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Retrospective study on survival and complication rates of posterior single implant according to the implant diameters, lengths and position (구치부 단일 임플란트의 직경과 길이, 식립 위치에 따른 생존율 및 합병증의 발생률에 대한 후향적 연구)

  • Soo-Young Hong;Seon-Ki Lee;Jin-Han Lee;Jae-In Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.101-112
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    • 2023
  • Purpose. This retrospective study was to investigate the survival and complication rates of posterior single implant according to the implant diameters, lengths and position. Materials and methods. Patients who had been restored single implant prosthesis in the posterior area by the three prosthodontists in the department of prosthodontics, Daejeon dental hospital of Wonkwang university, in the period from February 2014 to May 2018 were selected for the study. A total of 505 patients with 697 implants were observed. The survival and complications of implants were investigated using electronic medical records and radiographs. Fixture diameters, lengths, position, patient's sex and age were assessed as possible factor affecting the survival and complications of implants. Results. 3-year cumulative survival rates of posterior single implants were 98.5% and 5-year cumulative survival rates were 94.4%. 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm (97.0%) than implants with diameter ≤ 4.0 mm (89.5%), and in females (98.8%) than males (92.4%). There were statistically significant differences (P < .05). The mechanical complication rate was 20.1% and the biological complication rate was 4.7%. Complications occurred in order of abutment screw loosening (7.5%), decementation (6.3%), proximal contact loss (3.7%) and so on. Abutment screw loosening occurred more frequently in the lower molar region (10.5%), in males (9.5%) than females (5.1%), and in patients aged < 65 years (9.4%) than patients aged ≥ 65 years (5.1%). There were statistically significant differences (P < .05). Conclusion. The 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm than implants with diameter ≤ 4.0 mm and in females than males. Abutment screw loosening which was the most commonly occurring complication occurred more frequently in the lower molar region, in males than females, and in patients aged < 65 years than patients aged ≥ 65 years. There were statistically significant differences.

Cryopreservation of Bovine IVM/IVF/IVC Hatched Blastocysts (체외생산된 소 완전탈출 배반포기배의 동결보존)

  • Lee, K.S.;Kim, E.Y.;Yi, B.K.;Nam, H.K.;Yoon, S.H.;Park, S.P.;Lim, J.H.
    • Korean Journal of Animal Reproduction
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    • v.23 no.2
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    • pp.141-148
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    • 1999
  • This study was to test whether the viability of bovine hatched blastocysts (HBs) can be maintained after vitrification and thawing. The HBs were produced in vitro at Day 9 and Day 10 after IVF, and they were classified to small (S-HBs; ø$\leq$300 ${\mu}{\textrm}{m}$) and large(L-HBs; ø>300 ${\mu}{\textrm}{m}$) on the basis of embryo diameter using eyepiece micrometer. As freezing solution, we used EFS35 which consisted of 35% ethylene glycol (EG), 18% ficoll, 0.3 M sucrose and 10% FBS added in mDPBS. Vitrification was taken by two-step method, the HBs were equilibrated in 10% EG for 5 minutes and then shortly exposed in EFS35 and plunged into L$N_2$for 30~45 sec. After thawing, the survival rates were assessed by the re-expansion of the blastocoel during 2 h and 16 h of culture. The results obtained in these experiments were summarized as follows; 1) When the blastocysts(40.8%) recovered at Day 8 after IVF were further cultured for 24 h(Day 9 after IVF) and 48 h(Day 10 after IVF), the rates of HBs were 20.5% and 6.7%, respectively. Also, the total cell number of HBs on Day 9 was significantly higher than that of HBs on Day 10 (p<0.01). 2) When the effects of freezing solution to the survival of Day 9 L-HBs were examined, the rate of vitrified group (75.7%) was significantly lower than 100% of control and exposed group(p<0.05). 3) When the survival rates of vitrified HBs according to size and developmental age were examined, the data of L-HBs (75.5%) and S-HBs(63.6%) on Day 9 were slightly higher than those of L-HBs(64.3%) and S-HBs(60.7%) on Day 10. 4) Also, when the in vitro survival of Day 9 HBs was evaluated under different culture condition after thawing, the result in culture medium only (79.3%) was significantly higher than 43.2% in co-culture group (p<0.05). These results demonstrated that bovine HBs can be successfully cryopreserved by two-step vitrification method using EFS35.

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A Study on the Gwanbang forest of Ganghwa in the Joseon Dynasty Period (조선시대 강화지역 관방림(關防林)의 특성 연구)

  • Shim, Sun-Hui;Lee Jae-Yong;Kim, Choong-Sik
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.1
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    • pp.35-46
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    • 2023
  • This study investigated and analyzed ancient records on the type, planting background, and construction process of Gwanbang forest(關防林) planned for military defense during the Joseon Dynasty to find out the purpose, location, and planting species of Gwanbang forest. The research results were as follows. During the Joseon Dynasty, Gwanbang forests were created around various government facilities(關防施設), such as Eupseong(邑城), major government offices, camps, and fortifications, for the purpose of defending against enemies. Gwanbang forest includes Yeongaeglim(嶺阨林), which was created on the crest of a strategically important hill, and Military Forest created for military purposes. Most of the spirit forest was designated as Geumsan(禁山) and protected and managed, and the Gwanbang forest was created for various purposes such as shielding, flood damage and river bank erosion prevention as well as external defense. In addition, in order to continuously and efficiently produce wood, which is a material for ships, buildings, and agricultural tools, in most cases, large areas were created as mixed forests. As for the species constituting the Gwanbang forest, there are records of tangerine tree, which is effective for defense because it has thorns, and deciduous broad-leaved trees such as zelkova, elm, willow, david hemiptelea, and oak appear. In the case of Ganghwa island, which served as the defense of the capital and the royal family during the Joseon Dynasty, several records have confirmed that a forest densely planted with trifoliate orange was created for the purpose of Gwanbang forest to reinforce the defense of the outer fortress. Based on historical research in the literature, assuming that the natural monument 'Gapgotri tangerine tree in Ganghwa Island' was planted in the 30th year of King Sukjong(1704), the first record of planting trifoliate orange in Ganghwa Island, the maximum age is estimated to be more than 319 years.

Marginal bone loss between internal- and external- abutment connection type implants placed in the first molar area (제1대구치 위치에 식립된 단일 임플란트의 지대주 연결 유형에 따른 임플란트 주위골 흡수)

  • Seok-Hyun Lee;Eun-Woo Lee;Ha-Na Jung;Ok-Su Kim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.1
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    • pp.32-44
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    • 2023
  • Purpose: The purpose of this study was to investigate the effect of implant connection type on marginal bone loss (MBL) and to analyze the factors that affect MBL. This study focuses on single implants planted in the upper and lower first molar area. Materials and Methods: A total of 87 implants from 68 patients were tracked for a period over 5 years. There were 57 external connection type (EC) implants and 30 internal connection type (IC) implants in 38 males and 30 females. The MBL and EA were measured from intraoral radiograph images taken after 5 years at most. Results: Significant difference in MBL between EC and IC type was observed in patients without GBR or diabetes. Patients without GBR exhibited an MBL of -0.065 ± 0.859 mm in EC type and -0.627 ± 0.639 mm in IC type (P = 0.025). Using multiple regression analysis, a statistically significant negative correlation was observed between MBL and conditions including implant-abutment connection type (β = -0.303), diabetes (β = -0.113), emergence angle > 30° (β = -0.234), and age (β = -0.776). Conclusion: Within this results, IC type implants had less MBL than EC type, and implant prosthesis with emergence angle over 30° showed greater MBL. To minimize the MBL of the implant and ensure implant stability, careful consideration should be given to the EA of implant prosthesis and its connection type.

Optimization of One-Step Dilution Method of Vitrified Bovine IVM/IVF/IVC Blastocysts (초자화 동결된 체외생산 소 배반포기배의 1 단계 융해 방법의 적정화)

  • Lee, K.S.;Kim, E.Y.;Nam, H.K.;Park, S.Y.;Park, E.M.;Yoon, S.H.;Park, S.P.;Chung, K.S.;Lim, J.H.
    • Korean Journal of Animal Reproduction
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    • v.24 no.1
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    • pp.89-95
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    • 2000
  • This study was to establish an effective dilution technique in a vitrification of bovine blastocysts for the field trial. For vitrification, blastocysts were exposed in glycerol (G) and ethylene glycol (EG) mixture in m-DPBS supplemented with 10% FBS. Blastocysts were first exposed to 10% (v/v) G for 5 min, and subsequently were transferred to 10% G plus 20% EG (v/v) for 5 min. Finally, embryos were transferred to 25% G plus 25% EG (v/v) for 30 see and were placed in nitrogen vapor for 3 min, and then were plunged into L$N_2$. At thawing, the straw containing blastocysts was placed in air for 10 sec, and then plunged into a water bath at $25^{\circ}C$ until all ice had disappeared. They were placed in $25^{\circ}C$ and 36$^{\circ}C$ water according to treatment group for different time. Also, in vitro survival was assessed by the re-expansion and hatched rates at 24 hand 48 h postwarming, respectively. The results obtained in these experiments were summarized as follows; 1) In the survival rates of vitrified bovine blastocysts according to different dilution time at thawing, the data of 1 min group (86.6, 56.6%) were higher than those of other treatment groups (2 min; 93.5, 35.4%, 2.5 min; 76.9, 30.7%, 3 min; 88.8, 36.1% and 3.5 min; 83.7, 8.1%). 2) When the in vitro survival of vitrified groups according to different developmental stage was examined at 48 h after thawing using 1 min dilution method, the hatching rates of fast developed embryos (expanded blastocyst: 81.3%: early hatching blastocyst: 86.2%) were higher than that of delayed developed one (early blastocyst: 46.6%). 3) In addition, when the in vitro survival of vitrified groups according to different embryo age was compared, the hatched rates at 48 h after thawing of Day 7 (66.6%) and Day 8 embryos (60.0%) were significantly higher than that of Day 9 embryos (22.7%) (P<0.05). These results demonstrate that vitrified bovine IVM/IVF/IVC blastocysts can be successfully survived in vitro using one-step dilution (1 min) method.

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Long-Term Results of Surgical Treatment for the Idiopathic Clubfoot (선천성 만곡족의 장기 수술적 치료 결과)

  • Kim, Hui Taek;Kim, In Hee;Cho, Yoon Je;Ahn, Tae Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.547-556
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    • 2019
  • Purpose: This study evaluated the results of surgical treatment for residual or recurrent deformity after the conservative treatment of idiopathic clubfoot. Materials and Methods: Fifty-one cases (32 patients), who were followed up to skeletal maturity, were reviewed retrospectively. The mean age at the last follow-up was 18.7 years. The surgical options included selective or comprehensive soft tissue release, tendon lengthening and transfer, and various types of osteotomy. The radiology measurements included the talocalcaneal angle and talo-first metatarsal angle in the anteroposterior (AP) view, and the talocalcaneal angle and calcaneal pitch in the lateral view. The radiology measurements were compared with the normal values for adults. The clinical evaluations were made using the ankle-hindfoot score and the midfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS): excellent (>85), good (71-85), pair (56-70), and poor (<56). Results: At the last follow-up, the percentages of the 51 cases, whose parameter values fell within the normal ranges were as follows: in the AP view, 41.2% (talocalcaneal angle); and 90.2% (talo-first metatarsal angle). In the lateral view, the percentage was 84.3% (talocalcaneal angle). For the calcaneal pitch, the percentages were 61%. The mean AOFAS score was 88.1±10.7 on the ankle-hindfoot score and 86.7±11.5 on the midfoot score. Conclusion: The long-term outcome of patients with idiopathic clubfoot, who underwent surgical treatment after conservative treatment, was found to be 43%-90% of the normal range of radiographic indices. Clinically, the mean AOFAS scores were "excellent". Therefore, a satisfactory result can be obtained by analyzing the elements of deformity more accurately and then using the selective operation method, even if the non-surgical correction method fails.

Surgical Treatment of Osteoporotic Vertebral Compression Fractures at Thoraco-Lumbar Levels: Only Pedicle Screw Constructs with Polymethylmethacrylate Augmentation (흉요추부 골다공증성 척추 압박 골절의 수술적 치료: 골시멘트 보강술을 이용한 척추경 나사 고정)

  • Jun, Deuk Soo;Baik, Jong-Min;Park, Ji Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.327-335
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    • 2019
  • Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm2. The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

Does a Preoperative Temporary Discontinuation of Antiplatelet Medication before Surgery Increase the Allogenic Transfusion Rate and Blood Loss after Total Knee Arthroplasty? (항 혈소판 제제의 술 전, 일시적 중단은 슬관절 전치환술 이후의 실혈량 및 동종수혈의 필요성을 증가시키지 않는가?)

  • Cho, Myung-Rae;Lee, Young Sik;Kwon, Jae Bum;Lee, Jae Hyuk;Choi, Won-Kee
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.127-132
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    • 2019
  • Purpose: The aim of this study was to determine if preoperative temporary discontinuation of antiplatelet medication (aspirin, clopidogrel, or cilostazol) is a safe procedure that does not increase early postoperative bleeding and allogenic blood transfusion after a total knee arthroplasty. Materials and Methods: A retrospective analysis was conducted among consecutive patients who underwent navigation assisted primary total knee arthroplasty performed by a single surgeon, from January 2013 to December 2016. A total of 369 patients enrolled in this study were divided into two groups, 271 patients with no history of antiplatelet therapy and 98 patients who underwent 7 days of temporary withdrawal of antiplatelet therapy. Comparative analysis between the two groups, on the variation of hemoglobin and hematocrit during the first and second postoperative days, was conducted to determine the amount of early postoperative bleeding and the frequency of allogenic blood transfusion during hospitalization. Results: The variation of hemoglobin, hematocrit during the first and second postoperative days and the frequency of allogenic blood transfusion between no history of antiplatelet medication and discontinuation antiplatelet medication before 7 days from surgery were similar in both groups. Of the 369 patients, 149 patients received a blood transfusion during their hospitalization. Compared to patients who did not receive a blood transfusion, those who did received blood transfusion were significantly older in age, smaller in height, lighter in weight, and showed significantly lower preoperative hemoglobin and hematocrit values. No statistically significant differences in sex, preoperative American Society of Anesthesiologists scores, and the history of antiplatelet medication until 7 days prior to surgery were observed between the two groups according to blood transfusion. Conclusion: Compared to patients with no history of antiplatelet medication, the temporary discontinuation of antiplatelet medication 7 days prior to surgery in patients undergoing antiplatelet medication did not increase the amount of postoperative bleeding or the need for allogenic blood transfusion.

Treatment of Pyogenic Arthritis of the Knee Using Drainage Tube Insertion in the Posterior Compartment through the Posterior Transeptal Portal after an Arthroscopic Synovectomy (관절경적 활액막 절제술 후 후격막 삽입구를 통한 배액관의 후방 거치를 이용한 무릎의 화농성 관절염 치료)

  • Kim, Tae Ho;Yu, Chang Eon;Shin, Chung Shik
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.269-275
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    • 2019
  • Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.

Value of Tibiotalocalcaneal Arthrodesis Using Retrograde Intramedullary Nailing in Severe Hindfoot Deformity and Arthritis (심한 후족부 변형 및 경거종골간 관절염에서 골수강내 금속정을 이용한 경거종골 관절 유합술의 가치)

  • Park, Jae-Gu;Chung, Hyung-Jin;Bae, Su-Young;Lee, Jung-Hwan;Kim, Hwi-Young;Lee, Jun Seok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.133-140
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    • 2019
  • Purpose: This study examined the radiological and clinical outcomes of tibiotalocacalcaneal arthrodesis using retrograde intramedullary nailing in a severe hindfoot deformity and ankle/subtalar arthritis. Materials and Methods: A total of 22 patients (22 cases) with a severe hindfoot deformity and arthritis underwent tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. The average age was 57.4 years (22-82 years) and the mean follow-up was 29.6 months (12-74 months). The radiological outcomes included an assessment of the preoperative and postoperative coronal ankle alignment, hindfoot alignment, sagittal alignment, and postoperative union time. The clinical outcomes were evaluated using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and postoperative complications. The results were analyzed statistically by dividing the patients into two groups based on a 10° angle of deformity. Results: Regarding the preoperative coronal ankle alignment, 14 patients had a mean varus deformity of 17.8°±14.5° and six had a mean valgus deformity of 8.1°±6.6°. Postoperatively, a satisfactory postoperative coronal ankle alignment of less than 5° was obtained in all patients. Regarding the preoperative hindfoot alignment, 12 patients showed a mean varus deformity of 15.2°±10.5° and six had a mean valgus deformity of 8.1°±4.2°. In total, 94.4% (17 patients) had satisfactory postoperative hindfoot alignment of less than 5°. Radiological union was achieved in 90.9% at an average of 19.2 weeks (12-32 weeks) and there were 2 cases of nonunion. The clinical outcomes showed improvement in the mean VAS and AOFAS scores (p<0.001, p<0.001, respectively). Even a preoperative severe deformity more than 10° showed a significant deformity correction of coronal ankle alignment and hindfoot alignment, postoperatively (p<0.001, p<0.001, respectively). No significant differences were found between the patients with a preoperative coronal ankle deformity more than 10° and those less than 10° regarding the mean postoperative coronal ankle alignment (p=0.162). Conclusion: Tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is an acceptable technique for achieving satisfactory deformity correction, high union rate with minimal complications, and improvement of the clinical outcomes. In addition, tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is considered an effective treatment option, particularly in severe ankle and hindfoot deformities.