• 제목/요약/키워드: Lengthening technique

검색결과 34건 처리시간 0.024초

압축력을 병용한 하악골 신장술 (MANDIBULAR DISTRACTION OSTEOGENESIS WITH COMPRESSION FORCE - BONE DENSITY, HISTOLOGICAL FINDINGS AND TMJ RESPONSE)

  • 황영섭;허준;김욱규;박성진;황대석;김용덕;정인교;김규천
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권6호
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    • pp.531-548
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    • 2006
  • The purpose of this study was to investigate the biomechanical, histologic findings of distracted regenerate and TMJ response in modified distraction osteogenesis (DO) technique combined with compression force as biomechanical stimulation method which has been suggested in 2002, and developed thereafter by authors. This study was performed with two experiments. First experiment was designed to explore the optimal ratio of compression force versus distraction force for the new DO technique. Second experiment was planned to evaluate the reaction of TMJ tissue, especially condyle, disc after application of the DO technique with compression force. Total 52 New Zealand adult male-rabbits with 3.0kg body weight were used for the study. For the first study, 30 adult male-rabbits underwent osteotomy at one side of mandibular body and a external distraction device was applied on each rabbit with same manner. In the control group of 10 rabbits, final 8 mm of distraction with 1 mm rate per day was done with conventional DO technique after 5 latency days. For the experimental group of 20 rabbits, a compression force with 1 mm rate per day was added to the distracted mandible on 3-latency day after over-distraction (over-lengthening). As the amount of the rate of compression versus distraction, experimental subgroup I (10 rabbits) was set up as 2 mm compression versus 10 mm distraction (1/5) and experimental subgroup II (10 rabbits) was set up as 3 mm compression versus 11 mm distraction (about 1/3). All 30 rabbits were set up to obtain final 8 mm distraction and sacrificed on postoperative 55 day to analysis on biomechanical, and histologic findings of the bone regenerates. For second study, 22 adult male-rabbits were used to evaluate TMJ response after the DO method application with compression force. In the control group, 10 rabbits was used to be performed with conventional DO method, on the other hand, in a experimental group of 10 rabbits, 10 mm distraction with 2 mm compression (1/5 ratio) was done. The remaining 2 rabbits served as the normal control group. Histomorphologic examinations on both condyle, histological studies on condyle, disc were done at 1, 2, 3, 4, 7 weeks after distraction force application. The results were as follows: 1. On the bone density findings, the experimental group II (force ratio - 1/3) showed higher bone density than the other experimental group (force ratio - 1/5) and control group (control group - $0,2906\;g/cm^2$, experimental group I - $0.2961\;g/cm^2$, experimental group II - $0.3328\;g/cm^2$). 2. In the histologic findings, more rapid bone maturation like as wide lamellar bone site, more trabeculae formation was observed in two experimental groups compared to the conventional DO control group. 3. In morphologic findings of condyle, there were no differences of size and architecture in the condyle in the control and experimental groups. 4. In histologic findings of condyles, there were thicker fiberous and proliferative layers in experimental group than those of control group until 2 weeks after distraction with compression force. But, no differences were seen between two groups on 3, 4, 7 weeks after compression. 5. In histologic findings of disc, more collagen contents in extracellular matrix, more regular fiber bundles, and less elastin fibers were seen in experimental group than control group until 2 weeks after distraction with compression. But, no differences were seen between two groups on 3, 4, 7 weeks after distraction with compression. From this study, we could identify that the new distraction osteogenesis technique with compression stimulation might improve the quality of bone regeneration. The no remarkable differences on TMJ response between control and experimental groups were seen and TMJ tissues were recovered similarly to normal TMJ condition after 3 weeks.

가토 하악골에서 신연 골형성술시 신연속도에 따른 TGF-$\beta$1, IGF-I, bFGF의 발현 (THE EXPRESSION OF TGF-$\beta$1, IGF-I, BFGF IN DISTRACTION OSTEOGENESIS ACCORDING TO DIFFERENT DISTRACTION RATES IN RABBIT'S MANDIBLE)

  • 신선아;지유진;송현철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권3호
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    • pp.205-217
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    • 2005
  • Distraction osteogenesis is a technique of lengthening bone including soft tissue by gradual separation of surgically divided bone surfaces. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the molecular mechanisms governing the formation of new bone in distracted bone segments remain largely unclear. However, such information has significant clinical implications because it may enable targeted therapeutic manipulations designed to accelerate osseous regeneration. The purpose of this study was to evaluate the expression of TGF-$\beta$1, IGF-I and bFGF in distraction osteogenesis according to different distraction rates in a rabbit's mandible. When twenty-four adult rabbits underwent open osteotomy between the premolar and mental foramen, an external bilateral distraction device was applied. Latency was allowed for five days before distraction. Three different distraction rates were 0.7 mm/day (A, n=8), 1.4 mm/day (B, n=8) and 2.4 mm/day (C, n=8). The distraction device was activated with the same distraction rhythms of twice a day until 4.9 mm (A & B group) and 8.4 mm (C group) length gains was achieved. The animals were sacrificed at postoperative 3, 7, 14 and 28 days. The bony specimens were stained with H&E for histologic examination, and RT-PCR analysis was done for the identification of the expression of TGF-$\beta$1, IGF-I and bFGF. The results obtained from this study were as follows : The 0.7 mm/day and 1.4 mm/day distraction rate groups were shown to improve regenerative bone formation on radiographic and histologic examination. Also, TGF-$\beta$1, IGF-I and bFGF expression increased in the 0.7 mm/day and 1.4 mm/day distraction rate groups. But the 2.4 mm/day distraction rate group specimen was different with adjacent normal bone and hardly expressed of growth factors. These findings suggest that improved new bone formation in the 0.7 mm/day and 1.4 mm/day distraction rates is associated with enhanced expression of TGF-$\beta$1, IGF-I and bFGF by mechanical tension stress. Additionally, the 0.7 mm/day and 1.4 mm/day distraction rate groups were significantly different from the 2.4 mm/day distraction rate group in the expression of growth factors. According to the above results, it seems possible to apply a distraction rate of up to 1.4 mm/day a day in rabbit's mandible. And further studies are needed to evaluate growth factors of TGF-$\beta$1 and IGF-I, which are excellent in expression.

4세 소아 대퇴골 골육종의 슬관절 보존형 절제 및 재건술 - 증례 보고 - (Knee Joint Sparing Tumor Resection in 4years-Old Patient with Osteosarcoma - A Case Report -)

  • 조완형;조상현;원호현;전대근
    • 대한골관절종양학회지
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    • 제14권2호
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    • pp.157-162
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    • 2008
  • 악성 골종양의 사지 구제술이 보편화 되었으나 슬관절 주위의 골육종환자 중 예상되는 하지부동이 5 cm 이상 되는 경우의 재건 술식의 선택은 아직 논란이 많다. 양측 골단판 중 하나를 희생하는 것이 불가피한 미성숙 소아의 슬관절 주위 악성골종양에서 가장 이상적인 재건술은; 1)인접 골 단판을 손상하지 않고, 2)가동관절을 유지할 수 있으며, 3) 일차술식이 추후 하지 연장술에 방해가 되지 않아야 할 것으로 생각된다. 저자들은 4세 원위 대퇴골 간부 골육종을 분절절제술 후 저온 열처리 자가골 재삽입술로 재건하였다. 술 후 6개월에 대퇴골 과 열처리 자가골 근위부의 불유합, 열처리 자가골의 흡수 및 파괴 와 내고정물의 해리가 발생하여 환자의 근위 대퇴골을 동종골 간단부에 안착시키는 술식을 이용하여 3개월 만에 근위부 골유합을 얻었으며 기능적 결과도 양호하여 보고하고자 한다.

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어군탐지기에 의한 어군량 추정에 관한 기초적 연구 ( 1 ) - 어군량추정이론의 검증실험 - (Studies on Estimation of Fish Abundance Using an Echo Sounder ( 1 ) - Experimental Verification of the Theory for Estimating Fish Density-)

  • 이대재
    • 수산해양기술연구
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    • 제27권1호
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    • pp.1-12
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    • 1991
  • 적분방식에 의한 어군량추정법을 실험적으로 검증하기 위하여, 실험수조에서 50 kHz와 200 kHz의 주파수를 대상으로 모의어군의 분포밀도와 초음파산란강도의 관계를 검토하고, 또 계량어군탐지기의 정도를 개선하기 위한 문제들에 대하여 고찰을 행한 결과를 요약하면 다음과 같다. 1. 어체의 모의표적으로 이용한 steel ball (직영 35mm)의 실측 echo 파형은 이론 echo 파형과 잘 일치하였다. 2. 5 종류의 주파수에 대하여 고등어 (체장 36cm)의 반사주파수특성을 조사한 결과, 측정주파수가 변화함에 따라 어체에 의한 echo 신호의 진폭과 파형이 크게 변동하고 있음을 알 수 있었다. 3. 송수파기의 음속 내에서 5개/m 상(3)와 30개/m 상(3)의 표적 군이 서로 상하로 존재할 때, 상부 표적군의 존재에 의해 하부 표적군의 echo level이 -0.43 dB 감쇠하는, 소위 그늘효과(shadowing effect)가 발생하였다. 4. 동지나해에서 정박 중에 탐지한 고밀도 어군의 echo신호와 그 어군직하의 해저에서 산란된 echo 신호를 상호 연관시켜 분석한 결과, 어군층내에서 발생한 어군감쇠와 다중산란효과가 해저 echo 신호의 변동에 큰 영향을 미치고 있음을 알 수 있었다. 5. 정치망의 원통에 인망한 정어리의 단위체적당에 대한 분포밀도가 36마리/m 상(3)였을 때, 해저기녹이 소실되는 어군감쇠현상과, 어군 echo 신호가 해저까지 신장되는 다중산란현상이 동시에 발생하였다. 6. 50kHz와 200kHz의 주파수에서 표적군의 평균체적산란강도(:dB)와 표적의 분포밀도($\rho$:개/m 상(3))의 간에 다음의 회귀직선식을 얻었다. 50kHz : =-46.2+13.7 Log($\rho$). 200kHz : =-43.9+13.4 Log($\rho$). 7. 표적의 분포밀도가 5, 10, 15, 20, 25, 30 개/m 상(3)였을 때, 적분방식에 의한 추정치는 50kHz에서 2.0, 8.1, 9.9, 14.1, 19.2, 26.7 개/m 상(3)이었고, 200kHz에서는 2.0, 8.0, 9.1, 15.0, 20.1, 24.1 개/m 상(3)이었으며, 단위체적당에 분포하는 표적의 수가 많을수록, 그 추정치의 정도가 높아지는 경향을 나타내었다. 또한, 양주파수에서 분포밀도의 추정치는 실제보다 약 30%정도 과소추정되었다.

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