• 제목/요약/키워드: Extended defect

검색결과 119건 처리시간 0.024초

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

  • 최도현;유선열;김옥준;허원실
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권1호
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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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Leigh 증후군 환자의 임상적 생화학적 진단 (Clinical and Biochemical Diagnosis in Children with Leigh Syndrome)

  • 이선호;전미나;이현주;박대영;김세훈;이영목
    • 대한유전성대사질환학회지
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    • 제15권2호
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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.

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

  • 강효진;정겨운;방은경
    • 대한치과의사협회지
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    • 제54권5호
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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
    • 한국발생생물학회지:발생과생식
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    • 제16권4호
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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.

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

  • 이상열
    • 한국전산구조공학회논문집
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    • 제17권1호
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    • pp.39-47
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    • 2004
  • 본 연구에서는 경계 요소법을 이용하여 2차원 비등방성 탄성체의 손상 규명을 수행한다. 경계에서의 적분항만을 포함하는 본 수치모델은 1차원으로 줄게된다. 이러한 장점은 특히 균열 역학과 같은 문제에 있어서 중요한 의미를 갖는다. 또한 일정 영역을 분할하는 기법을 피함으로서 수치해석 과정을 간편하고 효율적으로 수행할수 있기 때문에 역문제 해결에 있어서 장점을 갖는다. 본 연구에서는 기존의 등방성 재료에 대한 비파괴 추정기법을 복합신소재와 같은 비등방성 재료로 이루어진 탄성체의 해석에 대하여 확장한다. 먼저 경계요소법에 의한 수치모델의 타당성을 기존의 문헌과 비교 검증하며, 서로 다른 특성을 보이는 비등방성 형식의 변화에 따라 실제 측정시 발생하는 노이즈 영향을 분석한다. 수치예제는 적층 형태 및 하중조건에 대하여 수행하며, 결함 추정에 미치는 적층 형태의 영향을 시험한다.

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

  • 경현우;오상하;서영준;김동운
    • Archives of Plastic Surgery
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    • 제36권3호
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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.

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

  • 안희창;임영수;김창연;황연중
    • Archives of Plastic Surgery
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    • 제32권1호
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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.

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

  • 이정렬
    • Journal of Chest Surgery
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    • 제25권1호
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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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연하곤란을 초래하는 구인두 후벽에서 발생한 거대육아종 (Dysphagia Caused by Giant Granuloma Arising from the Oropharyngeal Posterior Wall)

  • 정은경;신봉진;김종민;이준규
    • 대한후두음성언어의학회지
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    • 제32권1호
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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.

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

  • 김학제;황재준;최영호;손영상;김욱진;김태식;김현구
    • Journal of Chest Surgery
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    • 제31권11호
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    • pp.1037-1042
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    • 1998
  • 연구배경 : 승모판의 노출을 위한 여러 접근방식 중, 확장시킨 경중격 절개방식은 다른 방법에 비하여 쉽고 빠르게 승모판막에 접근할 수 있으며 모든 판막구조물의 노출이 잘 되어 월등한 방법이라 할 수 있다. 그러나, 이러한 장점에도 불구하고 혹자는 광범위한 절개 및 동방결절 동맥의 손상으로 치명적인 부정맥이 발생하지 않을까 우려하여 이용을 기피하는 경향이 있고 반론을 재기하는 사람들도 많이 있다. 재료 및 방법 : 따라서 본 교실에서는 1992년 9월부터 1997년 7월까지, 모두 80명의 환자에서 확장시킨 경중격 절개방식을 적용한 후, 어떠한 장·단점이 있나 알아보고 수술후 심장율동에 미치는 영향을 알아보았다. 결과 : 78명의 환자가 승모판 치환수술을 받았고 2명은 좌심방 점액종 제거수술을 받았다. 승모판 치환수술을 받은 78명중 38명의 환자가 동시에 대동맥판 치환수술(n=22), 삼첨판성형술(n=14), 관상동맥 우회로조성술(n=1), 심실중격결손증 교정수술(n=1) 등을 받았다. 수술 후 총 74명에서 평균 23.3개월간 외래추적관찰을 하였다. 병원사망률은 3.8%(3례)를 보였고, 술전 심방세동을 보이던 46명의 환자중 1명이 수술후 정상 동조율로 전환 되었으며, 술전 정상동조율을 보였던 34명은 술후에도 계속 정상 동조율을 유지하였다. 평균 대동맥 차단시간은 71분이었고, 승모판막 단일 수술인 경우는 평균 62분이었다. 수술후 가장 흔한 부정맥은 서맥으로 일시적인 심장조율로 호전되었으며 다른 수술과 연관된 특별한 합병증은 없었다. 결론 : 승모판막수술시 확장시킨 경중격 절개방식의 적용으로 특별한 합병증 없이 좋은 결과를 얻을 수 있고 특히 좌심방의 크기가 작은 경우 많은 도움이 될 것으로 사료된다

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