• Title/Summary/Keyword: SOFT TISSUE

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Operative Treatment of Tibial Plateau Fractures (경골과 골절의 수술적 치료 결과)

  • Shin, Duck-Seop;Seong, Byeong-Yeon;Kim, Dong-Won
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.187-198
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    • 2001
  • Background: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. Materials and Methods: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. Results: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. Conclusion: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

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TREATMENT OF OKC ON RAMUS OF MANDIBLE BY SAGITTAL SPLITTING TECHNIQUE (하악 상행지부에 발생한 치성각화낭의 시상 분할 골절단술을 이용한 치험례)

  • Song, Hyun-Woo;Ryu, Dong-Mok;Kim, Yeo-Gab;Lee, Baek-Soo;Kwon, Young-Dae;Choi, Byung-Jun;Kim, Young-Ran;Yim, Jin-Hyuk;Lee, Jung-Gyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.408-413
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    • 2009
  • Odontogenic keratocyst (OKC) is a epithelial developmental cyst which were first described by Phillipsen in 1956. The frequency of OKC has been reported to vary from 3% to 11% of odontogenic cysts. The most characteristic clinical aspect of OKC is the high frequency of recurrence. The mechanism of recurrence is thought to be related to residues of cyst epithelium and an intrinsic growth potential following excision. And since the lining of the OKC is thin and friable, removal of the cyst in one piece may sometimes be difficult. Complete removal of the cyst lining without leaving behind remnants attached to the soft tissue or bone is necessary to avoid recurrence. Therapeutic approaches vary in different studies from marsupialization and enucleation, which may be combined with adjuvant therapy such as cryotherapy or Carnoy's solution, to marginal or radical resection. The recurrent rate varies from approximately 20% to 62%. And OKC in the angle-ramus region of the mandible had a higher tendency to recur, because of the difficulty in accessing and removing OKC from the ramus. By employing a sagittal splitting of the mandible a good surgical access was provided and cyst could be removed completely. We present an illustrative case of a small, lobulated OKC that involved ramus on mandible, and a review of the contemporary literature.

AN EVALUATION ON THE INDICATIONS OF BIONATOR IN CLASS II DIVISION 1 MALOCCLUSION (II급 1류 부정교합 환자에서 Bionator의 적응증에 관한 연구)

  • Ahn, Sug-joon;Kim, Jong-Tae;Suhr, Cheong-hoon
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.45-54
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    • 1997
  • The purpose of this study was to evaluate the indications of bionator in Class II division 1 malocclusion, The 48 subjects were classified into good result group(group1) and poor result group(group2) in reference to posttreatment molar relation, posttreatment overbite and overjet, posttreatment profile, and relapse. Pretreatment lateral cephalograms were calculated and evaluated by t-test stepwise discriminant analysis. The results were as follows ; 1. In jaw bone relationship, ANB, facial convexity angle, AB to facial plane angle were significantly different between two treatment groups. In denture pattern, L1 to facial plane, L1 to A-Pog, FMIA, and U1 to facial plane were significantly different and m soft tissue profile, protuberance of lower lip and upper lip were significantly different between tw o treatment groups. 2. The results in according to discriminant analysis stated that L1 to facial plane, ANB, FMIA and protuberance of lower lip help prediction of treatment result of bionator. 3. 3 major influential variables were obtained by stepwise discriminant analysis - L1 to facial plane, articular angle and ANB difference. And Fisher discriminant function was made by these three major variables.

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Physical Therapy Session Duration in patients with low Back Pain: Descriptive Research (요통 환자에 대한 물리치료방법의 적용 시간을 중심으로 한 기술적 연구)

  • Kim, Suhn-Yeop;Chae, Jung-Byung;Kwon, Jae-Hoak
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.51-66
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    • 2001
  • Objective: The purpose of study was to compare physical therapy duration in relation tohealth care organization system in patients with low back pain. Subjects: Subjects of this study were 759 patients who are receiving physical therapy at 56 health care organization. Methods: Data were collected by questionnaire that had been completed by patients and physical therapist for two months. Physical therapy procedures consisted of modality application, manual therapy, active therapeutic exercise, and patient education. Physical therapy session duration was investigated for each physical therapy procedure. Data were analyzed in relation to the university hospital, hospital, and clinic. Results: The mean age of subjects was $42.84{\pm}15.46$. There were no significant differences in age among three groups. The number of patients diagnosed with herniated disc were 244(32.15%) and with mechanical low back pain was 187(24.64%). The mean treatment duration per day was 53.22 minutes, and the longest treatment duration was 61.28 minutes at the university hospitals (p<0.001). The mean modality application duration was 42.17 minutes, and the longest application duration was 46.26 minutes at the university hospitals (p<0.001). The mean duration for manual therapy was 5.11 minutes, and the longest treatment duration was 5.97 minutes at clinics. The mean duration for active therapeutic exercise was 4.16 minutes. It was 7.60 minutes at the university hospitals, and 2.48 minutes at clinics. There was a significant difference in active therapeutic exercise duration between university hospitals and clinics(p<0.001). For modalities, hot packs(89.33%) and interferential current therapy(60.87%) were mostly applied. For manual therapy, Soft tissue mobilization(32.93%) and manipulation(14.10%) were mostly applied. In general, treatment application duration was longer at University hospital (p<0.05). For therapeutic exercise, exercise without equipment(18.84%) and muscle strengthening (16.73%) were mostly performed. The longest treatment duration for therapeutic exercise was 7.60 minutes at the university hospital(p<0.05). Conclusion: physical therapy session duration for low back pain was 53.22 minutes. Modality application constitutes 79%, manual therapy 10%, active therapeutic exercise 8% of total treatment duration. It is concluded that patients do not participate actively in treatment procedures.

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A Case of Cryptococcosis involving Lung and CNS without Underlying Disease (폐와 중추신경계를 침범한 효모균증(Cryptococcosis) 1예)

  • Lee, Min-Su;Park, Sang-Seon;Koh, Young-Il;Jang, An-Soo;Lim, Sung-Chul;Yang, Ju-Yeoul;Park, Hyung-Kwan;Na, Hyun-Joo;Kim, Young-Chul;Choi, In-Seon;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.618-623
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    • 1995
  • Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to $6{\mu}m$ in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other environmental areas, especially those contaminated by pigeon droppings. Humans and animals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum KOH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.

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A Case of Primary Pulmonary Sarcoma with Morphologic Features of Malignant Fibrous Histiocytoma (악성 섬유조직구종 형태를 가진 원발성 폐육종 1예)

  • Lee, Youn-Jeong;Hur, Won-Haing;Lo, Dae-Keun;Kim, Seung-Joon;Lee, Sook-Young;Kim, Young-Kyoon;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Park, Gyeong-Sin;Lee, Kyo-Young
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.186-191
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    • 2002
  • A malignant fibrous histiocytoma is a malignant soft tissue neoplasm that occurs frequently in the metaphyseal ends of the long bones of adults. The lung is a common site for metastasis but it is a rare site for a primary malignant fibrous histiocytoma. Here we report a case of a primary malignant fibrous histiocytoma of the lung. The patient was a 53-year-old man who presented with a moderate amount of a left pleural effusion and an illdefined mass in the left lower lobe on a chest radiograph and a local invasion to the left 10th and 11th rib on chest CT. Under the strong suspicion of lung cancer with a pleural invasion, a serial diagnostic thoracentesis was performed. The cytologic examination of the pleural effusion revealed no malignant cells. Consequently, a thoracoscopic pleural biopsy was performed. The histological examination revealed slender spindle cells and scattered epitheloid cells arranged in a vague storiform or a whirling pattern. Immunohistochemicaily, the tumor cells tested positive for vimentin and negative for cytokeratin, desmin, CD 34 and PAS. These features were consistent with a malignant fibrous histiocytoma. This case is an unusual addition to the small number of published reports on a primary malignant fibrous histiocytoma of the lung.

Study on the stress distribution depending on the bone type and implant abutment connection by finite element analysis (지대주 연결 형태와 골질에 따른 저작압이 임프란트 주위골내 응력분포에 미치는 영향)

  • Park, Hyun-Soo;Lim, Sung-Bin;Chung, Chin-Hyung;Hong, Ki-Seok
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.531-554
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    • 2006
  • Oral implants must fulfill certain criteria arising from special demands of function, which include biocompatibility, adequate mechanical strength, optimum soft and hard tissue integration, and transmission of functional forces to bone within physiological limits. And one of the critical elements influencing the long-term uncompromise functioning of oral implants is load distribution at the implant- bone interface, Factors that affect the load transfer at the bone-implant interface include the type of loading, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface. To understand the biomechanical behavior of dental implants, validation of stress and strain measurements is required. The finite element analysis (FEA) has been applied to the dental implant field to predict stress distribution patterns in the implant-bone interface by comparison of various implant designs. This method offers the advantage of solving complex structural problems by dividing them into smaller and simpler interrelated sections by using mathematical techniques. The purpose of this study was to evaluate the stresses induced around the implants in bone using FEA, A 3D FEA computer software (SOLIDWORKS 2004, DASSO SYSTEM, France) was used for the analysis of clinical simulations. Two types (external and internal) of implants of 4.1 mm diameter, 12.0 mm length were buried in 4 types of bone modeled. Vertical and oblique forces of lOON were applied on the center of the abutment, and the values of von Mises equivalent stress at the implant-bone interface were computed. The results showed that von Mises stresses at the marginal. bone were higher under oblique load than under vertical load, and the stresses were higher at the lingual marginal bone than at the buccal marginal bone under oblique load. Under vertical and oblique load, the stress in type I, II, III bone was found to be the highest at the marginal bone and the lowest at the bone around apical portions of implant. Higher stresses occurred at the top of the crestal region and lower stresses occurred near the tip of the implant with greater thickness of the cortical shell while high stresses surrounded the fixture apex for type N. The stresses in the crestal region were higher in Model 2 than in Model 1, the stresses near the tip of the implant were higher in Model 1 than Model 2, and Model 2 showed more effective stress distribution than Model.

Socket preservation using deproteinized horse-derived bone mineral

  • Park, Jang-Yeol;Koo, Ki-Tae;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.40 no.5
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    • pp.227-231
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    • 2010
  • Purpose: The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. Methods: The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. Results: The surgical sites healed uneventfully. The mean ridge width was $7.75{\pm}2.75\;mm$ at baseline and $7.00{\pm}2.45\;mm$ at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was $7.5{\pm}5.20\;mm$, and at 6 months, $3.50{\pm}0.58\;mm$. The mean palatal crest height at baseline was $7.75{\pm}3.10\;mm$, and at 6 months, $5.00{\pm}0.82\;mm$. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was $9.88{\pm}2.90%$, the amount of graft particles was $42.62{\pm}6.57%$, and the amount of soft tissue was $47.50{\pm}9.28%$. Conclusions: Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities.

LOCAL ANESTHESIA IN CHILDREN USING JET INJECTION INSTRUMENT (분사식 주사기를 이용한 소아환자의 국소마취)

  • Lee, Jae-Chun;Kim, Dae-Eop;Lee, Kwang-Hee;Kim, Seong-Hyeong;Yang, Kye-Sik
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.633-637
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    • 2001
  • Local anesthesia procedure in pediatric dentistry using needle-tipped syringes is stressful and painful for the child patients The Syrijet Mark II (Mizzy Inc. USA) is a jet injection instrument, which uses high pressure to propel fluids into soft tissue without the use of a hollow neeldle, so it seems to be able to reduce the injection phobia of the child patients. The authors compared the Syrijet with the conventional syringe by assessing the pain level after local anesthetic procedures using CAS(color analogue scale) which was developed from VAS(visual analogue scale). The result showed that the pain was reduced by the use of syrijet. The advantages of syrijet were no use of neeldes, the reuse of the anesthetic cartridge, and the safety to nerves and vessels. The disadvantages were the large size, the high price, and the need of skill to use.

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ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA (주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고)

  • Kang, Eun-Joo;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.133-140
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    • 2013
  • Cyclic neutropenia is a hematologic disorder characterized by a marked decrease in the number of circulating neutrophils occurring at regular intervals and after this period, the level of neutrophils usually recovers to a normal range. The clinical symptoms of cyclic neutropenia include fever, malaise, headaches and oral findings associated with painful soft tissue ulceration where lips, tongue and gingiva are typically involved. A 4 year 1 month old boy was presented to the hospital. His chief complaint was mobility of his teeth and swollen gums. The patient had suffered from cyclic neutropenia. Clinical examination revealed evident decay on all primary teeth except for the mandibular anterior teeth and localized alveolar bone loss around mandibullar right and left first primary molars which have mobility was notable. The patient was diagnosed with multiple dental caries, gingivitis and localized periodontitis associated with cyclic neutropenia and treated based on it. The dental treatment, including regular tooth care and appropriate treatment of dental caries or gingivitis, is essential for patients suffering cyclic neutropenia. Especially, proper care at an early stage is needed for young patients to minimize the unwanted consequences for permanent teeth development.