• Journal of Trauma and Injury
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• v.33 no.1
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• pp.18-22
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• 2020

Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.121-124
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• 2014

A 7-year-old, intact female Jindo dog was presented for assessment of weight-bearing lameness of the right hindlimb. On physical examination, crepitus and pain was noted in the right coxofemoral joint upon extension. Radiographs revealed a craniodorsal luxation of the right coxofemoral joint and degenerative joint disease (DJD) of both coxofemoral joints. Total hip replacement (THR) was performed for the right coxofemoral joint. Intraoperatively, dorsal acetabular rim (DAR) deficiency was noted, which can be related to a high risk for acetabular cup implant dislocation. Deficiency of the dorsal acetabular rim realigned with the acetabular cup using universal locking plate (ULP) and polymethylmethacrylate (PMMA) bone cement. After surgery, the patient had an uneventful course and a successful outcome. The ROM and thigh girth were dramatically improved. There were no complications associated with prosthesis implants. Hip luxation with dorsal acetabular rim deficiency in a dog was successfully repaired with THR and dorsal acetabular rim augmentation using ULP and PMMA bone cement. This technique should be considered when conventional THR is precluded by dorsal acetabular rim deficiency.

• Journal of Periodontal and Implant Science
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• v.41 no.2
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• pp.92-97
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• 2011

Purpose: The present study was performed to compare the treatment outcomes of non-surgical periodontal treatment according to the distribution of attachment loss of a given patient. Methods: Forty-five patients with moderate to severe periodontitis were divided in two subgroups; Group I patients with teeth manifesting attachment loss of ${\geq}$ 6 mm at one or more sites on the buccal/labial aspect while maintaining an attachment level ${\leq}$ 5 mm at the lingual/palatal aspect, Group II patients with teeth manifesting an attachment level ${\geq}$ 6 mm at more than one site on the lingual/palatal aspect while maintaining an attachment level ${\leq}$ 5 mm at the buccal/labial aspect. The probing pocket depth, probing attachment level, tooth mobility, and chewing discomfort were recorded at baseline and 6 months examinations following non-surgical periodontal therapy. Results: The buccal/ abial surfaces of teeth with moderate to severe periodontitis in Group I patients demonstrated a greater amount of pocket reduction, gain of attachment level, and tooth mobility reduction than the lingual/palatal aspects of teeth examined in Group II patients. Conclusions: Within the limits of the present study, the patients demonstrating attachment loss ${\geq}$ 6 mm at buccal/labial surfaces responded better to the nonsurgical periodontal therapy than those demonstrating comparable attachment loss at lingual/ palatal surfaces.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.425-430
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• 2009

Objective : The present study analyzed the risk factors, prevalence and clinical results following revision surgery for adjacent segment degeneration (ASD) in patients who had undergone lumbar fusion. Methods : Over an 8-year period, we performed posterior lumbar fusion in 81 patients. Patients were followed a minimum of 2 years (mean 5.5 years). During that time, 9 patients required revision surgery due to ASD development. Four patients underwent autogenous posterolateral arthrodesis and extended transpedicle screw fixation, 4 patients underwent decompressive laminectomy and interspinous device implantation, and 1 patient underwent simple decompression. Results : Of the 9 of patients with clinical ASD, 33.3% (3 of 9) of patients did not have radiographic ASD on plain radiographs. Following revision surgery, the clinical results were excellent or good in 8 patients (88.9%). Age > 50 years at primary surgery was a significant risk factor for ASD development, while number of fusion levels, initial diagnosis and type of fusion were not. Conclusion : The incidence of ASD development after lumbar surgery was 11.1% (9 of 81) in this study. Age greater than 50 was the statistically significant risk factor for ASD development. Similar successful clinical outcomes were observed after extended fusion with wide decompression or after interspinous device implantation. Given the latter procedure is less invasive, the findings suggest it may be considered a treatment alternative in selected cases but it needs further study.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.127-131
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• 2010

Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

• Proceedings of the KOSOMBE Conference
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• v.1994 no.12
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• pp.71-74
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• 1994

In cementless total hip arthroplasty(THA), an initial stability of the femoral component is mandatory to achieve bony ingrowth and secondary long term fixation. Bone ingrowth depends strongly on relative micromotion and stress distributions at the interface. Primary stability of the femoral component can be obtained by minimizing the magnitude of relative micromotions at bone-prosthesis interface, Hence an accurate evaluation of interface behavior and stress/strain fields in the bone implant system may be relevant for better understanding of clinical situations and improving THA design. However, complete evaluation of load transfer in the bone remains difficult to assess experimentally, Hence, recently finite element method (FEM) was introduced in orthopaedic research field to fill the gap due to its unique capacity to evaluate stress in structure of complex shape, loading and material behavior. The authors developed the 3-dimensional numerical finite element model which is composed of totally 1179 elements off and 8 node blick. We also analyzed the micromotions at the bone-stem interface and mechanical behavior of existing bone prosthesis for a loading condition simulating the single leg stance. The result indicates that the values of relative motion for this well fit Multilock stem were $150{\mu}m$ in maximum, $82{\mu}m$ in minimum, and the largest relative motion developed in medial region of proximal femur with anterior-posterior direction. The proximal region of the bone was much larger in motion than the distal region and the stress pattern shows high stress concentration on the cortex near the tip of the stem. These findings indicates that the loading in the proximal femoral bone in the early postoperative situation can produce micromotions on the interface and clinically cementless TEA patient should not be allowed weight bearing strictly early in the postoperative period.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• Journal of Pharmaceutical Investigation
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• v.25 no.2
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• pp.109-116
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• 1995

For the administration of narcotic antagonist with short half-life and low patient compliance, the sustained release system using biodegradable matrix is effective. Polyphosphazenes are of considerable interest as biodegradable matrix systems for controlled release of drugs. In this study, biodegradable polyphosphazenes available for the sustained release implantable device were synthesized, and their application was examined. Poly[dichlorophosphazene] was synthesized by solution polymerization method and confirmed with IR spectrum. Poly[bis(ethyl glycinate) phosphazene] and poly[ (diethyl glutamate)-co-(ethyl glycinate)phosphazene] were then produced by substitution of amino acid alkyl esters for chloride side groups. Using these polymers, the implantable devices of 1 mm thickness and $10{\times}10\;mm$ size containing naloxone hydrochloride were prepared and their release and degradation profiles were measured. In the case of poly[bis(ethyl glycinate)phosphazene] with swelling characteristics, degradation rate was slower than the release rate, showing that the release rate is partly dependent on the swelling rate. In contrast, the degradation rate of polyl[(diethyl glutamate)-co-(ethyl glycinate)phosphazene] matrix was identical with release rate of naloxone hydrochloride. On the basis of these results, it is expected that these polymers can be applied to sustained release implantable systems delivering narcotic antagonist.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.463-466
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• 2017

A 3-year-old, 26 kg, castrated male Chow Chow was presented for assessment of weight-bearing lameness of the left hind limb. The patient had a history of triple pelvic osteotomy on the left side to correct hip dysplasia 2 years prior to his presentation of clinical signs and underwent total hip replacement on the right coxofemoral joint 1 year later. Upon physical examination, pain and crepitus were noted on the left hip joint during extension. Radiological examination revealed coxofemoral joint subluxation and moderate degenerative bone changes on the left hip joint and pelvic axis, which relates to acetabular angles that were changed after triple pelvic osteotomy (TPO). Preoperative computed tomography was used for 3-dimensional printing to establish an accurate surgical plan. The changed angles of the acetabulum after TPO were evaluated, and rehearsal surgery was performed using a 3-demensional printing bone model. Three months after the THR surgery, the function of the affected limb had improved, with no lameness. Complications, such as luxation and implant failure, were not observed until 6 months after the operation. Accurate evaluation of acetabulum angles and rehearsal surgery using a 3D-printed bone model is effective for total hip replacement after unsuccessful TPO.

• Journal of Periodontal and Implant Science
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• v.46 no.4
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• pp.277-287
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• 2016

Purpose: The purpose of this study was to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection by assessing the radiographic anatomical factors affecting the reconstruction of the interdental papilla. Methods: Fifty-seven treated sites from 13 patients (6 males and 7 females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic and periapical radiographic standardization devices were designed for each patient. A 30-gauge needle was used with an injection-assistance device to inject a hyaluronic acid gel to the involved papilla. This treatment was repeated up to 5 times every 3 weeks. Patients were followed up for 6 months after the initial gel application. Clinical photographic measurements of the black triangle area (BTA), height (BTH), and width (BTW) and periapical radiographic measurements of the contact point and the bone crest (CP-BC) and the interproximal distance between roots (IDR) were undertaken using computer software. The interdental papilla reconstruction rate (IPRR) was calculated to determine the percentage change of BTA between the initial and final examination and the association between radiographic factors and the reconstruction of the interdental papilla by means of injectable hyaluronic acid gel were evaluated. Results: All sites showed improvement between treatment examinations. Thirty-six sites had complete interdental papilla reconstruction and 21 sites showed improvement ranging from 19% to 96%. The CP-BC correlated with the IPRR. More specifically, when the CP-BC reached 6 mm, virtually complete interdental papilla reconstruction via injectable hyaluronic acid gel was achieved. Conclusions: These results suggest that the CP-BC is closely related to the efficacy of hyaluronic acid gel injection for interdental papilla reconstruction.