• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.73-78
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• 2011

Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.29-35
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• 2014

Introduction: Persistent vesicoureteral reflux (VUR), a major cause of urinary tract infection (UTI) in children, can result in serious renal complications, such as reflux nephropathy and chronic renal failure. We evaluated the clinical characteristics and prognostic factors of VUR. Methods: From December 1993 to May 2011, we examined 117 children with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Chungbuk National University hospital for a UTI. The patients were managed medically or surgically. Results: Male patients had a slightly higher prevalence of VUR than female patients (55%). The degrees of the 161 refluxing ureters, as classified by the International Reflux Study Committee, were as follows: grade I, 15 ureters; grade II, 32 ureters; grade III, 54 ureters; grade IV, 26 ureters; grade V, 34 ureters. One hundred and sixty-one renal units (115 cases) underwent a 99m TC-DMSA renal scan, and 62% showed abnormal findings. The incidence of renal cortical defects showed a direct correlation with the severity of VUR. Ninety-four refluxing ureters were followed up medically, and 66 ureters (67%) either disappeared or improved. However, 9 refluxing ureters persisted. The spontaneous resolution rate of VUR seemed to be higher in younger patients with lower grades of reflux, and without renal cortical defects. Sixty-seven refluxing ureters (41%) were treated surgically, 62 refluxing ureters (92%) disappeared, and 5 refluxing ureters (8%) persisted. Conclusion: The incidence of renal cortical defects in patients with UTIs was 62% (in a 99m TC-DMSA renal scan), and showed a direct correlation with the severity of VUR. The spontaneous resolution rate seemed to be lower in the patients with higher grades of VUR, older age (over 4 years old) and diffuse renal cortical defects.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.815-821
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• 2000

Parasplenial arteriovenous malformations(AVMs) are rare vascular malformations which have distinct clinical and anatomical features. They are situated at the confluence of the hippocampus, isthmus of the cingulate gyrus and the gyrus occipitotemporalis medialis. These lesions are anterior to the calcarine sulcus and their apex extends towards the medial surface of the trigonum. Posterolaterally, these lesions are in close proximity to the visual cortex and optic radiation. The objectives in the surgery of parasplenial AVMs are complete resection of the lesions and preservation of vision. These objectives must be achieved with comprehensive understanding of the following anatomical features :1) the deep central location of the lesions within eloquent brain tissue ; 2) the lack of cortical representation of the AVMs that requires retraction of visual cortex ; 3) deep arterial supply ; 4) deep venous drainage ; 5) juxtaposition to the choroid plexus with which arterial supply and venous drainage are shared. A 16-year-old female student presented with intraventricular hemorrhage from a right parasplenial-subtrigonal AVM. The lesion, fed by posterior cerebral artery and drained into the vein of Galen, was successfully treated by the inter-hemispheric parietooccipital approach. To avoid visual field defect a small incision was made on precuneus anterior to the calcarine sulcus. In this report, the authors describe a surgical approach with special consideration on preservation of visual field.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.1
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• pp.115-125
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• 1995

Forty-four cases of developmental salivary gland defects in 43 patients were analysed radiologically. The obtained results were as follows ; 1. It occurred more frequently in males(86 ％) than in females(14 ％). The age distribution of patients ranged from 20 to 74 years with the average being 52.7 years. 2. All but one were located between the angle of the mandible and the molar tooth. Only one patient showed bilateral occurrence. 3. The shape of the defect was ovoid(15 cases), round(10 cases), or half-ovoid(5 cases) 4. Their size ranged from 5 x 6 mm to 16 x 30 mm with the average around 9 x 14 mm. 5. Twenty-eight cases appeared to be surrounded partially(1/3 - 2/3) by a hyperostotic border. The thickness of the hyperostotic border varied ; thick(14 cases), moderate(l1 cases), thin(9 cases), or mixed(6 cases) 6. Thirteen cases were in contact with the superior border of the mandibular inferior cortex, 11 cases partially eroded the cortical plate, and 7 cases showed discontinuity of the mandibular inferior cortex. 7. Twenty-three cases were located below the mandibular canal, 13 cases overlapped the mandibular canal, and 2 cases showed slight deviation of the mandibular canal.

• Investigative Magnetic Resonance Imaging
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• v.11 no.1
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• pp.49-53
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• 2007

Fibrous dysplasia is a skeletal developmental anomaly of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a nonhereditary disorder of unknown cause. In fibrous dysplasia, the medullary bone is replaced by fibrous tissue, which appears various imaging findings. It is usually an incidental finding, generally not requiring further investigation. However, fibrous dysplasia may be complicated by pathologic fracture, and rarely by malignant degeneration. We present the image findings of a 44-year-old man who had a chondroblastic osteosarcoma arising from polyostotic fibrous dysplasia in the femur. Evidence of cortical destruction on plain radiography and soft tissue mass in the lesion on MR images suggested a tumor of malignant transformation.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.4
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• pp.403-411
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• 1997

To elucidate the mechanism of gentamicin induced renal dysfunction, renal functions and activities of various proximal tubular transport systems were studied in gentamicin-treated rats (Fisher 344). Gentamicin nephrotoxicity was induced by injecting gentamicin sulfate subcutaneously at a dose of 100 $mg/kg{\cdot}day$ for 7 days. The gentamicin injection resulted in a marked polyuria, hyposthenuria, proteinuria, glycosuria, aminoaciduria, phosphaturia, natriuresis, and kaliuresis, characteristics of aminoglycoside nephropathy. Such renal functional changes occurred in the face of reduced GFR, thus tubular transport functions appeared to be impaired. The polyuria and hyposthenuria were partly associated with a mild osmotic diuresis, but mostly attributed to a reduction in free water reabsorption. In renal cortical brush-border membrane vesicles isolated from gentamicin-treated rats, the $Na^+$ gradient dependent transport of glucose, alanine, phosphate and succinate was significantly attenuated with no changes in $Na^+-independent$ transport and the membrane permeability to $Na^+$. These results indicate that gentamicin treatment induces a defect in free water reabsorption in the distal nephron and impairs various $Na^+-cotransport$ systems in the proximal tubular brush-border membranes, leading to polyuria, hyposthenuria, and increased urinary excretion of $Na^+$ and other solutes.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.139-142
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• 1998

BCG osteomyelitis is rare comlication and the incidence rate has been estimated to be 1/milion vaccinated neonate and infants. BCG osteomyelitis is also reported as a complication of intravesical BCG treatment for bladder carcinoma. We had experienced a 14 months old infant who presented swelling, tenderness and redness on left upper arm suspicious due to BCG vaccination. The MRI finding showed $2{\times}4{\times}4cm$ subcutaneous abscess with cortical defect on proximal humerus and axillary lymph adenopathy. The histologic finding showed diffuse caseous necrosis and Langhans type giant cell. We report A case of BCG osteomyelitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.112-126
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• 1998

In dentistry, bony defects can be formed by cyst, tumor, inflammation, trauma and surgery in maxilla and mandible. If the overlying soft tissue invades and preoccupies the jaw bony defects, regenerated bony tissue same as adjacent bone can not replace whole space of the defects, thus preventing osteogenesis from occurring. Guided bone regeneration(GBR) is based on the prevention of overlying soft tissue from entering the bony defect during the initial healing periods. E-polytetrafluoroethylene(e-PTFE) is one of an effective and widely used barrier membrane for GBR, but it has the disadvantages such as surgical removal and high price. To overcome such disadvantages of e-PTFE, many investigators have proposed various absorbable barrier membranes. Inexpensive oxidized cellulose($Surgicel^{(R)}$) membrane was shown to have potential for use as an absorbable barrier membrane for regenerative procedure and it would not require surgical removal. The purpose of this study is to investigate the absorption periods of oxidized cellulose at the implant site and usefulness as a mechanical barrier, preventing the ingrowth of the overlying soft tissue into the bony defects. Two bony defects were made in each tibia of a dog using drill and one defect covered with oxidized cellulose and the other covered with periosteum directly as control. The experimental animals were sacrificed at 1st-7th, 10th, 14th, 21th, 28th day postoperatively, Inspection of the specimens was done to evaluate gross changes. Specimens were examined histopathologically by hematoxylin-eosin and Masson's trichrome staining under light microscope. The results were as follows : 1. There was no significant differences of inflammatory reaction between the experimental and the control group. 2. The resorption of oxidized cellulose was almost completed within 14th day. 3. Histologically, bone formation in the experimental group was somewhat more than that of the control group at 10th, 14th, 21th and 28th day postoperatively. The bone forming pattern of the experimental group was more regular than that of the control group. 4. There was no evidence of soft tissue invasion into the bony defect in the experimental group. In conclusion, oxidized cellulose membrane might be used as an alternative absorbable barrier membrane to prevent overlying soft tissue invasion into the bony defects.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.691-694
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• 2010

Purpose: Central giant cell granuloma is a rare, benign giant cell tumor which commonly develops in areas near the teeth. It accounts for approximately less than 7% of benign tumors of the mandible. Clinically, central giant cell granuloma is classifed into aggressive and non-aggressive type, and usually requires surgical treatment. There has been no report of central giant cell granuloma in plastic surgery field of the country, and we report a case with a brief review of the diagnosis and treatment of the disease. Methods: A 23-year-old male presented with a hard, non-tender, growing mass with the size of $4.0{\times}3.0\;cm$ on mandible for several months. Computed tomography scan showed a solid mass within thinned outer cortex on mandible. The thinned outer cortex was excised with the mass and the inner cortex was partially removed burring. After the tumor removal, mandible was fixed by reconstruction plate. Results: Pathologic report showed numerous large multinucleated giant cells, diffusely distributed in a background of ovoid-to-spindle-shaped mononuclear cells. There was no evidence of recurrence after 1 year follow up. Bony defect was regenerated and we removed the reconstruction plate. Conclusion: Removal of central giant cell granuloma results in defect of outer cortex, which can be reconstructed by using reconstruction plate, autologous bone graft or bone cement. We used reconstruction plate as a conservative method to induce secondary healing of the outer cortical defect area, which resulted in normal mastication and occlusion with no recurrence.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.225-243
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• 1991

In recent years immediate implantation has been tried by a few clinicians. This study placed IMZ implants in the rabbit femur with and without bony defects around the implant for simulating fresh extraction site. And one group with bony defects used porous hydroxyapatite ganules(HA) to fill if and the other group left the bony defects around the implant. The purpose of this study was to compare the shear bond strength and the bony contact and formation around the implant. Fifteen rabbits were divided into three groups and placed 10 IMZ implants to each group. Implant sites were surgically prepared with IMZ drills kit and implants were placed(Control), artificial bony defect was created with Apaceram drills kit around the implant sites and implants were placed(Experimental I), bony defect was filled with porous hydroxyapatite granules(Experimental II). Thereafter, rabbits were sacrificed at 8th week and specimens were prepared and pushout tested for shear bond strength of bone-implant interface immediately. Undecalcified and decalcified specimens were prepared with Vilanueva and hematoxylin-eosin stain for light microscopic finding. The results of this study were as follows. 1. In the control group, mean shear strength of bone-implant interface was $2.614{\pm}0.680$ MPa, experimental I was $0.664{\pm}0.322$ MPa, and experimental II was $2.281{\pm}0.606$ MPa. There was significant difference between control and experimental I, between experimental I and experimental II, but did not show significant difference between control and experimental II statistically. 2. In the bony formation surrounding IMZ implant of the three groups, that of cortical bone is more advanced than cancellous bone area. 3. In the histological findings of undecalcified specimens, control and experimental II showed more than 50% of bony or osteoid formation at the bony-implant interface. 4. In the histological findings of undecalcified specimens, experimental I showed less than 50% of bony or osteoid formation at the interface, and observed partial bony defect in the coronal zone. 5. In the experimental II group, were observed direct bony contact to hydroxyapatite granules, and infiltration of a few giant cells. 6. No inflammatory responses were seen around the titanium implants and the hydroxyapatite granules.