• Title/Summary/Keyword: Extended defect

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THE EFFECT OF BIOPLANT $HTR^{(R)}$(HARD TISSUE REPLACEMENT) ON OSTEOGENESIS OF THE MANDIBULAR BONE DEFECTS IN RABBITS (하악골 결손부의 골형성에 미치는 Bioplant $HTR^{(R)}$의 영향)

  • Choi, Do-Hyun;Ryu, Sun-Youl;Kim, Ok-Joon;Huh, Won-Shil
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.1
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    • pp.87-94
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    • 2001
  • The present study was performed to investigate the effect of $HTR^{(R)}$ (Hard Tissue Replacement) on osteogenesis in the mandibular bone defects. Eight adult male white rabbits weighing 2.5 to 3.0kg were used. Four bone defects (8mm in diameter and 4mm in depth) were made at the both mandibular body. In the control group, the right mesial bone defect was filled with blood clot and spontaneously healed. In the DFDB group, the right distal bone defect was filled with xenogenic demineralized freeze-dried bone. In the $HTR^{(R)}$ group, the left mesial bone defect was filled with $HTR^{(R)}$. In the $HTR^{(R)}-membrane$ group, the left distal bone defect was filled with $HTR^{(R)}$ and covered with BioMesh membrane. The rabbits were sacrified at 2,4,6 and 9 weeks after the operation and microscopic examination was performed. Results obtained were as follows: In the control and DFDB groups, inflammatory cells and the fibrous connective tissue existed and the bone growth was slower than $HTR^{(R)}$ group by 6 week, and there was intervention of the soft tissue at 9 week. In the $HTR^{(R)}$ group, bone trabeculi extended between the $HTR^{(R)}$ particles without intervention of inflammatory cells and the connective tissue at 4 and 6 weeks. In addition, extensive osseous ingrowth into the $HTR^{(R)}$ particles was observed at 9 week. Bone formation was more active in the $HTR^{(R)}$ group than the control and DFDB groups. There was not obvious difference in the bone healing rate between the $HTR^{(R)}$ and the $HTR^{(R)}-membrane$ group. These results suggest that the $HTR^{(R)}$ promotes osteogenesis in the bone defects and the $HTR^{(R)}$ group has no difference in comparison with the $HTR^{(R)}-BioMesh^{(R)}$ membrane group in bone healing.

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Clinical and Biochemical Diagnosis in Children with Leigh Syndrome (Leigh 증후군 환자의 임상적 생화학적 진단)

  • Lee, Sun Ho;Jeon, Mina;Lee, Hyun Joo;Park, Dae Young;Kim, Se Hoon;Lee, Young-Mock
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.72-77
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    • 2015
  • Purpose: Deficits of the respiratory chain are reported to be the major cause of Leigh syndrome is said to be the underlying causes. The need for biochemical diagnosis to draw more accurate diagnosis or prognosis to support treatments is rapidly increasing. This study tried to analyze the aspects of clinical characteristics and biochemical diagnosis of mitochondrial respiratory chain complex (MRC) defect in Leigh syndrome, using methods of biochemical enzyme assay. Methods: We included total number of 47 patients who satisfied the clinical criteria of Leigh syndrome and confirmed by biochemical diagnosis. All those patients went through muscle biopsy to perform biochemical enzyme assay to analyze MRC enzyme in order to find the underlying cause of Leigh syndrome. Results: MRC I defect was seen in 23 (48.9%) cases taking the first place and MRC IV defect in 15 (31.9%) following it. There were 9 (19.2%) cases of combined MRC defect. Combined cases of type I and IV were detected in 7 (14.9%) patients while type I and V in 2 (4.3%). The onset age of symptom was less than 1 year old in 28 (59.6%). The most common early symptom, observed in 23 (48.9%), was delayed development, but there were other various neurological symptoms observed as well. In regard with the disease progression, 35 (74.5%) patients showed slowly progressive course, the one that progressed continuously but slowly over 2 years of period. As for Maximum motor development, 22 (46.8%) were bed-ridden state, most of them suffering serious delayed development. Patients showed various symptoms with different organs involved, though neuromuscular involvement was most prominent. Delayed development was seen in all cases. Multifocal lesion in brain MRI study was seen in 36 (76.6 %) cases, taking a greater percentage than 11 (23.4%) cases with single lesion. In MR spectroscopy study, the characteristic lactate peak of mitochondrial disease was identified in 20 (42.6%) patients. Conclusions: Further analysis of clinical and biochemical diagnosis on more extended group of patients with Leigh syndrome will enable us to improve diagnostic precision and to understand the natural course of mitochondrial disease.

Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report (재생술식을 이용한 치근단 병소를 동반한 백악질 열리의 치료)

  • Kang, Hyo-Jin;Jung, Gyu-Un;Pang, Eun-Kyoung
    • The Journal of the Korean dental association
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    • v.54 no.5
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    • pp.365-373
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    • 2016
  • Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

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Ectopic Expression of Cenexin1 S796A Mutant in $ODF2^{+/-}$ Knockout Background Causes a Sperm Tail Development Defect

  • Lee, Kyung Ho
    • Development and Reproduction
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    • v.16 no.4
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    • pp.363-370
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    • 2012
  • The outer dense fiber 2 (ODF2) protein is an important component of sperm tail outer dense fiber and localizes at the centrosome. It has been reported that the RO072 ES cell derived homozygote knock out of ODF2 results in an embryonic lethal phenotype, and XL169 ES cell derived heterozygote knock out causes severe defects in sperm tail development. The ODF2s splicing variant, Cenexin1, possesses a C-terminal extension, and the phosphorylation of serine 796 residue in an extended C-terminal is responsible for Plk1 binding. Cenexin1 assembles ninein and causes ciliogenesis in early stages of the cell cycle in a Plk1-independent manner. Alternatively, in the late stages of the cell cycle, G2/M phase, Cenexin1 binds to Plk1 and results in proper mitotic progression. In this study, to identify the in vivo function of Plk1 binding to phosphorylated Cenexin1 S796 residue, and to understand the in vivo functional differences between ODF2 and Cenexin1, we generated ODF2/Cenexin1 S796A/Cenexin1 WT expressing transgenic mice in a RO072 ES cell derived $ODF2^{+/-}$ knock out background. We observed a severe defect of sperm tail development by ectopic expression of Cenexin1 S796A mutant and no phenotypic differences between the ectopic expression of ODF2/Cenexin1 WT in $ODF2^{+/-}$ background and in normal wild type mice.

Nondestructive Defect Detection in Two-dimensional Anisotropic Composite Elastic Bodies Using the Boundary Element Method (경계 요소법을 이용한 2차원 비등방성 복합재료 탄성체의 비파괴 결함 추정)

  • 이상열
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.17 no.1
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    • pp.39-47
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    • 2004
  • In this paper, the defects of two-dimensional anisotropic elastic bodies are identified by using the boundary element method. The use of numerical models that contain only boundary integral terns reduces the dimensionality of the problem by one. This advantage is particularly important in problems such as crack mechanics. Avoiding domain meshing is also particularly advantageous in the solution of inverse problems since it overcomes mesh perturbations and simplifies the procedure. In this paper, nondestructive approaches for the existing isotropic materials are extended to analyze the elastic bodies made of anisotropic materials such as composites. After verifying that the proposing boundary element model is in good agreement with numerical results reported by other investigators, the effect of noise in the measurements on the identifiability is studied with respect to different design parameters of layered composites. Sample studies are carried out for various layup configurations and loading conditions. The effects of the layup sequences in detecting flaw of composites is explored in this paper.

Reconstruction of the Extended Region of the Upper Auricle Using the Superior Auricular Artery Island Flap (상이개동맥 도상피판을 이용한 이개상부 및 그 주변부의 재건)

  • Kyung, Hyun Woo;Oh, Sang-Ha;Seo, Young Joon;Kim, Dong-Woon
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.289-293
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    • 2009
  • Purpose: The retroauricular flap has many advantages for facial reconstruction and is being performed by many surgeons. However, it is difficult for the retroauricular flap to perform reconstruction of the upper region of the auricle and its surroundings, due to limited rotation arc and length of pedicle. We successfully reconstructed the upper region of the auricle and its surroundings with retroauricular flap by using the superior auricular artery as a supplying pedicle. The purpose of this study is to present an anatomic study about the superior auricular artery and its clinical application. Methods: We investigated the relationship between the superior auricular artery and its surrounding structures through anatomic studies with 7 fresh cadavers and then applied the findings clinically. From February to December 2008, we performed 7 cases of the superior auricular artery island flap to reconstruct the defects in patients operated on skin cancer. Sizes of the defects varied form $0.8{\times}0.8cm$ to $3.5{\times}3.0cm$. Results: We found that the superior auricular artery is a reliable pedicle for the retroauricular flap, based on anatomical studies. All wounds of the patients were successfully closed. The flap donor site was primary closed except in one patient with a large defect. The aesthetic outcomes of the donor and recipient sites were satisfying. Conclusions: The superior auricular artery island flap has several advantages. Therefore, we suggest that the superior auricular artery island flap is a treatment of choice for reconstructing soft tissue defect at the upper region of the auricle and its surrounding area.

Reconstruction of Necrosis Following Total Knee Replacement Arthroplasty (슬관절 전치환술 후 발생한 피부 괴사부의 재건)

  • Ahn, Hee Chang;Lim, Young Soo;Kim, Chang Yeon;Hwang, Weon Joong
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.93-99
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    • 2005
  • In spite of proper maneuver of total knee replacement arthroplasty, some patients suffer from skin necrosis just above the implant. From Mar. 2000 to Jan. 2004, the authors performed reconstruction of knee skin defects after total knee replacement athroplasty. Total 6 cases of flap surgery were performed and patients ranged between 43-years-old to 82-years-old. Rectus femoris perforator based reversed adipofascial flaps were used in 2 cases, medial gastrocnemius muscular island flaps were used in 2 cases and sural artery based on adipofascial rotation flap was used in 1 case. One patient with extended necrosis underwent reconstruction with dual flaps of sural artery based adipofascial rotation flap and medial gastrocnemius muscular island flap. There were no distinctive complication needing additional procedure in all cases during the long term follow up. Reconstruction of necrosis following total knee replacement arthroplasty had several characteristics different from simple knee defect. The patients might have the history of long term steroid usages, excessive skin tension due to implants, underlying disease such as diabetes, rheumatoid disease, and etc. In addition, the early ambulation is mandatory in these patients of total knee replacement arthroplasty. With regards to these special considerations, a single stage and reliable operation must be needed. The authors introduce various reconstruction methods and algorithm that may aid easy decision making.

Complete Repair of Tetralogy of Fallot in Neonate or Infancy (신생아및 영아기 활로씨 사징증의 완전 교정술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.32-41
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    • 1992
  • From August 1982 to December 1991, 58 consecutive infants with tetralogy of Fallot underwent primary repair. Age ranged from 22 days to twelve months [n=58, 8.7$\pm$2.7 months] and body weight from 3.1 to 13 kilograms [n=58, 7.8$\pm$1.7 kilograms]. Qne infant had absence of the pulmonary valve; one had Ebstein`s anomaly and one had supramitral ring. Thirty-two patients [56%] experienced anoxic spell. Preoperative pulmonary artery indices were measured in 38 cases, ranging 126-552mm2/M2BSA[n=38, 251$\pm$79mm2/M2BSA]. All infants required a right ventricular outflow tract patch; in 41, the patch extended across the pulmonary valve annulus, in 13 of them, monocusps were constructed. All had patch closure of ventricular septal defect. Two infants had REV operation for avoiding injury to the canal branch of the right coronary artery which cross the right ventricular out flow tract. Post repair PRV/LV were measured at operating room in 40 cases, which revealed mean value of 0.49$\pm$0.12 [range: 0.25-0.74]. The hospital mortality was 10.3% [6 patients], and causes of deaths were right heart failure due to sustained right ventricular hypertension[4] and right ventricular outflow tract obstruction, intractablesuraventricular tachyarrhythmia[1], hypoxia[1] due to residual right to left shunt across the atrial septal defect in patient associated with Ebstein`s anomaly. All infants were doing well at follow-up from 1 to 101 months[20.6 months /patient, 1, 072 patient-month] Serial postoperative echocardiograms revealed no residual ventricular septal defects and estimated RVOT gradients between 0 and 40 mmHg except 3 cases [50, 50, 60 mmHg]. There were no late deaths and late ventricular arrhythmias or congestive heart failure. Redo operations were done in 2 cases because of residual right ventricular outflow tract obstruction. This experience with infants with tetralogy of Fallot suggests that, if mortality is tolerable, eletive repair of tetralogy of Fallot could be reasonably undertaken during the first year of life, and even better results could be anticipated along with improvement of methods of myocardial protection and postoperative care.

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Dysphagia Caused by Giant Granuloma Arising from the Oropharyngeal Posterior Wall (연하곤란을 초래하는 구인두 후벽에서 발생한 거대육아종)

  • Jung, Eun Kyung;Shin, Bong-Jin;Kim, Jongmin;Lee, Joon Kyoo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.1
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    • pp.39-42
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    • 2021
  • Granuloma is an uncommon benign disease that develops in the process of wound healing. Pharyngeal or laryngeal granuloma can be associated with gastric reflux, mechanical injury or trauma including intubation, voice abuse, or foreign body. 50-year-old female was transferred to our institute with a huge mass occupying the upper aerodigestive tract causing dysphagia. The patient has been suffering from a brain hemorrhage for several months and was kept in bed due to the quadriplegia with stuporous mental status, and was tracheotomized. On examination, the whole oropharynx and hypopharynx was covered by a smooth-surfaced soft big diffuse granular mass, which extended down to the upper trachea through the larynx. The huge granuloma was successfully removed with surgery and was found to have a pedunculating stalk on the oropharyngeal posterior wall with a small mucosal defect, suggestive of the origin of the mass. The defect was closed primarily after the cauterization. The patient is now followed up regularly without any recurrence of the disease.

Clinical Study of 80 Cases of Mitral Valve Operations Via Extended Transseptal Approach (확장시킨 경중격 절개방식을 통한 승모판 수술의 80례 임상 분석)

  • 김학제;황재준;최영호;손영상;김욱진;김태식;김현구
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1037-1042
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    • 1998
  • Background: Among the various techniques for the adequate exposure of the mitral valve, the extended transseptal approach is the essential prerequisite for accurate repair or replacement of the mitral apparatus. But the efficacy and safty of the extended transseptal approach has not determined in Korea yet. Materials and methods: Retrospective data of 80 consecutive patients, operated from September 1992 to July 1997 were reviewed. Seventy- eight patients underwent mitral valve replacement and 2 patients underwent excision of left atrial myxoma. Thirty-eight of 78 patients had other concomitant procedures such as aortic valve replacement(n=22), tricuspid annulopasty(n=14), coronary artery bypass graft(n=1) and closure of ventricular septal defect(n=1). Mean follow up was 23.3±15.0 months and total follow up was 1792 patient-months. Results: The hospital mortality rate was 3.8%(3 patients). Two deaths were due to low cardiac output and one due to postoperative bleeding of coagulopathy. Among the 46 patients who had atrial fibrillation preoperatively, 45 had atrial fibrillation postoperatively and 1 converted to sinus rhythm. All 34 patients who were in normal sinus rhythm preoperatively remained in sinus rhythm after the operation. Mean aortic cross clamping time was 62 minutes for isolated mitral procedure and 90 minutes for concomitant procedures. There were no specific complications related to this approach. Conclusions: We suggest that the extended transseptal approach is an easy and good method for mitral valve surgery, especially in patients with small sized left atrium.

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