• Title/Summary/Keyword: Cortical Invasion

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A ramus cortical bone harvesting technique without bone marrow invasion

  • Jeong-Kui Ku;Min-Soo Ghim;Jung Ho Park;Dae Ho Leem
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.2
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    • pp.100-104
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    • 2023
  • Autogenous bone grafts from the mandibular ramus are a known source of inadequate bone volume scenarios of the residual alveolar ridge. However, the conventional block-type harvesting technique cannot prevent bone marrow invasion, which can cause postoperative complications such as pain, swelling, and inferior alveolar nerve injury. This study aims to suggest a complication-free harvesting technique and present the results of bone grafting and donor sites. One patient received two dental implants with a complication-free harvesting technique that involves creation of ditching holes with a 1 mm round bur. Sagittal, coronal, and axial osteotomies produced grid-type cortical squares using a micro-saw and a round bur to confirm the cortical thickness. The grid-type cortical bone was harvested from the occlusal aspect, and the harvesting was extended through an additional osteotomy on the exposed and remaining cortical bone to prevent bone marrow invasion. The patient did not suffer postoperative severe pain, swelling, or numbness. After 15 months, the harvested site exhibited new cortical bone lining, and the grafted area had healed to a cortico-cancellous complex with functional loading of the implants. Our technique, grid-type cortical bone harvesting without bone marrow invasion, allowed application of autogenous bone without bone marrow invasion to achieve acceptable bone healing of the dental implants and to regenerate the harvested cortical bone.

CT evaluation of underlying bone sclerosis in patients with oral squamous cell carcinoma: A preliminary retrospective study

  • Jo, Gyu-Dong;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Choi, Soon-Chul;Huh, Kyung-Hoe
    • Imaging Science in Dentistry
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    • v.47 no.4
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    • pp.255-259
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    • 2017
  • Purpose: Underlying bone sclerosis is frequently observed in clinical settings when oral squamous cell carcinoma (OSCC) invades the jaw bone. The aim of this study was to assess the prevalence and characteristics of underlying bone sclerosis in patients with OSCC. Materials and Methods: We retrospectively reviewed the computed tomographic (CT) images of 131 patients who underwent mandibulectomy between January 2012 and December 2015 to treat OSCC. The presence, degree, and extent of underlying bone sclerosis were assessed on CT images and correlated with the following imaging patterns of bone invasion: cortical invasion, medullary invasion with a smooth margin, and medullary invasion with an irregular margin. The chi-square test was used to determine the relationships between the variables. Results: The prevalence of underlying bone sclerosis on CT images was 70.1% (47 of 67). The prevalence was 85.7% (42 of 49) in patients with medullary invasion, but it was 27.8% (5 of 18) in patients with only cortical invasion, indicating a significant increase in the prevalence of underlying bone sclerosis in patients with medullary invasion (P<.05). Aggressive patterns of bone invasion were associated with increases in the degree and extent of the underlying bone sclerosis(P<.05). Conclusion: More than two-thirds of OSCC cases with bone invasion showed underlying bone sclerosis. On CT images, reactive sclerosis in the remaining margin of the alveolar bone should not be used as the primary means to differentiate periodontal inflammatory lesions from those resulting from OSCC.

A Virilizing Adrenal Cortical Tumor in a Child (소아에서 남성화를 보인 부신 피질 종양 1예)

  • Kim, Sung-Yong;Kim, Tae-Yoon;Baek, Moo-Jun;Lee, Moon-Soo;Kim, Hyung-Chul;Min, Yong-Sik;Kim, Dae-Joong;Kim, Chang-Ho
    • Advances in pediatric surgery
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    • v.5 no.2
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    • pp.152-158
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    • 1999
  • Adrenal cortical tumors are rare in adults and children. Most are malignant and functional. The principal clinical features are virilization, Cushing's syndrome, hyperaldosteronism and feminization. Recently, we treated a case of virilizing adrenal cortical tumor in a 26 month-old boy. The diagnosis was made by hormone assay, abdominal CT and tissue pathology. Right adrenalectomy was successful performed. Pathologic examination revealed an adrenal cortical adenoma with vascular invasion.

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Histological and Cytological Changes Associated with Susceptible and Resistant Responses of Chili Pepper Root and Stem to Phytophthora capsici Infection

  • Kim, Sang-Gyu;Kim, Young-Ho
    • The Plant Pathology Journal
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    • v.25 no.2
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    • pp.113-120
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    • 2009
  • Microscopic study of chili pepper (Capsicum annuum L.) infected with Phytophthora capsici, causing Phytophthora blight of chili pepper, was conducted to compare histological and cytological characteristics in the root and stem of susceptible (C. annuum cv. Bugang) and resistant (C. annuum cv. CM334) pepper cultivars. The susceptible pepper roots and stems were extensively penetrated and invaded by the pathogen initially into epidermal cells and later cortical and vascular cells. Host cell walls adjacent to and invaded by the infecting hyphae were partially dissolved and structurally loosened with fine fibrillar materials probably by cell wall-degrading enzymes of the pathogen. In the resistant pepper, the pathogen remained on root epidermal surface at one day after inoculation, embedded and captured in root exudation materials composed of proteins and polysaccharides. Also the pathogen appeared to be blocked in its progression at the early infection stages by thickened middle lamellae. At 3 days after inoculation, the oomycete hyphae were still confined to epidermal cells of the root and at most outer peripheral cortical cells of the stem, resulting from their invasion blocked by wound periderms formed underneath the infection sites and/or cell wall appositions bounding the hyphal protrusions. All of these aspects suggest that limitation of disease development in the resistant pepper may be due to the inhibition of the pathogen penetration, infection, invasion, and colonization by the defense structures such as root exudation materials, thickened middle lamellae, wound peridems and cell wall appositions.

Reconstruction of Mandibular Bone Defect Using a Titanium Mesh with Autogenous Particulate Cortical Bone Graft by an Intraoral Approach: A Case Report (구강내 접근으로 자가 분쇄 피질골과 Titanium Mesh를 이용한 광범위한 하악골 골결손부 재건: 증례보고)

  • Choi, Seok-Tai;Leem, Dae-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.466-472
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    • 2012
  • The loss of mandibular continuity due to trauma, neoplasm, or infection results in major esthetic and biologic compromise. The reconstruction of the mandibular bone defect still poses a challenge to oral and maxillofacial surgeons. There have been a number of variety graft materials. Among them, free block bone graft with rigid fixation has been widely used. However, cases using free block bone grafts may lead to a marked invasion of the donor site, mal-union, and absorption of the block bone. In this respect, particulate cortical bone using a titanium mesh tray can be an effective alternative option in order to achieve a proper bone contour and good oral rehabilitation. We have developed an intraoral approach for the mandibular reconstruction method using a titanium mesh tray with autogenous particulate cortical bone graft.

Aggressive Squamous Cell Carcinoma of the Scalp with Invasion into the Skull and Dura Mater (두개골과 뇌경질막까지 침윤된 매우 공격적인 임상양상을 보이는 두피의 편평세포암)

  • Park, Sun Hee;Rhie, Jong Won;Seo, Je Won;Oh, Deuk Young;Lee, Jung Ho;Ahn, Sang Tae
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.138-141
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    • 2009
  • Purpose: Squamous cell carcinoma of the scalp sometimes exhibits unusually aggressive behavior. We report a case of extradordinarily aggressive squamous cell carcinoma of the scalp with invasion into the skull and dura mater. Method: The patient is a 38-year-old man with two cystic masses on the occipital area. He was diagnosed as squamous cell carcinoma in that region and have undergone surgical resections including cortical osteotomy of the skull, several years ago. On this occasion, 3-dimensional computed tomographic imaging revealed an erosive lesion on the occipital bone and magnetic resonance imaging showed two cystic masses invasion into the skull and dura mater. Results: He has undergone wide resection of the masses and cranioplasty with dural repair. Histopathologic examination indicated squamous cell carcinoma with moderate differentiation of the masses, bone marrow and dura mater. Conclusion: Squamous cell carcinoma on the scalp can readily penetrate the full thickness of the cranium and invade the dura mater, sagittal sinus and brain. We suggest wide resection of the scalp and split thickness skin graft with sentinel lymph node biopsy, following by postoperative radiation therapy.

AN EXPERIMENTAL STUDY ON THE EFFECTS OF OXIDIZED CELLULOSE COVERAGE ON THE CORTICAL BONY DEFECTS (피질골 골결손부에서 Oxidized Cellulose 피개의 영향에 관한 실험적 연구)

  • Kim, Hoi-Jong;Rim, Jae-Suk
    • 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.

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Histopathological changes in fingerlings of Japanese flounder, Paralichthys olivaceus, with severe scuticociliatosis (스쿠지카섬모충에 중감염된 넙치 (Paralichthys olivaceus) 치어에 대한 병리조직학적 관찰)

  • Lee, Nam-Sil;Park, Jeong-Hee;Han, Kyu-Sik;Huh, Min-Do
    • Journal of fish pathology
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    • v.7 no.2
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    • pp.151-160
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    • 1994
  • In order to elucidate the patterns of tissue damage evoked by the scuticociliatids, eighteen fingerlings of Japanese flounder, Paralichthys olivaceus, heavily infected with an unidentified scuticociliatid were histopathologically examined. Skin layer with the underlying musculature were severely necrotized due to the infestation of the ciliates. However in the early lesions, both dermis and myofibres remained relatively intact compared with other surrounding loose connective tissues. Mild damages were found in more dense tissues. One or more scuticociliatids were recognized in the blood and lymph vessels of the loose connective tissues with or without destructive changes. Many of nerve trunks or ganglia were also parasitized with less marked histological damage in the parenchyma. Dura and its adjacent tissues in the spinal cord were severely necrotized with massive accumulation of the ciliates in subdural space. The parasitic invasion in the central nervous system was usually confined to the cortical region. In the gill, variable degenerative changes were occurred due to the invasion of the ciliates recognized in the blood vessels of branchial arches or primary filaments. From these results, it was strongly suggested that the scuticociliatids are very actively penetrated into the deep tissues mainly through the severe destruction of the loose connective tissue components and that the vascular system could play a role in the rapid distribution of the ciliates to the remote tissues or organs.

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Reconstruction of Distal Radius Using Ultrahigh Molecular Weight Polyethylene Liner after Excision of Giant Cell Tumor - A Case Report - (원위 요골에 발생한 거대 세포종의 일괄 절제 후 초고분자량 폴리에틸렌 삽입물을 이용한 재건술 - 증례보고 -)

  • Jeon, Dae-Geun;Song, Won-Seok;Oh, Jung-Moon
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.29-33
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    • 2004
  • A giant cell tumor (GCT) of the distal radius is not common. Curettage with bone cementation is considered as a treatment of choice but, in the case of recurrence, marked cortical disruption, or articular invasion, en bloc excision and reconstruction with proximal fibular bone graft is usual procedure. In reconstruction of en bloc resected distal radius which had recurred GCT after conservative operation, we used the ultrahigh molecular weight polyethylene (UHMWPE) liner with intramedullary rod and bone cement, because the contamination was extent in previous operation and recurrence after fibular bone graft was fearful. This article introduce our new surgical procedure.

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Invasive Thymoma Originating from Right Pleura with Normal Thymus A case Report (흉막에서 발생한 침습성 흉선종,정상 흉선을 가진 예)

  • 박희철;옥창석
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1381-1384
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    • 1996
  • Thymoma Is an anterior mediastinal tumor, arising from the thymus, but occasionally has ectopic focus such as neck, trachea, thyroid, pulmonary hilum, lung parenchyme and pleura. Forty-two year old male patient was admitted due to progressive development of shortness of breath in 4 months. He had a history of exposure to asbestos for About 10 years duration In recent 15 years. Radiologically, multiple pleural masses were seen rom apex to diaphrAgm, with no evidence of anterior mediastinal mass,with fluid in right pleural cavity. Closed thoracotomy drainage with open biopsy were performed. Effusion cell block showed many T cell marker positive Lymphocytes & some epithelial cells compatible with thymoma, and the tissue also showed cortical type thymoma. Pleuropneumonectomy and thymectomy followed by 60 Gy radiation therapy were done and the patient is well 8 months postoperatively. The pleura is markedly thickened by the invasion of thymoma and the interstitial space of the lung tissue,but the normal appearance of thymus was present in remote area (Masaoka classification IVa). We report a case of ectopic invasive thymoma arising from the right pleura with intact thymus.

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