• Journal of Chest Surgery
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• v.35 no.6
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• pp.454-459
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• 2002

Clinical analysis of the relation between the clinical data of chest trauma patients and bone scan results was done to investigate the sensitivity and specificity of bone scan for the diagnosis of rib or chondral fracture. Material and Method： 445 patients treated due to chest trauma in Dongguk University Kyungju Hospital from July 1998 to December 2001 were studied. Age and sex distribution, causes of chest trauma, interval from the injury to arrival at hospital, final diagnosis, relationship between the chest pain and bone scan results, relationship between local tenderness and bone scan results, and sensitivity and specificity of bone scan were studied. Result： The male was 61.6% and the female was 38.4%. Age distribution was nearly even from the twenties to the sixties. The traffic accident was the most common cause of chest injury(60.4%). Most patients(76.6%) were arrived to the hospital within 6 hours after chest trauma. Rib fracture was the most common final diagnosis(46.5 %). The relationship between the duration of chest pain and tenderness and the bone scan results were significant, and the same in the relationship between the duration of local tenderness and the bone scan results, but the latter is more significant. The sensitivity of bone scan was 99.4% and the specificity was 90.4%. Conclusion： If the patient complains the chest pain continuously and the local tenderness around the chest is continued over 3 weeks, it is good to perform the bone scan. Further study including the MRI may be helpful for more evaluation in chest trauma patients.

• Journal of Acupuncture Research
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• v.23 no.5
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• pp.69-77
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• 2006

Background : Mesenchymal stem cells (MSCs) are present in most of the tissue matrix, taking part in their regeneration when injury or damage occurs. The aim of this study was to investigate the presence of cells with pluripotential characteristics in human subchondral bone and the capacity of these cells to differentiate to osteoblast. Methods : Human subchondral bone were digested with collagenase. Isolated cells were cultured with a-MEM, 15% FBS, 10-8M dexamethasone and 50 ng/mL ascoric acid. Cells from 0 day(isolated cells), 7 day (first subculture) and 14 days (third subculture) were used to carry out phenotypic characterization experiments flowcytometry analysis with 11 monoclonal antibodies) and osteogenic differentiation experiments. Osteogenic differentiation of cells was assessment by quantification of bone extracellular matrix components by following analysis: alkaline phosphatase(ALP) stains to detect ALP activity, RT-PCR and western blot to detect osteocalcin (OCN), osteopontin (OPN) and type I collagen(Col I), and Alizarin red stains to detect calcium deposition. Results : Flowcytometry analyses showed that in our population more than 98% of cells were positive for MSC markers: SH-2(CD105, 99%), CD29 (95%), CD73 (95%). Cells were negative for hematopoietic markers (CD11b, CD34, and CD45). Furthermore, cells showed positive stain to multipotent markers such as CDl17 (c-kit) (15.1%), and CD166 (74.9%), and cell adhesion molecules such as CD54 (78.1%) and CD106 (63.5%). The osteogenic specific marker analyses showed that the culture of these cells for 7 and 14 days stimulates ALP, OCN, OPN and Col I synthesis by RT-PCR and Western blot analysis. Also, after 14 days in the culture of MSCs induces mineralization by Arizarin red stain. Conclusion : In this work, we demonstrated a new and efficient method for osteoblastic differentiation of human subchondral bone stem cells. As MSCs takes part in reparative processes of adult tissues, these cells could play an important role in osteogenesis.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.44-50
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• 2009

Purpose: The purpose of this study was to evaluate the causes of blow-out fractures, the computed tomography findings, and the associated facial bone fractures in aged patients. Methods: This study was performed by conducting a chart review. From January 2004 to December 2007, the patients who visited the emergency room of Asan Medical Center and were diagnosed as having a blow-out fracture were included in the study population. Patients 60 years of age or older were grouped as the aged group while patients younger than 60 years of age were grouped as the control group. Results: Between the aged group and the control group, there was a difference in the causes of blow-out fractures. The most common cause of blow-out fracture was a slip down in the aged group and violence in the control group (p<0.05). There were no differences in associated symptoms. Extraocular muscle herniation was the only statistically different computed tomography findings. In associated facial bone fractures, the most common fractures were the zygoma in the aged group and the nasal bone in the control group (p<0.05). Conclusion: In patients 60 years of age or older, the most common cause of blow-out fracture was a slip down, and the most common associated facial bone fracture was a zygomatic fracture.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.334-340
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• 2015

Background Full-thickness skin grafts (FTSGs) are generally considered unreliable for coverage of full-thickness finger defects with bone or tendon exposure, and there are few clinical reports of its use in this context. However, animal studies have shown that an FTSG can survive over an avascular area ranging up to 12 mm in diameter. In our experience, the width of the exposed bones or tendons in full-thickness finger defects is <7 mm. Therefore, we covered the bone- or tendon-exposed defects of 16 fingers of 10 patients with FTSGs. Methods The surgical objectives were healthy granulation tissue formation in the wound bed, marginal de-epithelization of the normal skin surrounding the defect, preservation of the subdermal plexus of the central graft, and partial excision of the dermis along the graft margin. The donor site was the mastoid for small defects and the groin for large defects. Results Most of the grafts (15 of 16 fingers) survived without significant surgical complications and achieved satisfactory functional and aesthetic results. Minor complications included partial graft loss in one patient, a minimal extension deformity in two patients, a depression deformity in one patient, and mild hyperpigmentation in four patients. Conclusions We observed excellent graft survival with this method with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages include an insufficient volume of soft tissue and graft hyperpigmentation. Therefore, FTSGs may be an option for treatment of full-thickness finger defects with bone or tendon exposure.

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.415-423
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• 2018

Objective : To identify the perioperative factors associated with instrument failure in patients undergoing a partial corpectomy with instrumentation (PCI) for spinal metastasis. Methods : We assessed the one hundred twenty-four patients with who underwent PCI for a metastatic spine from 1987 to 2011. Outcome measure was the risk factor related to implantation failure. The preoperative factors analyzed were age, sex, ambulation, American Spinal Injury Association grade, bone mineral density, use of steroid, primary tumor site, number of vertebrae with metastasis, extra-bone metastasis, preoperative adjuvant chemotherapy, and preoperative spinal radiotherapy. The intraoperative factors were the number of fixed vertebrae, fixation in osteolytic vertebrae, bone grafting, and type of surgical approach. The postoperative factors included postoperative adjuvant chemotherapy and spinal radiotherapy. This study was supported by the National Research Foundation grant funded by government. There were no study-specific biases related to conflicts of interest. Results : There were 15 instrumentation failures (15/124, 12.1%). Preoperative ambulatory status and primary tumor site were not significantly related to the development of implant failure. There were no significant associations between insertion of a bone graft into the partial corpectomy site and instrumentation failure. The preoperative and operative factors analyzed were not significantly related to instrumentation failure. In univariable and multivariable analyses, postoperative spinal radiotherapy was the only significant variable related to instrumentation failure (p=0.049 and 0.050, respectively). Conclusion : When performing PCI in patients with spinal metastasis followed by postoperative spinal radiotherapy, the surgeon may consider the possibility of instrumentation failure and find other strategies for augmentation than the use of a bone graft for fusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.103-113
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• 1990

The study was based on a series of 252 patient with facial bone fractures who visited to Chun Cheon Sacred Heart Hospital, College of Medicine, Hallym University during the period of Dec., 1984 trough Nov., 1989. The results obtained are as follows; 1. The most frequent etiologic factor was traffic accident(45.2%). 2. The ratio of male to female was 5.5 : 1 and 2nd decade(44%) was the highest age group in incidence. 3. Monthly incidence was the highest in Aug(14.3%). 4. The most common site of fracture was mandible(55.3%) and zygoma complex(24.2%), nasal bone(11.6%), maxilla(8.9%) were next in order of frequeny. 5. In mandible fractures, the most frequent site was symphyseal area(36.9%) and 142 cases(85%) had fractures only in mandible. 6. In maxillary fractures, fracture with other facial bones(85.2%) was more frequent than fracture on maxilla only. The major fracture type on maxilla was Le Fort II type. 7. In fracture of zygoma complex, zygoma & zygomatic arch was the most frequent site(52.0%) and zygomatic arch(24.7%), zygoma(23.3%) were next in order. 8. Open reduction was major method of treatment in facial bone fractures except nasal bone ; mandible(62.9%), maxilla(77.8%), zygoma complex(65.8%). 9. Maxillofacial fractures were most frequently combined with head & neck injury(43.1%), and upp. & low. extremities(29.4%), chest and abdomen(11.9%) were in order of frequency.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.143-153
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• 2017

One of the common complications of dental injury is tooth ankylosis. Unlike adults, when tooth ankylosis occurs in the adolescents, ankylosis interfered the growth of the adjacent alveolar bone, resulting in the developmental failure of the alveolar bone and subsequent open bite. The most common treatment option for ankylosed tooth is extraction. However, when prognosis of ankylosed tooth after extraction is expected to be poor due to severity of infrapositioning or prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests multidisciplinary treatment that might bring functionally and esthetically favorable result included alveolar bone distraction osteogenesis and decoronation of ankylosed maxillary anterior tooth with orthodontic and prosthetic treatments.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.1-9
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• 2009

There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

• International Neurourology Journal
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• v.22 no.4
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• pp.260-267
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• 2018

Purpose: A major question remaining in approaches to tissue engineering and organ replacement is the role of native mobilized native cells in the regeneration process of damaged tissues and organs. The goal of this study was to compare the cell mobilizing effects of the chemokine CXCL12 and cell therapy on the urinary sphincter of nonhuman primates (NHP) with chronic intrinsic urinary sphincter dysfunction. Methods: Either autologous lenti-M-cherry labeled skeletal muscle precursor cells (skMPCs) or CXCL12 were injected directly into the sphincter complex of female NHPs with or without surgery-induced chronic urinary sphincter dysfunction (n=4/treatment condition). All monkeys had partial bone marrow transplantation with autologous lenti-green fluorescent protein (GFP) bone marrow cells prior to treatment. Labeled cells were identified, characterized and quantified using computer-assisted immunohistochemistry 6 months posttreatment. Results: GFP-labeled bone marrow cells (BMCs) were identified in the bone marrow and both BMCs and skMPCs were found in the urinary sphincter at 6-month postinjection. BMCs and skMPCs were present in the striated muscle, smooth muscle, and lamina propria/urothelium of the sphincter tissue. Sphincter injury increased the sphincter content of BMCs when analyzed 6-month postinjection. CXCL12 treatment, but not skMPCs, increased the number of BMCs in all layers of the sphincter complex (P<0.05). CXCL12 only modestly (P=0.15) increased the number of skMPCs in the sphincter complex. Conclusions: This dual labeling methodology now provides us with the tools to measure the relative number of locally injected cells versus bone marrow transplanted cells. The results of this study suggest that CXCL12 promotes mobilization of cells to the sphincter, which may contribute more to sphincter regeneration than injected cells.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.68-74
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• 2009

Purpose: This study was designed to evaluate the results and efficacy of subtalar distraction two bone-block arthrodesis for calcaneal malunion. Materials and Methods: From January 2004 to June 2007, we operated on 8 patients (12 cases). There were 7 male patients and 1 female patient; their mean age was 42 years. 8 cases among them were operated initially. The period between initial injury and arthrodesis was 21 months. At an average follow up was 19 months. In operation, we used extensile lateral approach and arthrodesis was performed through tricortical two bone-block and cannulated screws. The Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined union and various parameters. Results: All cases achieved radiologic union at the final follow-up. The mean Ankle-hindfoot scale (maximum of 94 points) increased from 43.4 points preoperatively to 84 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographs showed and average increase of 5.5 mm in talo-calcaneal height, $5.1^{\circ}$ in talocalcaneal angle, $6.1^{\circ}$ in talar declination angle and decrease of $5.7^{\circ}$ in talo-first metatarsal angle. Conclusion: The short term results of subtalar distraction two bone-block arthrodesis is promising, but longer follow-up was needed.