• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.199-203
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• 1997

Chordoma is an uncommon neoplasm that accounts for approximately 1% to 4% of all primary bone neoplasms and thought to originate from remnants of the fetal notochordal elements. It usually occurs in adults and has a predilection for the sacrococcygeal and spheno-occipital areas. Chondroid chordoma, first described by Heffelfinger et al, is a rare variant of chordoma; it contains both chordomatous and chondromatous features, and has a considerably better prognosis than either chordoma or chondrosarcoma. The cytologic findings of fine needle aspiration of sacrococcygeal chondroid chordoma in a 57-year-old man are presented. Aspiration cytology showed many sheets and cords of neoplastic cells in a thick amorphous blue-purple mucinous background. The cells had small too medium sized round nuclei with coarse granular chromatin and abundant eosinophilic or bubbly cytoplasm. Some cells had pleomorphic and hyperchomatic nuclei with prominent nucleoli. Cytologic findings were compared to histologic findings. Histologically, areas of chondroid differentiation were noted which were absent in the cytologic smear. Immunohistochemically, both the chondroid and chordoid areas had an epithelial phenotype and stained for cytokeratin, epithelial membrane antigen and S-100 protein. This is the first case of cytologic findings of chondroid chordoma to our knowledge in literature.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.37-45
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• 2010

Objective : Craniovertebral junction (CVJ) consists of the occipital bone that surrounds the foramen magnum, the atlas and the axis vertebrae. The mortality and morbidity is high for irreducible CVJ lesion with cervico-medullary compression. In a clinical retrospective study, the authors reviewed clinical and radiographic results of occipitocervical fusion using a various methods in 32 patients with CVJ instability. Methods : Thirty-two CVJ lesions (18 male and 14 female) were treated in our department for 12 years. Instability resulted from trauma (14 cases), rheumatoid arthritis (8 cases), assimilation of atlas (4 cases), tumor (2 cases), basilar invagination (2 cases) and miscellaneous (2 cases). Thirty-two patients were internally fixed with 7 anterior and posterior decompression with occipitocervical fusion, 15 posterior decompression and occipitocervical fusion with wire-rod, 5 C1-2 transarticular screw fixation, and 5 C1 lateral mass-C2 transpedicular screw. Outcome (mean follow-up period, 38 months) was based on clinical and radiographic review. The clinical outcome was assessed by Japanese Orthopedic Association (JOA) score. Results : Nine neurologically intact patients remained same after surgery. Among 23 patients with cervical myelopathy, clinical improvement was noted in 18 cases (78.3%). One patient died 2 months after the surgery because of pneumonia and sepsis. Fusion was achieved in 27 patients (93%) at last follow-up. No patient developed evidence of new, recurrent, or progressive instability. Conclusion : The authors conclude that early occipitocervical fusion to be recommended in case of reducible CVJ lesion and the appropriate decompression and occipitocervical fusion are recommended in case of irreducible craniovertebral junction lesion.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.579-583
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• 2010

An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.827-830
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• 2010

Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.11-16
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• 2015

Background: Source material used to fill calvarial defects includes autologous bones and synthetic alternatives. While autologous bone is preferable to synthetic material, autologous reconstruction is not always feasible due to defect size, unacceptable donor-site morbidity, and other issues. Today, advanced three-dimensional (3D) printing techniques allow for fabrication of titanium implants customized to the exact need of individual patients with calvarial defects. In this report, we present three cases of calvarial reconstructions using 3D-printed porous titanium implants. Methods: From 2013 through 2014, three calvarial defects were repaired using custom-made 3D porous titanium implants. The defects were due either to traumatic subdural hematoma or to meningioma and were located in parieto-occipital, fronto-temporo-parietal, and parieto-temporal areas. The implants were prepared using individual 3D computed tomography (CT) data, Mimics software, and an electron beam melting machine. For each patient, several designs of the implant were evaluated against 3D-printed skull models. All three cases had a custom-made 3D porous titanium implant laid on the defect and rigid fixation was done with 8 mm screws. Results: The custom-made 3D implants fit each patient's skull defect precisely without any dead space. The operative site healed without any specific complications. Postoperative CTs revealed the implants to be in correct position. Conclusion: An autologous graft is not a feasible option in the reconstruction of large calvarial defects. Ideally, synthetic materials for calvarial reconstruction should be easily applicable, durable, and strong. In these aspects, a 3D titanium implant can be an optimal source material in calvarial reconstruction.

• Toxicological Research
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• v.26 no.3
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• pp.209-216
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• 2010

Limb bud (LB) and central nerve system (CNS) cells were prepared from 12.5 day old pregnant female Crj:CD (SD) rats and treated with olaquindox and vitamin A. Cytotoxicity and inhibition on differentiation were measured in each cell. Three doses of olaquindox (4, 21 and 100 mgkg), and 0.2 and 75 mg/kg of vitamin A were administered to pregnant rat for 11 days from $6^{th}$ to $16^{th}$ of pregnancy. $IC_{50}$ values of olaquindox for proliferation and differentiation in CNS cell were 22.74 and $28.32\;{\mu}g/ml$ and 79.34 and $23.29\;{\mu}g/ml$ in LB cell and those values of vitamin A were 8.13 and $5.94\;{\mu}g/ml$ in CNS cell and 0.81 and $0.05\;{\mu}g/ml$ in LB cell, respectively. Mean body weights of pregnant rats were decreased at high dose of olaquindox (110 mg/kg) but relative ovary weight, number of corpus lutea, and number of implantation were not changed. Resorption and dead fetus were increased at high dose of olaquindox, and relative ovary weight, the number of corpus lutea and implantation, and sex ratio of male to female were not significantly changed in all dose of olaquindox. Mean fetal and placenta weights were significantly (p < 0.01) decreased in rats of high group. Seven fetuses out of 103 showed external anomaly like bent tail, and 10 out of 114 fetuses showed visceral anomalies at high group. The ossification of sternebrae and metacarpals were significantly (p < 0.01) increased by low and middle dose of olaquindox but it was significantly (p < 0.01) prohibited by high dose of olaquindox. In rats treated with vitamin A, the resorption and dead fetus were increased by high dose. Mean fetal weights were significantly (p < 0.01) increased by low dose but significantly (p < 0.01) decreased by high dose. Thirty four fetuses out of 52 showed external anomaly; bent tail (1), cranioarchschisis (14), exencephaly (14), dome shaped head (22), anophthalmia (15), brcahynathia (10) and others (19). Forty five fetuses out of 52 showed soft tissue anomaly; cleft palate (42/52) and anophthalmia (22/52) by high dose of vitamin A. Sixty one fetuses out of 61 (85.2%) showed skull anomaly; defect of frontal, partial and occipital bone (21/61), defect of palatine bone (52/61) and others (50/61). In summary, we support that vitamin A is strong teratogen based on our micromass and in vivo data, and olaquindox has a weak teratogenic potential in LB cell but not in CNS cell. We provide the in vivo evidence that a high dose of olaquindox could have weak embryotoxic potential in rats.

• Archives of Reconstructive Microsurgery
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• v.13 no.2
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• pp.93-100
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• 2004

This study was designed to investigate the optimal period of pedicles implantation in the prefabricated periosteofascial flap with a vascular tissue transfer. The flap prefabrication was prepared with a transposition of left occipital pedicles on the calvarial fascia of male Sprague-Dawley rats. Thirty flaps were divided into five groups of six flaps, including control group (group I) of the conventional periosteofascial flap based on the lateral border of the rat calvarium. The prefabricated flap was elevated as an $1{\times}1cm$ sized island flap based on the implanted pedicle at 1, 2, 3, and 4 weeks after the pedicles transfer in groups II, III, IV, and V, respectively. After the completion of creating a critical-sized calvarial defect and implanting with hydroxyapatite granules, the flap was sutured back for covering the defect and kept isolated from surrounding tissues. Six weeks after flap repositioning, the osseous changes of the defect were examined with simple radiographic findings, radiodensitometric analysis, and histological studies. By simple radiographic findings, specimens of the control, groups IV and V showed homogeneous radioopacity within the defect. But in groups II and III, focal radiolucency was observed in the defect. In the radiodensitometric analysis, the control group and the group V showed significant increased radiodensites statistically. Histologically, the implanted hydroxyapatite was absorbed partly in the defect in groups II, III, and IV. In the defects of the control group and the group V, the implanted hydroxyapatite was kept in its volume and the deposition of the bone cells was observed sparsely. In conclusion, the prefabricated periosteofascial flap can be created with a vascular tissue transfer and the pedicles should be implanted at least for 4 weeks to bring out positive osseous changes in the calvarial defect.

• The korean journal of orthodontics
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• v.38 no.6
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• pp.427-436
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• 2008

Objective: The purpose of this study is to compare landmark position between cephalometric radiography and midsagittal plane projected images from 3 dimensional (3D) CT. Methods: Cephalometric radiographs and CT scans were taken from 20 patients for treatment of mandibular prognathism. After selection of land-marks, CT images were projected to the midsagittal plane and magnified to 110% according to the magnifying power of radiographs. These 2 images were superimposed with frontal and occipital bone. Common coordinate system was established on the base of FH plane. The coordinate value of each landmark was compared by paired t test and mean and standard deviation of difference was calculated. Results: The difference was from $-0.14{\pm}0.65$ to $-2.12{\pm}2.89\;mm$ in X axis, from $0.34{\pm}0.78$ to $-2.36{\pm}2.55\;mm$ ($6.79{\pm}3.04\;mm$) in Y axis. There was no significant difference only 9 in X axis, and 7 in Y axis out of 20 landmarks. This might be caused by error from the difference of head positioning, by masking the subtle end structures, identification error from the superimposition and error from the different definition.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.2
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• pp.161-164
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• 2002

In recent, distraction osteogenesis has been used to correct skeletal malformations and discrepancies in the craniofacial area. It also seems to be considered as an alternative in the treatment of severe midfacial hypoplasia. There are some types of distractors for midfacial distraction such as subcutaneous distractors and rigid external distractors. We used a rigid external distractor for correction (RED) of craniofacial hypoplasia. Seven patients underwent a midfacial distraction osteogenesis with a rigid external distractor between April 2000 and July 2001. Three patients suffered from Apert's syndrome, three patients from Crouzon's syndrome, and one patient suffered from midfacial hypoplasia due to midfacial radiotheraphy during childhood. On average, the mean distance of distraction was 19.8mm ($10{\sim}25mm$) and the distraction lasted for 24 days. The patients showed no severe complications like infections, optic disturbance, or wrong distraction vectors. One patient complained pain on the site of the occipital fixation of the distractor. In one patient who underwent subtotal craniectomy 3 months before Le Fort III distraction, the distractor was dislocated as the cranial bone was too weak to support the distractor. This report reveals that the application of rigid external distractor and transfacial pull results in an exact control of the distraction vectors and an excellent correction of midfacial hypoplasia without any severe complications.

• Journal of Acupuncture Research
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• v.17 no.3
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• pp.125-139
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• 2000

Study of the fourteen meridians that include name of P'ung(風) point. The results were summarized as follows. 1. Pyongp'ung(秉風) is located middle of the supraspinatous fossa(Small intestine Meridian, 手太陽小腸經). we can cute the local area disease and also use to cure the pathway of the Arm greater yang small intestine which is attacked by P'ung(風) disease. 2. Yep'ung(翳風) is located behind the lobule of the auricle, in the depression between the mastoid process and the mandible(Triple Energizer Meridian, 手少陽三焦經). we can cure the local area disease especially hyper yang disease and also use to cure the pathway of the Arm lesser yang triple energizer which is attacked by P'ung(風) and Yo'l(熱) disease. 3. P'ungmun(風門) is located 1.5 chon beside the lower end of the spine of the second thoracic vertebra(Bladder Meridian, 足太陽膀胱經). we can cure the local area disease and also use to cure the pathway of the Leg greater yang bladder which is attacked by P'ung(風) disease. 4. P'ungbu(風府) is located 1 chon above the middle of natural line of the hair at the back of the head, in the depression below the occiptal protuberance(Governor meridian, 督脈). It connects (Liver meridian, 足厥陰肝經) and Yin Link Vessel(陽維脈). we can cure the rigidity and pain in head and nape which is related Yin Link Vessel(陽維脈). 5. P'ungshi(風市) is located on the lateral part of the thigh, 7 hon above the patella(From the greater trochanter to the knee joint is 19 chon, Gallbladder Meridian (足少陽膽經). we can cure the local area disease(leg, knee, etc). 6. P'ungji(風池) is located Below the occipital bone, in the depression on the outer part of the trapezius muscle(Gallbladder Meridian, 足少陽膽經) on a level with P'ungbu(風府) (Governor vessel, 督脈). we can cure the local area disease and also use to cure the pathway of the Leg lesser yang gall bladder which is attacked by P'ung(風) disease.