• Title/Summary/Keyword: Extent of surgery

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Being a front-line dentist during the Covid-19 pandemic: a literature review

  • Fallahi, Hamid Reza;Keyhan, Seied Omid;Zandian, Dana;Kim, Seong-Gon;Cheshmi, Behzad
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.12.1-12.9
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    • 2020
  • Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

Current Methods for the Treatment of Alveolar Cleft

  • Kang, Nak Heon
    • Archives of Plastic Surgery
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    • v.44 no.3
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    • pp.188-193
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    • 2017
  • Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

Intracranial Metastases of Cervical Intramedullary Low-Grade Astrocytoma without Malignant Transformation in Adult

  • Jang, Se-Youn;Kong, Min-Ho;Song, Kwan-Young;Frazee, John G.
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.381-385
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    • 2009
  • The first case of intracranial metastases of a cervical intramedullary low-grade astrocytoma without malignant transformation in adult is presented in this report. Seven years ago, a 45 year-old male patient underwent biopsy to confirm pathologic characteristics and received craniocervical radiation and chemotherapy for a grade II astrocytoma in the cervical spinal cord. Two years later, posterior fusion was necessary for progressive kyphosis in the cervical spine. He was well for approximately 7 years after the primary surgery. Two months ago, he presented with partial weakness and incoordination with gait difficulty. MRI Scan demonstrated multiple small lesions in the cerebellar vermis and left hemisphere. After suboccipital craniectomy and posterior cervical exposure, the small masses in the cerebellar vermis and hemispheres were excised to a large extent by guidance of an intraoperative navigation system. The tumor at the cervical and brain lesions was classified as an astrocytoma (WHO grade II). When a patient with low-grade astrocytoma in the spinal cord has new cranial symptoms after surgery, radiaton, and chemotherapy, the possibility of its metastasis should be suspected because it can spread to the intracranial cavity even without malignant transformation as shown in this case.

Growth of Pulmonary Autograft in Swine, I.Feasibility of the Operation (신생돈을 이용한 이식 자가 폐동맥의 성장에 관한 연구, 제1보, 수술의 적합성)

  • 안재호
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.885-891
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    • 1995
  • In order to test the hypothesis that the pulmonic valve, when used to replace the aortic root as a pulmonary autograft, will remain a viable anatomical structure and will grow and develop normally along with the host, we performed aortic valve replacement with the pulmonary autograft in 15 neonatal piglets. The weight of the donor was 9.3 $\pm$ 0.2 kg, the recipient 9.6 $\pm$ 0.3 kg. Measured diameters of pulmonic annulus were 14 $\pm$ 0.2 mm for autograft and 14.2 $\pm$ 0.2 mm for pulmonary artery homograft. Operation was performed under cardiopulmonary bypass with deep hypothermia [20oC at low flow perfusion [70 ml/kg/min . The mean operation time was 227 $\pm$ 10 min., bypass time 152$\pm$ 7.6 min. and aortic cross clamp time 73$\pm$ 4.6 min.. 9 piglets survived more than 12 hours. One survived 12 days and died of pneumonia and the latest one survived in good condition and sacrificed at postoperative 6th week for cardiac catheterization and pathologic examination that revealed the viability and growing of the pulmonary autograft. Currently we are able to complete the operation with good preservation of cardiac function, and our postoperative care has evolved to the extent that we are now confident enough of having an acceptable percentage of long term survivors to undertake a definite study in this regard.

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Current Concepts in Reconstruction of Anterior Cruciate Ligament (전방십자인대 재건술의 경향)

  • Yoon, Kyoung Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.1-7
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    • 2013
  • This article provides an overview of the current concepts regarding anterior cruciate ligament reconstruction, including anatomy, biomechanics, operative techniques and clinical results. Many techniques have been introduced for ACL reconstruction: single bundle reconstruction, remnant preserving augmentation, and double bundle reconstruction. Each technique has its strong and weak points, and it is not sure which technique is superior than others. It is considered to suggest that rather than to select the same method of surgery in all patients, select the method of reconstruction depending on the characteristics of the individual patient, the state of the residual ligaments and extent of the damage.

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Correlation Between Apoptosis and Intratumoral Microvessel Density in Non-Small Cell Lung Cancer. (비소세포 폐암에서 아포프토시스와 종양내 미세 혈관 밀도의 관계)

  • 장인석;김종우;김진국;한정호
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.151-157
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    • 1999
  • Background: Increasing evidences from experimental studies indicate that apoptosis may be inversely related to angiogenesis in tumor progression. Material and Method: To explore how apoptosis correlates with tumor angiogenesis, we measured the apoptotic index(AI) using the terminal deoxynucleotidyl transferase method(Apop Tag In Situ Apoptosis Detection Kit, ONCOR) and the intratumoral microvessel density using the anti-CD31 monoclonal antibody in non-small cell lung cancer. Result: Statistical analysis revealed an inverse correlation between AIs and intratumoral microvessel densities in squamous cell lung carcinoma(Spearman rank correlation coefficient r=- 0.229, p=0.047). Conclusion: The results of this study demonstrated that the amount of apoptosis in squamous cell lung carcinoma may be influenced by the extent of neovascularization. This suggests that tumor angiogenesis may contribute to a reduction of apoptosis in tumor cells.

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Clinical Significance of the Ghrelin Concentrations in Plasma and Tumor Tissue from Patients with Gastric Cancer (위암 환자의 혈장 및 종양 조직에서 측정된 그렐린 농도의 임상적 의의)

  • An, Ji-Yeong;Choi, Min-Gew;Hong, Seong-Kweon;Baik, Yong-Hae;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.238-245
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    • 2005
  • Purpose: Ghrelin, produced primarily in the gastrointestinal tract, including the stomach, has been reported to reflect nutritional status and to control homeostasis by influencing food intake and adiposity. The purpose of this study is to evaluate nutritional status, as well as plasma and gastric tissue ghrelin levels, in patients with gastric cancer who underwent a gastrectomy. Materials and Methods: Eighty patients were analyzed by the degree of weight loss $(weight\;loss{\geq}5%\;or\;<5%)$ and the extent of gastrectomy (subtotal or total gastrectomy). Blood samples were collected from all patients preoperatively and postoperatively especially at seven days. Gastric tissues, including tumor and normal tissues, were obtained from the resected stomach. levels of plasma and tissue ghrelin were measured with a commercial ELISA kit. Results: There were no significant differences in the clinical characteristics and ghrelin levels of plasma, gastric tumor tissue and normal tissue by the degree of weight loss. The ghrelin levels in plasma and tumor tissue showed no correlations with each other while the ghrelin level in tumor tissue was significantly lower than that in normal tissue. The degree of cellular differentiation also had an association with ghrelin production. A gastrectomy proved to decrease significantly plasma ghrelin levels, body mass index, and biochemical markers, regardless of the extent of gastric resection. Conclusion: These results show that gastric cancer affects the production of ghrelin in the gastric mucosa and that ghrelin is mainly produced in stomach even though it could be partially covered by endogenous ghrelin from other organs following a gastrectomy. However, we should further investigate which other factors have an impact on energy consumption, ghrelin secretion, and changes in ghrelin levels after a gastrectomy.

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Interaction between odontoblast and bio-calcium phosphate cement reinforced with chitosan (치아모세포와 키토산으로 강화된 생체 적합 칼슘인산시멘트와의 상호작용)

  • Chun, Byung-Do;Kim, Sung-Won;Lee, Sung-Tak;Kim, Tae-Hoon;Lee, Jung-Han;Kim, Gyoo-Cheon;Kim, Yong-Deok;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.5
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    • pp.415-420
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    • 2011
  • Purpose: Calcium phosphate cement (CPC) is one of many useful materials for restoring tooth defects, periodontium and maxillofacial area. Chitosan is a biodegradable material that has been shown to promote the growth and differentiation of osteoblasts in culture. This study examined the interaction between odontoblasts and bio-calcium phosphate cement reinforced with chitosan. Materials and Methods: $5{\times}10^3$ odontoblastic cells were seeded into each well. Various concentrations of bio-calcium phosphate cement reinforced with chitosan (10, 20, 50, 100, 200, 500 ${\mu}g$/ml, 1, 2, 4 mg/ml) were diluted and added to the wells. The well was incubated for 24 h, 48 h and 72 h. After incubation, the number of cells was assessed to determine the cell viability. A cytokinesis-block micronucleus assay and chromosomal aberration test were carried out to estimate the extent of chromosomal abnormalities. Microscopic photographs and RT-PCR were performed to examine the adhesion potential of bio-calcium phosphate cement reinforced with chitosan. Results: Bio-CPC-reinforced chitosan did not show significant cytotoxicity. The number of damaged chromosomes in the cells treated with Bio-CPC-reinforced chitosan was similar to that in the control cells. There was no significant increase in the number of chromosomal aberrations in the Bio-CPC reinforced chitosan exposed cells. Microscopic photographs and RT-PCR confirmed the adhesive potential of bio-CPC reinforced chitosan to odontoblasts. Conclusion: Bio-CPC-reinforced chitosan did not affect the odontoblastic cell viability, and had no significant cytotoxic effect. Bio-CPC-reinforced chitosan showed adhesive potential to odontoblasts. These results are expected form the basis of future studies on the effectiveness of dental restorative materials in Bio-CPC reinforced with chitosan.

Effects of three-dimensionally printed polycaprolactone/β-tricalcium phosphate scaffold on osteogenic differentiation of adipose tissue- and bone marrow-derived stem cells

  • Park, Hannara;Kim, Jin Soo;Oh, Eun Jung;Kim, Tae Jung;Kim, Hyun Mi;Shim, Jin Hyung;Yoon, Won Soo;Huh, Jung Bo;Moon, Sung Hwan;Kang, Seong Soo;Chung, Ho Yun
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.181-189
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    • 2018
  • Background: Autogenous bone grafts have several limitations including donor-site problems and insufficient bone volume. To address these limitations, research on bone regeneration is being conducted actively. In this study, we investigate the effects of a three-dimensionally (3D) printed polycaprolactone (PCL)/tricalcium phosphate (TCP) scaffold on the osteogenic differentiation potential of adipose tissue-derived stem cells (ADSCs) and bone marrow-derived stem cells (BMSCs). Methods: We investigated the extent of osteogenic differentiation on the first and tenth day and fourth week after cell culture. Cytotoxicity of the 3D printed $PCL/{\beta}-TCP$ scaffold was evaluated by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium assay, prior to osteogenic differentiation analysis. ADSCs and BMSCs were divided into three groups: C, only cultured cells; M, cells cultured in the 3D printed $PCL/{\beta}-TCP$ scaffold; D, cells cultured in the 3D printed $PCL/{\beta}-TCP$ scaffold with a bone differentiation medium. Alkaline phosphatase (ALP) activity assay, von Kossa staining, reverse transcription-polymerase chain reaction (RT-PCR), and Western blotting were performed for comparative analysis. Results: ALP assay and von Kossa staining revealed that group M had higher levels of osteogenic differentiation compared to group C. RT-PCR showed that gene expression was higher in group M than in group C, indicating that, compared to group C, osteogenic differentiation was more extensive in group M. Expression levels of proteins involved in ossification were higher in group M, as per the Western blotting results. Conclusion: Osteogenic differentiation was increased in mesenchymal stromal cells (MSCs) cultured in the 3D printed PCL/TCP scaffold compared to the control group. Osteogenic differentiation activity of MSCs cultured in the 3D printed PCL/TCP scaffold was lower than that of cells cultured on the scaffold in bone differentiation medium. Collectively, these results indicate that the 3D printed PCL/TCP scaffold promoted osteogenic differentiation of MSCs and may be widely used for bone tissue engineering.

Optimal Radiation Therapy Field for Malignant Astrocytoma and Glioblastoma Multiforme (악성 성상세포종 및 교모세포종의 적정 방사선 조사 영역에 대한 고찰)

  • Cho, Heung-Lae;Choi, Young-Min
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.199-205
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    • 2002
  • Purpose : This study was peformed to determine the optimal radiation therapy field for the treatment of malignant astrocytoma and glioblastoma multiforme. Materials and Methods : From Jan. 1994 to Mar. 2000, 21 patients with malignant astrocytoma and glioblastoma multiforme, confirmed as recurrent by follow up MRI after surgery and radiation therapy, were analyzed. The distance from the margin of the primary lesion to the recurrent lesion was measured. The following factors were analyzed to Investigate the influence of these factors to recurrence pattern; tumor size, degree of edema, surgical extent, gamma knife radiosurgery and multiple lesions. Results : Among the 21 patients, 18 $(86\%)$ were recurred within 2 cm from the primary lesion site. 12 within 1 cm, 6 between 1 and 2 cm. The other 3 patients all with multiple lesions, were recurred at 3, 4, 5 cm, from the primary lesion site. The recurrence pattern was not influenced by the factors of tumor size, extent of edema, surgical extent, or gamma knife radiosurgery. However, patients with multiple lesions showed a tendency of recurrence at sites further from the primary lesion. Conclusions : Most $(86\%)$ of the recurrences of malignant astrocytoma and glioblastoma multiforme occurred within 2 cm from the primary lesion site. The width of treatment field does not need to be changed according to tumor size, degree of edema, surgical extent, or gamma knife radiosurgery. However, the treatment field for multiple lesions appears to be wider than that for a single lesion.