• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.4
• /
• pp.287-294
• /
• 2011

Introduction: Ameloblastoma is a benign but locally invasive tumor with a high recurrence rate. The aim of this study was to make an easier diagnosis and treatment planning of ameloblastoma. Materials and Methods: From January 1993 to October 2009, 139 cases from 123 patients, who had been diagnosed with ameloblastoma through radiologic and biopsy in the department of oral and maxillofacial surgery of Kyunpook National University, were selected as the subjects in this study. According to the medical charts, 9 factors (age, gender, location, chief complaints, duration, radiographic findings, size and recurrence) concerned in deciding the treatment method and the relevance between each factor and the treatment methods were examined.(Conservative treatments were marsu-pialization, enucleation, curettage and lateral decortication. Radical treatments included block excision, resection and hemisection) Results: In the patients under the age of 20, 77.14% had conservative treatments, whereas 22.86% underwent radical treatments. In the patients over the age of 20, 44.23% were treated conservatively treatments, and 55.77% underwent radical treatments. For unilocular types, 28.57% had conservative treatments, whereas 71.43% had radical treatments. For the multilocular types, 66.67% underwent conservative treatments, and 33.33% had radical treatments. For the primary cases, 58.68% were treated conservatively and 41.32% had radical treatments. For the recurrent cases, 16.67% and 83.33% underwent conservative and radical treatments, respectively. Conclusion: There was statistical significance in the factors affecting the treatment methods, such as age, radiographic findings and recurrence.

• Journal of Periodontal and Implant Science
• /
• v.30 no.4
• /
• pp.793-803
• /
• 2000

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically self-curing glass-ionomer cement and light-curing glass-ionomer cement as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on maxillary third(P3), forth(P4) and fifth(P5) premolar. 2 month later experimental group were self-curing glassionomer cement and light-curing glassionomer cement. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. Results were as follows. 1. In all experiment group, there were not epithelial down growth and glass ionomer cement were encapsulated connective tissue. 2. In 4 weeks experiment I group slighly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, experiment groups I, II were encapsulated fine connective tissue. 4. Therefore glass-ionomer cement filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances were possible clinical methods and this technique is useful method for Maxillary furcation involvement.

• Journal of Periodontal and Implant Science
• /
• v.30 no.4
• /
• pp.803-814
• /
• 2000

Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet Rich Plasma have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the possibility of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar. 2 month later experimental group were PRP plus bovine bone and bovine bone only. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus bovine bone group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 4 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.3
• /
• pp.252-264
• /
• 1991

The purpose of this study was to compare the response of adjacent tissue and new bone formation after implantation by different methods of subperiosteal using using Proplast I and II in rabbit mandible. Microstructure of Proplast I and II was observed by scanning electron microscope. And the implantation procedure was carried out by dividing into tow groups, A and B. a group consisted of subperiosteal graft on the cortex, and the other B group was made up onlay graft following artificial decortication in the madibular body of rabbit. The experimental animals were sacrificed on the 1st, 2nd, 4th and 8th week after grafting for macroscopic and histopathologic examination. The samples extracted at the 6th postgrafting week were also used for biometric test. The result ere as follows : 1. By scanning electron microscopic observation, pore size was $50{\sim}180{\mu}m$ in the Proplast I and $100{\sim}220{\mu}m$ in Proplast II. 2. Macroscopically, infection of the graft site, deformation and displacement of the implanted materials were not observed in all experimental groups. 3. In the tissue response, infiltration of inflammatory cells and multinucleated giant cells were observed from the 2nd to the 8th week in Proplast I. Inflammatory cells decreased in number from the 2nd week in Proplast II suggesting that Proplast II is better than Proplast I. 4. Bone formation was not observed until the 8th week in the group A, but new bone formation from the surrounding graft bed and the periostium was appeared from the 4th week in the group B. 5. The maximum mean values of shear stress mere serially $65.5gf/mm^2$ in Proplast II of group B, $32.9gf/mm^2$ in Proplast I of group B, $17.0gf/mm^2$ in Proplast II of group A, and $15.7gf/mm^2$ in Proplast I. of group A.

• Journal of Periodontal and Implant Science
• /
• v.35 no.2
• /
• pp.491-510
• /
• 2005

This study was performed to evaluate the effect of inorganic polyphosphate on bone formation in the calvaria of rabbit in the procedure of guided bone regeneration with bovine cancellous bone graft and titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. The rabbits were divided into four groups. Control group I used only TR-ePTFE membrane, control group II used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in saline, experimental group III and IV used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 1% or 2% inorganic polyphosphate respectively. After decortication in the calvaria, GBR procedure was performed on 12 rabbits with titanium reinforced ePTFE membrane filled with deproteinized bovine bone mineral soaked in saline or inorganic polyphosphate. The animals were sacrificed at 2 weeks, 4 weeks, and 8 weeks after the surgery. Decalcified and non-decalcified specimens were processed for histologic and immunohistochemistric analysis. 1. Titanium reinforced ePTFE(TR-ePTFE) membrane showed good spacemaking and cell occlusiveness capability, but it showed poor wound stabilization. 2. The deproteinized bovine bone mineral did not promote bone regeneration, but it acted as a space filler. 3. There was no complete resorption of the deproteinized bovine bone mineral within 8 weeks. 4. 1% inorganic polyphosphate did not promote bone formation, but 2% inorganic polyphosphate promoted bone formation. Within the above results, 2% inorganic polyphosphate could be used effectively for bone regeneration.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.822-834
• /
• 1985

Reexpansion of the lung is the most desirable method of filling the pleural space whether it`s contents may be, and closed thoracotomy connected to a water-seal drainage remains the basic therapeutic modality in the treatment of the problems of the pleural space. We usually used rubber mushroom tubes, size No. from 16 to 34 Fr., and performed closed thoracotomy after preliminary thoracentesis to determine the exact depending position. Author reviewed 576 cases of closed thoracotomy which were performed in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, since Jan., 1980 to June, 1984. The results were as follows: 1. The age distribution was 10 days to 76 years old and mean age of the patients was 36.6 year, and the most prevalent age group was twenties, and sex predisposition was male dominant, 86.9%. 2. The most common etiologic disease group was pneumothorax and the most common etiologic disease was traumatic hemothorax. 3. Sites of tubing were predominantly at posterior axillary line, 7th intercostal space and midclavicular line, 2nd intercostal space even though frequent presence of free pleural space. The two sides, right and left difference of occurrence rate was more frequent at right side, 51.2%. 4. Usually the durations of tubing was less than 10 days, 52.6%, and the number of tubes used to the same patient concomitantly was one, 73.9%, and the time of tubing to the same patient was 1st, 83.6%. 5. The common symptom and sign were dyspnea, 50.0%, chest pain, 30.7%, cough, 10.7%, fever, 6.5%. Especially, fever and cough was the most common symptom and sign in pyogenic empyema, 59.3%. 6. The common etiologic lesions of pneumothorax were blebs and bullae, 73.3%, and of pyogenic empyema was pneumonia, 69.0%. 7. The complication rate of closed thoracotomy was 26.0%. Among these complications, infection was 44.7%, and intercostal neuralgia was 25.3%. 8. 70.9% of all patients recovered with only closed thoracotomy and the rest of patient needed additional some necessary managements such as open thoracotomy [Blebectomy, Resection, Pleurodesis, Decortication, Bleeding control], open drainage, thoracoplasty and so on to have successful results.

• Journal of Chest Surgery
• /
• v.22 no.5
• /
• pp.839-844
• /
• 1989

There appears to be significant problems remained in the treatment of tuberculous empyema with BPF in spite of several surgical methods: decortication, thoracoplasty, and pleuropneumonectomy. We presented one case of tuberculous empyema with BPF. The patient was 42-year-old male and his chief complaint was hemoptysis. In past history, he was treated with left closed thoracostomy and antituberculous medication for two months, 16 years ago. Chest X-ray, tomogram and C. T, revealed a huge mass with central necrosis in the lower 2/3 of left thoracic cavity and shifting of the mediastinal structure to the right. Needle aspiration cytology was undifferentiated large cell carcinoma. Left thoracotomy was made under the impression of lung cancer and pleuropneumonectomy was done. Operative findings; thick walled empyema sac filled with hematoma and BPF, the mediastinum was fixated due to fibrosis and calcification of the pleura and the mediastinum. Postoperative biopsy was consistent with tuberculosis. In the postoperative course, there was massive hemorrhage and so reoperation was done. But there was no active bleeding focuses in the thoracic cavity at the time of reoperation. Massive transfusion, coagulant therapy and intermittent clamping and declamping of the chest tube were carried out. Especially, serum calcium level was chronically decreased and so large amount of calcium gluconate was infused for the calcium level to be normal. Total transfused blood; whole blood was 33 pints, packed cell was 63 pints and fresh frozen plasma was 70 pints. At the postoperative[reop] 45th day, intrathoracic hemorrhage was stopped and the chest tube was removed. In conclusion, this suggest that uncontrollable bleeding after pleuropneumonectomy of the tuberculous empyema with BPF could be treated without reoperation in case of the mediastinal fixation due to fibrosis and calcification of the pleura and the mediastinum.

• Journal of Chest Surgery
• /
• v.2 no.2
• /
• pp.147-154
• /
• 1969

This is a report on a total of 11 cases of esophageal perforation in the department of thoracic surgery, Chonnam University Hospital during the period of 8 years from 1962 to 1969. They occurred by the following agents, that is,lye solution[7 cases], fish bone[2 cases]. compress air [one case], strong acid [one case]. The perforated portions of esophagus were cervical esophagus in 2 cases, upper third of esophagus in 5 cases, middle third of esophagus in 3 cases and lower third of esophagus [abdominal esophagus] in one case. 4 cases out of cases of esophageal perforation after ingestion of Lye solution were due to Bougination to improve esophageal stenosis: 2 cases occurred 2 months after ingestion of Lye solution and the remaining 2 cases, 2 to 3 weeks after Lye solution ingestion. Therefore, It is realized that Bougination for esephageal stricture by Lye solution is particularly dangerous. The complication after esophageal perforation were mediastinitis,[10 cases], right pyothorax with mediastinitis [8 cases], peritonitis [4 cases], esophago-bronchial fistula[one case]. Owing to the various complications above mentioned, surgical approach to esophageal perforation is accordingly complicated and a combination of more than two of the following different procedures were properly used case by case, that is. gastrostomy or jejunostomy for feeding and esophageal rest,thoracotomy and chest drainage, lung decortication for pyothorax, primary closure of compress air perforation and esophago-bronchial fistula, mediastinostomy, retrosternal esophagoplasty using right colon to Lye stricture etc. 5 cases[45. 5%] of 11 cases were expired and the rest of 6 cases[54.5%]were survived with complete accomplishment of surgical procedures and satisfactory healing in 4 cases and interruption of follow up in 2 cases because of poor economical condition of the patients.

• Journal of Trauma and Injury
• /
• v.34 no.2
• /
• pp.130-135
• /
• 2021

Celiac artery compression is a rare condition in which the celiac artery is compressed by the median arcuate ligament. Case reports of compression after trauma are hard to find. Blunt traumatic pericardium rupture is also a rare condition. We report a single patient who experienced both rare conditions from a single blunt injury. An 18-year-old woman was brought to the trauma center after a fatal motorcycle accident, in which she was a passenger. The driver was found dead. Her vital signs were stable, but she complained of mild abdominal pain, chest wall pain, and severe back pain. There were no definite neurologic deficits. Her initial computed tomography (CT) scan revealed multiple rib fractures, moderate lung contusions with hemothorax, moderate liver injury, and severe lumbar spine fracture and dislocation. She was brought to the angiography room to check for active bleeding in the liver, which was not apparent. However, the guide wire was not able to pass through the celiac trunk. A review of the initial CT revealed kinking of the celiac trunk, which was assumed to be due to altered anatomy of the median arcuate ligament caused by spine fractures. Immediate fixation of the vertebrae was performed. During recovery, her hemothorax remained loculated. Suspecting empyema, thoracotomy was performed at 3 weeks after admission, revealing organized hematoma without pus formation, as well as rupture of the pericardium, which was immediately sutured, and decortication was carried out. Five weeks after admission, she had recovered without complications and was discharged home.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.50 no.2
• /
• pp.103-109
• /
• 2024

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.