sagittal root position (SRP) of the maxillary anterior teeth to its associated osseous housing was recorded. Class I, II, and III were classified respectively when the root was positioned on the labial, central, and palatal aspect of the alveolar bone. Class IV was the position that at least two thirds of the root is engaging both the labial and palatal cortical plates. Then, the angulation of the root axis and the alveolar bone axis was measured. Descriptive statistics and Kruskal-Wallis test were used to compare the angulation according to the root position and SRP class. Results: The frequency distribution of sagittal root position of maxillary anterior teeth indicated that 81.1%, 10.3%, 1.9%, and 6.7% were classified as Class I, II, III, and IV, respectively. The sagittal angulation at approximately 77.5% of central incisor, lateral incisor, and canine was < 20 degrees, but the angle at more than 42.7% of canine was ≥ 20 degrees. Within the class, the angulation was statistically significantly greater in Class I (16.19) compared to Class II (8.72) and Class III (9.93), and smaller in Class IV (3.79). Conclusion: Within the limitation of this study, a majority of the maxillary anterior roots were positioned close to the buccal cortical plate. However, some roots have very thin alveolar bone and sagittal angulation larger than 30 degrees. Therefore, cone-beam CT analyses of the sagittal root position and the sagittal angulation are recommended for the selection of the appropriate dental implant treatment approach.

• Imaging Science in Dentistry
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• v.35 no.3
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• pp.127-131
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• 2005

Purpose : We performed the present study to investigate whether osteotropic hormomes play roles on the nitric oxide (NO) production in culture of ROS 17/12.8 osteoblastic cells. Materials and Methods : The osteoblastic cell line ROS17/2.8 cells were cultured In F12 medium supplemented with $5\%$ fetal bovine serum (FBS) at $37^{\circ}C$ in a humidified atmosphere of $5\%\;CO_2$ in air. ROS17/2.8 cells were plated in 96-well plates at a density of $2-3\times10^3cells/well$ and grown to confluence. Then the cells were pretreated with osteotropic hormones (parathyroid hormone (PTH) 20-500 ng/mL, 1, 25-dihydroxycholecalciferol $(1,\;25[OH]_2D_3)$ 1-100 nM; prostaglandin $E_2 (PGE_2)$ 20-500 ng/mL in the medium supplemented with $0.4\%$ FBS for 72 hours and the cells were treated with cytokines $(TNF{\alpha}\;and\;IFN{\gamma})$ in phenol red-free F12 medium for an additional 48 hours. NO synthesis was assessed by measuring the nitrite anion concentration, the reaction product of NO, in the cell culture medium using Griess reagent. Results : PTH and $1,\;25[OH]_2D_3$ pretreatment induced a significant increase in NO production in the presence of $TNF{\alpha}\;and\;IFN{\gamma}.\;PGE_2$ slightly induced NO production compared to the control group. But, $PGE_2$ pretreatment did not affect in NO production in the presence of $TNF{\alpha}\;and\;IFN{\gamma}$. Conclusions : These results suggest that the actions of osteotropic hormones In bone metabolism may be partially mediated by NO in the presence of cytokines.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.691-700
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• 2017

Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.1013-1021
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• 1996

There are many important factors in periodontal inflammation. $IL-1{\beta}$, $PGE_2$ and collagenase are predorminantly key factors. These inflammatory mediators induce gingival tissue and alveolar bone destruction. For the prevention and treatment of periodontal disease, it is necessary to inhibit $IL-1{\beta}$, $PGE_2$ production and collagenase activity. Ursodeoxycholic acid(UDCA) has immunomodulatory properties, and there is evidence that some natural extracts show antiinflammatory activity to some degree. The purpose of this study was to assess the inhibitory effect of UDCA and its mixture with natural extracts on $IL-1{\beta}$, $PGE_2$ production and collagenase activity. Accordingly we assessed the effect of UDCA and its mixture combined with some natural extracts on inhibition of $IL-1{\beta}$, $PGE_2$ production and collagenase activity. For the $IL-l{\beta}$ inhibition study, cultured cells were exposed to $25{\mu}g/ml$ LPS. $IL-1{\beta}$ activity was measured by $IL-1{\beta}$ enzyme immunoassay system. Human gingival fibroblasts were prepared and cells (l05/well) were seeded into culture plates. $rhIL-1{\beta}$ was added to induce $PGE_2$. The amount of $PGE_2$ in sample media was measured using enzyme immunoassay system. Crude collagenase was prepared from Porphyromonas gingivalis and collagenolytic activity was determined using a Collageno kit CLN-100. The test inhibitor was added to the assay mixture consisting of 0.1ml of 50mM Tris buffer(pH 7.5) and 0.2ml of substrate solution. UDCA and UDCA combined with natural extracts generally inhibited $IL-1{\beta}$ production. groups above 0.01% UDCA strongly inhibited $IL-l{\beta}$ synthesis. Both groups inhibited $IL-1{\beta}-induced$ synthesis of $PGE_2$. In low concentration, the degree of inhibition was as same as prednisolone. In high concentration, each group was superior to prednisolone. UDCA group and UDCA mixture group exerted a moderate inhibition of collagenolytic enzyme. The present study suggested that UDCA and its mixture with natural extracts could be further investigated as antiinflammatory drug for periodontal disease.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.97-104
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• 2005

Purpose: To report the results of surgical treatment of comminuted fractures of distal humerus and to identify factors that affect the results. Materials and Methods: Thirty-two patients who were treated with open reduction and internal fixation for comminuted fracture of distal humerus were enrolled. According to the AO classification, A2.3 was 1 case, A3.2, 2 cases, A3.3, 8 cases, B1.3, 1 case, B2.3, 1 case, C2.2, 5 cases, C2.3, 4 cases, C3.2, 3 cases and C3.3, 7 cases. As fixation technique, 17 cases were fixed by double plates, 4 cases by only K-wires, 4 cases by only screws, 3 cases by K-wires and screws and 4 cases by one plate and screws. The mean age at the time of the operation was 49 years(range, $19{\sim}77$ years). The mean follow-up period was 16 months(range, $8{\sim}51$ months). Results: At the last follow-up, the mean maximum flexion was $116.4^{\circ}\;(range,\;85{\sim}140^{\circ})$ and the mean loss of terminal extension was $11.8^{\circ}\;(range,\;0{\sim}40^{\circ})$. The average Mayo elbow performance score was $91.4^{\circ}\;(range,\;55{\sim}100^{\circ})$. Overall 29 cases(91%) showed good to excellent results. The mean range of motion of extraarticular and intraarticular fracture group was $105.5^{\circ}\;(range,\;65{\sim}140^{\circ})$ and $104^{\circ}\;(range,\;55{\sim}140^{\circ})$, respectively. The average elbow score of both groups was$93^{\circ}\;(range,\;70{\sim}100^{\circ})$ and $90.7^{\circ}\;(range,\;55{\sim}100^{\circ})$. Over 90% showed more than good results. 30 cases(94%) showed complete bony union but two cases, nonunion. One case of the nonunion cases underwent replating with bone graft as revision surgery and total elbow arthroplasty was performed in the other case. At the last follow-up, 27 patients(84.4%) showed subjective satisfaction. Conclusion: Open reduction and internal fixation with appropriate surgical technique for comminuted fractures of distal humerus showed good results, which were not affected by age at the time of operation, fixation methods and anterior transposition of the ulnar nerve. Transolecranon approach may be considered as good choice for intraarticular comminuted fractures of distal humerus.