• Title/Summary/Keyword: Fibula

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LONG TERM EVALUATION OF VOLUME CHANGE IN FREE VASCULARIZED FIBULAR FLAP MANDIBLE RECONSTRUCTION (하악골 결손의 재건을 위한 혈행화된 비골 이식술에서의 장기간의 체적변화)

  • Kim, Yoon-Tae;Jeon, Seung-Ho;Yeom, Hak-Ryol;Ahn, Kang-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.138-141
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    • 2006
  • Introduction : In recent years, vascularized, i.e., living bone grafts, have been widely applied in the field of oral and maxillofacial surgery, as a method of treatment of congenital or acquired non-unions, and a large defects in mandible. The vascularized fibular graft has been especially used for this purpose because of its shape and mechanical strength. The postoperative hypertrophy of grafted fibula is of particular interest to us. Material and methods : This study was undertaken to determine the volume change(indirect methods) and radiographic appearance of a free vascularized fibular graft as it responds to the mechanical and physiologic features of its new environment. In order to elucidate the long term effect on fibular mass after mandibular reconstruction, change in various method of volume change was utilized as indirect measure of change in long-term. Results : The younger the patient, the more prominent and rapid the hypertrophy of the graft. the hypertrophy of the graft never exceeded the diameter of the recipient bone, except for callus enlargement after stress fracture of the grafted bone. Conclusion : Etiologic explanations for this phenomenon have not been clarified in the previeous literature. some of the factors implicated include a periosteal reaction or new bone formation, as seen at the onset of bone union after a fracture in a child, a reaction to the mechanical loading on the graft and a reaction to the circulatory changes resulting from the grafting procedure.

Effects of Safflower Seeds on the Serum Levels of Insulin-like Growth Factors, Insulin-like Growth Factor Binding Protein-3 and BALP in Osteoporosis Induced-ovariectomized Rats (흰쥐의 난소제거로 유발한 골다공증에 대한 홍화씨의 IGFs, IGF binding protein-3 그리고 BALP에 대한 혈청내 효과)

  • Kim, Soo-mi;Park, In-hyuk;Kim, Nam-soo
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.263-273
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    • 2003
  • This study was carried out to investigate the effects of the Korean Safflower (Carthamus inctorius L) seed powder on serum level of hormones and trabecula area during the recovery from osteoporosis induced ovariectomized rats. Four month-old rats were ovariectomized (OVX), remained untreated for 8 weeks, and were subsequently administered safflower seed (0.03 g/kg) every other day 30 for days. We examined the effects of treated safflower seed every 10 days on ovariectomy-related changes in Insulin-like Growth Factors, Insulin-like Growth Factor binding protein-3 (IGFBP-3), Estrogen, Bone-specific alkaline phosphotase, Calcium, and Phospotase in the serum, and also histomorphology of the proximal fibula metaphysis and femur/body weight rate. Ten and 20 days after safflower seed treatment in OVX rats, serum levels of IGF-I, -II and IGFBP-3 were not different from the Sham and OVX groups. In 30 days, serum levels of IGF-I,-II and IGFBP-3 were higher after safflower seed treatment in OVX rats as compared to the other two groups (p<0.05). Bone alkaline phosphatase levels were increased through safflower seed treatment in OVX rats compared to the other two groups in 30 days. There were no differences between OVX and safflower seed treated OVX rats in serum levels of estrogen and femur/body weight rate, but estrogen levels for the sham group were higher than for the other two groups. The safflower seed is increased to serum levels of IGFs, IGFBP-3 and BALP of osteoporosis induced by ovariectomized rats. Thus, we conclude that the safflower seed is a possible role for improvement of osteoporosis induced-ovariectomized rats.

Clinical Application of Recombinant Human Bone Morphogenetic Protein-2 for Delayed Fractures in Dogs (개에서 골절의 지연유합에 대한 rhBMP-2의 임상적 적용 2례)

  • Kim, Jae-Kyong;Kim, Se-Eun;Go, A-Ra;Kim, Seung-Hyun;Shim, Kyung-Mi;Bae, Chun-Sik;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.412-415
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    • 2012
  • A 1-year-old, castrated male Yorkshire terrier (case 1) and a 7-year-old female Poodle (case 2) presented with delayed union fractures. In case 1, the dog had a fractured right distal radius and ulna. In case 2, the dog had a fractured left distal tibia and fibula. A physical examination and radiographs performed in both dogs revealed delayed union fractures with large gaps. The fracture sites were fixed by bone plate and screws. Autogenous cancellous bone graft was applied into the fracture gap. To encourage rapid bone union, we used matrigel containing $20{\mu}g$ of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the fracture site. Radiographs were taken postoperatively to monitor healing. Rapid bone union was noted in both dogs in long-term radiographs. In case 1, the radiographs revealed that the fracture gaps of the radius and ulna were bridged at 2 weeks. Fracture lines were not observed and normal appearance was restored at 20 weeks. In case 2, the radiographs showed that fracture repair had progressed at 11 weeks. The fractures healed faster than expected in these two cases. The results indicate that rhBMP-2 and matrigel may be effective and useful materials to enhance healing of delayed fractures.

Resection and Reconstruction for Liposarcoma Involving Popliteal Fossa and Antero-lateral Compartment of Lower Leg - A Case Report - (하퇴 슬와부 및 전외측 구획을 침범한 지방육종 환자의 절제 및 재건술 - 증례보고 -)

  • Won, Ho-Hyun;Hong, Youn-Seok;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.69-74
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    • 2009
  • Soft tissue sarcomas of popliteal fossa are rare, accounting for less than 5% of all soft tissue sarcomas of the extremities. In an extracompartmental space such as the popliteal, cubital fossa and inguinal space, where major vessels and nerves traverse, performing resections with wide margin is difficult and sometimes marginal margin is inevitable for limb salvage. For popliteal tumor resection, posterior approach would be a classic method. For tumors with small size and not adherent to surrounding structures, tumor is easily resected by this approach and dissection of nerve sheath or adventitia of vessel. On the contrary, tumors of large size and infiltrating the posterior structure of knee joint may show difficulty in en-bloc resection itself. These cases were candidates for amputation. Furthermore, tumors involving both popliteal fossa and anterior compartment usually had no choice but to have an amputation to prevent local recurrence. We regarded soft tissue sarcoma showing this kind of presentation as bone tumor having extraosseous mass. We performed wide en-bloc resection of proximal tibia and fibula along with sarcoma involving both compartment on liposarcoma of 47-year old man.

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A Study on the Causes of Injury Codes by Case-Based Injury Code of External Causes Frequency Analysis (사례 중심의 손상코드 별 손상외인코드 빈도수 분석에 따른 손상코드 발생 원인에 관한 연구)

  • Eun-Mee Choi;Hye-Eun Jin;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.1
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    • pp.50-59
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    • 2023
  • The purpose of this study was to analyze the patients hospitalized with damage by injury code based on data for two years in 2020 and 2021 of A institution located in Gangneung, Gangwon-do. Analyzed the injury codes with a large number of occurrences per year, and analyzed the injury codes of external causes accordingly. The cause of the injury code was analyzed by analyzing the frequency of the injury code of external causes. Injury code S0650 had the highest frequency of injury code of external causes W189 and X5999, which was judged to be the cause of traumatic subdural hemorrhage without open intracranial wounds when falling in an unspecified place or toilet. Injury code S72120 had the highest frequency of injury code of external causes W010 and W180, and it was judged to be the cause of obstructive femoral intertrochanteric fracture that occurs when falling in the residence. The injury code S32090 had a high frequency of X5999, and it was analyzed that it caused the obstructive fracture of the lumbar region due to an accident caused by exposure in an unspecified place, and the injury code S72.090 had a high frequency of W010 and W180. It was confirmed that the cause of the obstructive fracture of the femoral neck was mainly caused by slipping or slipping in the residence, and the injury code S0220 had a high frequency of the injury code of external causes Y049, and it was confirmed that the fibula was fractured mainly by the force or fist. As such, the cause of the injury code was analyzed by analyzing the frequency of the injury code for each injury code of external causes.

The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities (사지 골육종에서 체외 방사선 조사를 이용한 재건술)

  • Kim, Jae-Do;Lee, Gun-Woo;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.1-7
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    • 2010
  • Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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Comparison of Liver, Kidney, Bone Metal Concentration in OhJeokSan-Treated Rats (오적산(五積散)을 투여한 흰쥐의 간장, 신장, 골중 금속농도 비교에 관한 연구)

  • Park Chul-Soo;Lee Sun-Dong;Park Hae-Mo;Park Yeong-Chul
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.2
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    • pp.66-85
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    • 2002
  • Traditional herbal medicine is used extensively among the Korean populations, and other Asian countries employ similar therapies as well In recent years, extensive focus was laid on adulteration of the herbal medicine with heavy metals. This may be mainly due to a soil contamination by an environmental pollution. The objective of this study is to identify the contents of various heavy metals in the blood from OhJeokSan-Decoction (OD) treated-rats. For this study, 13 kinds of metals including essential and heavy metals, i.e. Al, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se and Zn were analyzed by a slight modification of EPA methods and the following results are obtained. ; 1. There is no significant difference between the OD-treated groups and control group in liver, kidney, bone, brain, weight, food intake. 2. The amount of each metal analyzed in the liver are as follows; Al ; $0.235{\sim}4.215mg/kg$, As ; $0.103{\sim}0.461mg/kg$, Cd ; $0.005{\sim}0.010mg/kg$, Co ; $0.017{\sim}0.046mg/kg$, Cr ; $0.137{\sim}0.403mg/kg$, Cu ; $1.736{\sim}4.827mg/kg$, Fe ; $54.472{\sim}381.447mg/kg$, Hg ; not detected, Mn ; $1.159{\sim}2.803mg/kg$, Ni ; $0.007{\sim}0.095mg/kg$, Pb ; not detected, Se ; $0.682{\sim}1.887mg/kg$, Zn ; $10.213{\sim}26.119mg/kg$, by groups, respectively. In control and other experimental group, several metal (Co, Cu, Mn, Zn, As, Cr) has a significant difference, but in experimental I and other experimental II, III, IV, V groups, there are no significant difference. 3. The amount of each metal analyzed in the kidney are as follows; Al ; $1.712{\sim}31.230mg/kg$, As ; $0.062{\sim}0.439mg/kg$, Cd ; $0.010{\sim}0.062mg/kg$, Co ; $0.000{\sim}0.101mg/kg$, Cr ; $0.125{\sim}0.636mg/kg$, Cu ; $3.385{\sim}12.502mg/kg$, Fe ; $41.148{\sim}99.709mg/kg$, Hg ; $0.000{\sim}0.270mg/kg$, Mn ; $0.433{\sim}2.301mg/kg$, Ni ; $0.000{\sim}0.221mg/kg$, Pb ; $0.000{\sim}0.584mg/kg$, Se ; $0.540{\sim}1.600mg/kg$, Zn ; $8.775{\sim}17.060mg/kg$, by groups, respectively. The concentration of Cu, Se, Cr, and Hg are variated significantly in control and other experimental group, and Cu, Se, Cd, Cr are variated significantly in experimental I and other experimental II, III, IV, V groups. 4. The amount of each metal analyzed in the bone(tibia and fibula) are as follows; Al ; $9.557{\sim}119.464mg/kg$, As ; $0.139{\sim}12.250mg/kg$, Cd ; $0.000{\sim}0.295mg/kg$, Co ; $0.022{\sim}0.243mg/kg$, Cr ; $0.239{\sim}1.999mg/kg$, Cu ; $0.000{\sim}2.291mg/kg$, Fe ; $240.249{\sim}841.956mg/kg$, Hg ; $0.000{\sim}0.983mg/kg$, Mn ; $0.214{\sim}7.353mg/kg$, Ni ; $5.473{\sim}11.453mg/kg$, Pb ; $0.000{\sim}8.502mg/kg$, Se ; $0.000{\sim}3.005mg/kg$, Zn ; $61.158{\sim}195.038mg/kg$, by groups, respectively. The concentration of Se, Cd are variated significantly in control and other experimental groups, and Se is variated significantly in experimental I and other experimental II, III, IV, V groups. 5. Exceptionally several metal concentration is increased or decreased. but there is no significant harmful difference of metal concentration in the liver, kidney and bone, from the OD-treated-rats compared to those of the control group even if higher dosage($1{\sim}8$ times dosage of person) of OD was administered. Thus, it is expected that the herbal decoction in the traditional herbal medicine would not lay any burden on the body and the heavy metal toxins would not affect our physiological system. However, other kinds of herbal treatment, such as i.v. and i.p. should be considered in terms of metal toxicity in the body since the level of certain metal.

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Analytical Review of the Forensic Anthropological Techniques for Stature Estimation in Korea (한국에서 사용되는 법의인류학적 키 추정 방법에 대한 제언)

  • Jeong, Yangseung;Woo, Eun Jin
    • Anatomy & Biological Anthropology
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    • v.31 no.4
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    • pp.121-131
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    • 2018
  • Stature is one of the unique biological properties of a person, which can be used for identification of the individual. In this regard, statures are estimated for the unknown victims from crimes and disasters. However, the accuracy of estimates may be compromised by inappropriate methodologies and/or practices of stature estimation. Discussed in this study are the methodological issues related to the current practices of forensic anthropological stature estimation in Korea, followed by suggestions to enhance the accuracy of the stature estimates. Summaries of forensic anthropological examinations for 560 skeletal remains, which were conducted at the National Forensic Service (NFS), were reviewed. Mr. Yoo Byung-eun's case is utilized as an example of the NFS's practices. To estimate Mr. Yoo's stature, Trotter's (1970) femur equation was applied even though the fibula equation of a lower standard error was available. In his case report, the standard error associated with the equation (${\pm}3.8cm$) was interpreted as an 'error range', which gave a hasty impression that the prediction interval is that narrow. Also, stature shrinkage by aging was not considered, so the estimated stature in Mr. Yoo's case report should be regarded as his maximum living stature, rather than his stature-at-death. Lastly, applying Trotter's (1970) White female equations to Korean female remains is likely to underestimate their statures. The anatomical method will enhance the accuracy of stature estimates. However, in cases that the anatomical method is not feasible, the mathematical method based on Korean samples should be considered. Since 1980's, effort has been made to generate stature estimation equations using Korean samples. Applying the equations based on Korean samples to Korean skeletal remains will enhance the accuracy of the stature estimates, which will eventually increase the likelihood of successful identification of the unknowns.

The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.33-39
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    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.