• Title/Summary/Keyword: Bone replacement

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Surgical Treatment for Pathologic Fracture of Skeletal Metastatic Lesion of the Proximal Femur: Comparison of Clinical Outcomes for Prosthetic Joint Replacement and Osteosynthetic Fixation (근위 대퇴골에 발생한 전이성 골종양의 병적 골절의 수술적 치료: 종양대치 인공관절 치환술과 골절 고정술의 치료 성적 비교)

  • Shin, Duk-Seop;Kim, Ui-Sik;Kwak, Hae-Jun;Ko, Young-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.44-50
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    • 2011
  • Purpose: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. Materials and Methods: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. Results: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. Conclusion: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.

MINI-IMPLANTS TO RESTORE MISSING TEETH IN SEVERE RIDGE DEFICIENCY AND SMALL INTERDENTAL SPACE (치조정 골 소실이 심한 경우와 치간 사이 공간이 부족한 경우에서의 미니 임프란트 식립)

  • Seo, Mi-Hyun;Yoo, Chung-Kyu;Lee, Eun-Kyung;Jung, Da-Unn;Suh, Je-Duck;Chung, Il-Hyuk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.67-70
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    • 2009
  • Purpose: This study presents the use of mini implants for fixed restoration and implant supported overdenture to enable the practitioner to overcome the anatomic obstacles of ridge width and narrow interdental space. Patients and methods: This study consisted of 9 patients who required single implants for one or two teeth replacement and 1 patient who required implant supported overdenture after mandiblectomy, iliac bone graft due to ghost cell tumor. The ages ranged from 29 to 70 years (mean 51). All patients were in good health. Clinical and radiographs were taken pretreatment, postoperatively, during rehabilitation, and at follow ups. Results: Total implant survival rate was 94.7%. One implant was removed due to its mobility as a result of bad bone quality (Type IV) and patient's carelessness (Heavy smoker). All patients except one reported complete satisfaction regarding to function, aesthetics, and phonetics. Radiographic follow up every 3months postoperatively showed success in achieving function and maintaining marginal bone level. Conclusion: Clinician can overcome both severe ridge deficiency and small interdental space with mini implant.

Isoflavones Extracted from Sophorae fructus Upregulate IGF-1 and TGF-$\beta$ and Inhibit Osteoclastogenesis in Rat Born Marrow Cells

  • Joo, Seong-Soo;Won, Tae-Joon;Kang, Hee-Cheol;Lee, Do-Ik
    • Archives of Pharmacal Research
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    • v.27 no.1
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    • pp.99-105
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    • 2004
  • Isoflavones have been a central subject in research on the natural phytoestrogens found in Leguminosae. Their effects on bone formation and remodeling are important in that they can act like estrogen by binding on estrogen receptors on the target cell surface. We, therefore, believed that isoflavones may help in the treatment of patients with estrogen deficiency disease such as estrogen replacement therapy (ERT) for osteoporosis. As commonly known, osteoporosis is one of the hormonal deficiency diseases, especially in menopausal women. When estrogen is no longer produced in the body a remarkable bone remodeling process occurs, and the associated events are regulated by growth factors in the osteoblast lineage. In the present study, we investigated whether isoflavones (Isocal) extracted from Sophorae fructus affect the growth factors IGF-I and TGF-$\beta$ that have been known to be related with bone formation. In the study, we found that the active control (PIII) effectively enhanced the level of nitric oxide (NO) and growth factors, and thereby inhibited osteoclastogenesis. The most efficient concentration was $10^{-8}$% within five days, whereas the comparative control (soybean isoflavone) was not as effective even at a lower concentration. In conclusion, the products which contain enriched glucosidic isoflavone and nutrient supplements such as shark cartilage and calcium can be used for osteoporosis therapy by enhancing the production of IGF-I and TGF-$\beta$. Furthermore, the NO produced through endothelial constitutive NO synthase (ecNOS) may playa role in inhibiting bone reabsorption.

Effects of gihyeolsotong-hwan on monosodium iodoacetate-induced osteoarthritis in rats (기혈소통환(氣血疏通丸)이 Monosodium iodoacetate로 골관절염(骨關節炎)을 유도(誘導)한 랫드에 미치는 영향(影響))

  • Xu, Wen-Qiang;Kim, Soon-Keun;Choi, Hak-Joo;Kim, Dong-Hee
    • The Korea Journal of Herbology
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    • v.33 no.3
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    • pp.45-53
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    • 2018
  • Objectives : In cases of osteoarthritis, the hypofunction of the cartilage and joint leads to a limited range of joint motion, swelling, and pain, which is generally treated using pharmaceutical drugs (e.g., anti-inflammatory agents, cartilage protectants, and nonsteroidal anti-inflammatory drugs) or replacement arthroplasty. However, long-term drug treatment is associated with adverse effects on the gastrointestinal systems. The present study aimed to evaluate the ability of Giheolsotong-hwan to treat of osteoarthritis symptoms in the MIA-induced rat model based on histological analysis, and factors that are associated with inflammation and bone mineral metabolism. Methods : Giheolsotong-hwan was administered orally at doses of 200 mg/kg/day or 400 mg/kg/day for 2 weeks before direct injection of monosodium iodoacetate ($3mg/50{\mu}{\ell}$ of 0.9% saline) into the intra-articular space of the rats' right knee. The rats subsequently received the same doses of oral Giheolsotong-hwan for another 4 weeks. We evaluated the treatment effects based on serum biomarkers and histopathological analysis of the knee joints. Results : Compared to those in control rats, the Giheolsotong-hwan treatments significantly decreased the serum concentration of inflammation factors (i.e., $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, $PGE_2$, and $LTB_4$), and bone degrade factors (i.e., MMP-9, CTX-II, and COMP). In addition, the Giheolsotong-hwan treatments significantly increased the concentration of glycosaminoglycans of bone defence factors, but no chage the TIMP-1. Furthermore, the Giheolsotong-hwan treatments effectively preserved the knee cartilage and proteoglycan. Conclusion : The results indicate that Giheolsotong-hwan treated osteoarthritis symptoms. Thus, Giheolsotong-hwan may be a novel oriental therapeutic option for the management of osteoarthritis.

Ten technical aspects of baseplate fixation in reverse total shoulder arthroplasty for patients without glenoid bone loss: a systematic review

  • Reinier W.A. Spek;Lotje A. Hoogervorst;Rob C. Brink;Jan W. Schoones;Derek F.P. van Deurzen;Michel P.J. van den Bekerom
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.88-107
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    • 2024
  • The aim of this systematic review was to collect evidence on the following 10 technical aspects of glenoid baseplate fixation in reverse total shoulder arthroplasty (rTSA): screw insertion angles; screw orientation; screw quantity; screw length; screw type; baseplate tilt; baseplate position; baseplate version and rotation; baseplate design; and anatomical safe zones. Five literature libraries were searched for eligible clinical, cadaver, biomechanical, virtual planning, and finite element analysis studies. Studies including patients >16 years old in which at least one of the ten abovementioned technical aspects was assessed were suitable for analysis. We excluded studies of patients with: glenoid bone loss; bony increased offset-reversed shoulder arthroplasty; rTSA with bone grafts; and augmented baseplates. Quality assessment was performed for each included study. Sixty-two studies were included, of which 41 were experimental studies (13 cadaver, 10 virtual planning, 11 biomechanical, and 7 finite element studies) and 21 were clinical studies (12 retrospective cohorts and 9 case-control studies). Overall, the quality of included studies was moderate or high. The majority of studies agreed upon the use of a divergent screw fixation pattern, fixation with four screws (to reduce micromotions), and inferior positioning in neutral or anteversion. A general consensus was not reached on the other technical aspects. Most surgical aspects of baseplate fixation can be decided without affecting fixation strength. There is not a single strategy that provides the best outcome. Therefore, guidelines should cover multiple surgical options that can achieve adequate baseplate fixation.

Sustainable Business Model of Water Purification Equipment and Local Manufacturing Technology Transfer of High Adsorption Bone Char to Remove Fluoride from Groundwater (지하수 불소제거를 위한 고흡착 골탄의 현지 제조기술 이전과 정수장치의 지속 가능한 비즈니스 모델 개발)

  • Maeng, Min-Soo;Lee, He-In;Byun, Jung-Seop;Park, Hyo-Jin;Shin, Gwy-Am
    • Journal of Appropriate Technology
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    • v.7 no.1
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    • pp.41-50
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    • 2021
  • Gongali model Co. Ltd located in Arusha, Tanzania is operating a Nanofilter water station using locally produced bone char to remove fluoride in groundwater. Bone char produced locally had a high turbidity and high concentration of organic matter, which cause color. In addition, since the fluorine adsorption efficiency is low, there is a problem in high maintenance cost due to a short replacement cycle of bone char. In order to overcome this challenge, our research team was that a local furnace was manufactured and applied for produce high adsorption bone char in Gongali model Co. Ltd. By producing high-adsorption bone char locally, the operating efficiency of the Nanofilter water station increased, and it was possible to stably and continuously provide drinking water to local residents. In addition, by presenting a sustainable business model to Gongali model Co Ltd, the persistence of high adsorption bone char and a plan to spread the Nanofilter water station were suggested. Therefore, it was possible to propose a plan to continuously supply low-cost drinking water to the low-income and the neglected class through this local project.

The Usefulness of Postoperative Pinhole Bone Scintigraphy in the Assessment of Prognosis after Multiple Drilling or Vascularized Bone Graft in Patients with Avascular Necrosis of Femoral Head (다발성 천공술 및 혈관 부착 골이식술을 시행한 대퇴골두 무혈관성 괴사의 예후: 수술 후 바늘구멍 골신티그라피의 유용성)

  • Chung, Yong-An;Kim, Sung-Hoon;Chun, Kyung-Ah;Park, Young-Ha;Sohn, Hyung-Seon;Chung, Soo-Kyo;Song, Mun-Kab
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.405-412
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    • 1999
  • Purpose: It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. Materials and Methods: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. Results: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). Conclusion: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.

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Evidence for VH Gene Replacement in Human Fetal B Cells

  • Lee, Jisoo;Cho, Young Joo;Lipsky, Peter E.
    • IMMUNE NETWORK
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    • v.2 no.2
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    • pp.79-85
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    • 2002
  • Background: In contrast to evidences of Ig H chain receptor editing in transformed cell lines and transgenic mouse models, there has been no direct evidence that this phenomenon occurs in human developing B cells. Methods: $V_HDJ_H$ rearrangements were obtained from genomic DNA of individual $IgM^-$ B cells from liver and $IgM^+B$ cells from bone marrow of 18 wk of gestation human fetus by PCR amplification and direct sequencing. Results: We found three examples of H chain receptor editing from $IgM^+$ and $IgM^-human$ fetal B cells. Two types of $V_H$ replacements were identified. The first involved $V_H$ hybrid formation, in which part of a $V_H$ gene from the initial VDJ rearrangement is replaced by part of an upstream $V_H$ gene at the site of cryptic RSS. The second involved a gene conversion like replacement of CDR2, in which another $V_H$ gene donated a portion of its CDR2 sequence to the initial VDJ rearrangement. Conclusion: These data provide evidence of receptor editing at the H chain loci in developing human B cells, and also the first evidence of a gene conversion event in human Ig genes.

Treatment and management of patients with inherited metabolic diseases (유전성 대사질환의 치료 및 관리)

  • Lee, Jin-Sung
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1152-1157
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    • 2006
  • Inherited metabolic disease is rare disorders that show symptoms mainly in pediatric age and early treatment is important for preventing complications of the disease. Recent development in molecular and biochemical techniques help clinicians with proper diagnosis of patients, however, many of the disease still remain lack of effective therapeutic strategies. Better understanding on biochemical and molecular basis of pathogenesis of the disease combined with advanced medical care would provide new sight on the disease that can also improve the quality of life and long-term prognosis of patients. Traditionally, there are several modalities in the treatment of metabolic diseases depend on the biochemical basis of the disease such as diet restriction, removing or blocking the production of toxic metabolites, and stimulating residual enzyme activity. The inherited metabolic disease is not familiar for many clinicians because the diagnosis is troublesome, treatment is complicated and prognosis may not as good as expected in other diseases. Recently, new therapeutic regimens have been introduced that can significantly improve the medical care of patients with metabolic disease. Enzyme replacement therapy has showed promising efficacy for lysosomal storage disease, bone marrow transplantation is effective in some disease and gene therapy has been trying for different diseases. The new trials for treatment of the disease will give us promising insight on the disease and most clinicians should have more interest in medical progress of the metabolic disease.

Experience of Hemophilic Pseudotumor Developed at the Fracture Site of the Proximal Phalanx of the Hand (수부 근위지골 골절 수술 후 발생한 혈우병성 가성종양의 치험례)

  • Park, Ji Ung;Kim, Chang Yeon;Shin, Jong In;Cho, Sang Hun
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.516-519
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    • 2007
  • Purpose: Hemophilia is one of the most common bleeding disorder, and circulating levels of factor VIII or IX are closely related to the severity and frequency of the bleeding. The severity of hemophilia is classified to be severe, moderate, and mild when the factor level is less than 1%, between 1% and 5%, and between 5% and 25%, respectively. Hemophilic pseudotumor is a rare complication occurring in 1 - 2% of patients with factor VIII or IX deficiency. If the treatment is delayed, it would cause disabling and life threatening results. Methods: We experienced hemophilic pseudotumor developed at the fracture site of the proximal phalanx of the hand in a hemophilic B patient. Hemophilic pseudotumor was successfully treated with perioperative factor replacement and surgical intervention included excision and autologous bone graft. Results: Hemophilic pseudotumor was healed with complete regression, and no specific complication was developed. Conclusion: When we accounter hematoma like lesion after surgery unpredictably, we must consider hemophilic pseudotumor and make a accurate diagnosis with preoperative hematologic screening and various imaging study. Subsequently, adequate perioperative supplement of concentrate and surgical intervention brings to the satisfactory result without recurrence.