• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.24-34
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• 2010

The aim of this study was to evaluate the effect of incorporated nano HA on the demineralization resistance and bonding strength of LC GIC in comparison with micro HA. Fuji II LC GIC was used as the control group and a base material for experimental groups. Two experimental groups were prepared. One was prepared by adding 15% micro HA to LC GIC by weight ratio (Exp. 1), and the other was prepared by adding 15% nano HA instead (Exp. 2). According to the results, the following conclusions could be obtained. 1. Observing under the CLSM, the control group showed thicker enamel demineralization layer than in the experimental groups, and the Exp. 2 group showed the thinnest demineralization layer. 2. In SEM analysis, there was greater enamel demineralization in the control group. The Exp. 2 group was more resistant to demineralization compared to the Exp. 1 group. 3. The bonding strength was found to be in the increasing order of control, Exp. 1, and Exp. 2 group (p < 0.05). 4. Observing the fractured surfaces under SEM after the bonding strength test was performed, there were bone-like apatite particles formed in HA-added experimental groups, and a greater number of bone-like apatite particles were formed in the Exp. 2 group compared to the Exp. 1 group.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.1
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• pp.73-82
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• 2009

Injectable calcium phosphate cement (CPC) has been used as bone substitute successfully due to good biocompatibility and osteoconductivity. One of the important mechanical characteristics of CPC is flowablility, which can be evaluated by measuring rheological parameters. However, there have been few studies that measured rheological properties of CPC. The purpose of this study was to evaluate the effects of temperature and concentrations of 2 kinds of setting solutions, hydroxyprophyl methylcellulose (HPMC) and polyacrylic acid (PAA), on rheological properties of CPC. The CPC used was dicalcium phosphate dihydrate (DCPD). Rheological properties of CPC paste were measured using rheometer. The effect of concentrations of each solution (2% and 1% HPMC and 35% and 17.5% PAA) was evaluated. The effect of temperature ($25^{\circ}C$ and $37^{\circ}C$) on the rheological properties of CPC was also investigated. The statistical analysis was carried out with Mann-whitney test with Bonferronis collection. CPC with both setting solutions showed shear thinning behavior. Higher concentrations of setting solution (2% HPMC and 35% PAA) produced significantly higher viscosity than lower concentrations of setting solution (1% HPMC and 17.5% PAA). CPC with HPMC showed significantly higher viscosity at $37^{\circ}C$ that at $25^{\circ}C$. CPC with PAA showed lower viscosity at $37^{\circ}C$ than at $25^{\circ}C$, although the difference was not statistically significant. The results showed that CPC with HPMC or PAA solutions are pseudoplastic and the concentrations of setting solutions and temperature may have an effect on the rheological properties of CPC paste. These results showed that the flowability of injectable CPC could be improved by use of increasing frequency of oscillation. In clinical practice, the use of ultrasonic vibration would be helpful in application of injectable CPC. CPC with HPMC could be more easily applicated at $25^{\circ}C$ than $37^{\circ}C$. The use of lower concentrations of HPMC and PAA solution would be beneficial in terms of flowability.

• Journal of Biomedical Engineering Research
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• v.25 no.3
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• pp.171-182
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• 2004

This study investigates the biomechanical efficacies of vertebroplasty which is used to treat vertebral body fracture with bone cement augmentation for osteoporotic patients using image and finite element analysis. Simulated models were divided into two groups: (a) a vertebral body, (b) a functional spinal unit(FSU). For a vertebral body model, the maximum axial displacement was investigated under axial compression to evaluate the effect of structural integrity. The stiffness of each FE model simulated was normalized by the stiffness of intact model. In the case of FSU model, 3 types of compression fractures were formulated to assess the influence on spinal curvature changes. The FSU models were loaded under compressive pressure to calculate the change of spinal curvature. The results according to the various factors suggest that vertebroplasty has the biomechanical efficacy of the increment of structural reinforcement in a patient who has relatively high level of BMD and a patient with the amount of 15％, PMMA injection of the cancellous bone volume. The spinal curvatures after compression fracture simulation vary from 9$^{\circ}$ to 17$^{\circ}$ of kyphosis compared to that the spinal curvature of normal model was -2.8$^{\circ}$ of lordosis. These spinal curvature changes cause the severe spinal deformity under the same loading. As the degree of compressive fracture increases the spinal deformity also increases. The results indicate that vertebroplasty has the increasing effect of the structural integrity regardless of the amount of PMMA or BMD and the restoration of decreased vertebral body height may be an important factor when the compressive fracture caused the significant height loss of vertebral body.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.4
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• pp.152-162
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• 2000

Purpose : To verify radiological changes of limb salvage operation using tumor prosthesis. Materials and Methods : Sixty-nine cases which used tumor prosthesis were reviewed. They have been followed up for average four years and nine months. We evaluated radiographs by ISOLS(International Symposium On Limb Salvage) radiological implants evaluation system immediate postoperatively, at postoperative 1 year and last follow-up. After converting 'excellent, good, fair, poor' to '4, 3, 2, 1' for stastical analysis, data were analyzed according to the use of cement, anatomical sites, diagnosis implant designs and age (<20 year vs. ${\geq}$20 year) using t-test and ANOVA. Results : The outcomes of cemented type prostheses were superior in remodelling and interface but inferior in anchorage. The scores of proximal femur and distal tibia were worse in bone remodelling. Osteosarcoma group had lower scores in anchorage and implant articular problem. There were no significant differences according to four different implant designs and age. Conclusion : In the intermediate term follow-up radiological evaluation, cemented type prosthesis were better in the aspects of bony resorption and osteolysis, and cementless one in anchorage. Distal femur and proximal tibia have higher scores in bony resorption, and osteosarcoma was worse tumor entity in anchorage and articular problem, and chemotherapy may be the cause.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.1
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• pp.1-11
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• 2002

Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.37-42
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• 2012

Purpose: To consider the proper management of proximal humerus fracture on gunshot wounds. Materials and Methods: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done. Result: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus. Conclusion: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.170-177
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• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• Journal of the Korean Recycled Construction Resources Institute
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• v.8 no.4
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• pp.498-505
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• 2020

Aggregate occupies about 70-85% of the concrete volume and is an important factor in reducing the drying shrinkage of concrete. However, when constructing high-rise buildings, it acts as a problem due to the high load of natural aggregates. If the load becomes large during the construction of a high-rise building, creep may occur and the ground may be eroded. Material costs increase and there are financial problems. In order to reduce the load on concrete, we are working to reduce the weight of aggregates. However, artificial lightweight aggregates affect the interface between the aggregate and the paste due to its higher absorption rate and lower adhesion strength than natural aggregates, affecting the overall strength of concrete. Therefore, in this study, in order to grasp the interface between natural aggregate and lightweight aggregate by type, we adopted a method of measuring electrical resistance using an EIS measuring device, which is a non-destructive test, and lightweight bone. The change in the state of the interface was tested on the outside of the material through a blast furnace slag coating. As a result of the experiment, it was confirmed that the electric resistance was about 90% lower than that in the air-dried state through the electrolyte immersion, and the electric resistance differs depending on the type of aggregate and the presence or absence of coating. As a result of the experiment, the difference in compressive strength depending on the type of aggregate and the presence or absence of coating was shown, and the difference in impedance value and phase angle for each type of lightweight aggregate was shown.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.71-78
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• 2004

Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

• 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.