• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.463-468
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• 2019

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare disease that affects the sensory and autonomic nervous system. The patients do not have the ability to sense different sensations, such as pain, which tends to lead to different injuries. In addition, the patients suffer from fluctuations in body temperature due to autonomic involvement. The present case was a five-year-old girl with a neglected distal femur fracture. X-rays taken during the follow-up showed marked callus formation and pseudarthrosis of the distal femur. She had biting injuries of the tongue, auto-amputation of the fingers, some developmental delay and a history of recurrent fever with an unknown origin. The electrodiagnostic study was normal. The quantitative sudomotor axon reflex test revealed markedly reduced postganglionic sudomotor axonal responses at all sites recorded on the left. She was diagnosed with CIPA. As the initial presentation of CIPA involves the musculoskeletal system, orthopedic surgeons should have a high index of suspicion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.6.1-6.8
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• 2016

Background: Intravenous bisphosphonates have been used in metastatic breast cancer patients to reduce pathologic bone fracture and bone pain. However, necrosis of the jaw has been reported in those who received intravenous bisphosphonates. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is caused by dental extraction, dental implant surgery, and denture wearing; however, it occurs spontaneously. The purpose of this study was to report BRONJ in metastatic breast cancer patients. Methods: Consecutive 25 female patients were referred from the Department of Oncology from 2008 to 2014 for jaw bone discomfort. Staging of breast cancer, history of bisphosphonate infusion, etiology of BRONJ, and treatment results were reviewed. Average age of the patients was 55.4 years old (38-74). Twelve maxillae and 16 mandibles were involved. Conservative treatments such as irrigation, antibiotic medication, analgesics, and oral gargle were applied for all patients for the initial treatment. Patients who had sequestrum underwent debridement and primary closure. Results: The etiologies of BRONJ were dental extraction (19 cases), dental implant (2 cases), and endodontic treatment (1 case). However, three patients did not have any risk factors to cause BRONJ. Three patients died of progression of metastasis during follow-up periods. Surgical debridement was performed in 21 patients with success in 18 patients. Three patients showed recurred bone exposure and infection after operation. Conclusions: Prevention of the BRONJ is critical in metastatic breast cancer patients. Conservative treatment to reduce pain, discomfort, and infection is recommended for the initial therapy. However, if there is a sequestrum, surgical debridement and primary closure is the key to treat the BRONJ.

• The Journal of the Korean dental association
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• v.54 no.5
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.7-10
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• 2006

Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.130-134
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• 2007

Purpose: To investigate the relationship between classification based on simple radiographic findings and arthroscopic findings of the cartilage lesions in medial degenerative arthritis of the ankle joint. Materials and Methods: We studied 41 ankles of 36 patients with asymmetrical narrowing of the medial joint space. Degenerative arthritis following fracture and those with generalized arthritic disease were excluded, but those with a history of ankle sprain were included. Standing radiographs of all patients were graded according to the Takakura classification and the Kellgren-Lawrence (K/L) classification. Arthroscopic findings were classified according to the depth, width, and anteroposterior dimension of articular cartilage damage. Results: According to the Takakura classification, 29 ankles were classified as stage II, 7 cases as stage IIIA and 2 cases as stage IIIB. According to our classification of arthroscopic findings of 29 ankles in stage II, 1 ankle was graded as Grade I, 3 ankles as grade II, 10 ankles as grade III, and 15 ankles as grade IV. Spearman correlation coefficient between Takakura classification and arthroscopic classification was 0.342 (P=0.028), and coefficient between K/L classification and arthroscopic classification was 0.480 (P=0.001). Conclusion: Degenerative changes of the articular cartilage are more advanced than radiographic findings in many patients with ankle degenerative arthritis with asymmetrical narrowing of medial joint space. Therefore, we conclude that more aggressive effort should be made for correct diagnosis and treatment of degenerative arthritis.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.1
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• pp.56-63
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• 2018

Severe dental attrition causes pathological changes of the tooth, collapsed occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension. Before increasing the vertical dimension with full-mouth rehabilitation, it is important to determine the amount of vertical dimension through accurate diagnosis. In this case, a 77 year old elderly male patient on anticoagulant medication with generalized attrition and fracture of teeth was treated with full-mouth rehabilitation in order to recover vertical dimension and aesthetics. Accurate clinical and radiographic examination, diagnostic, wax-up, and occlusal vertical dimension evaluation were step by step performed considering pre-medical history and old age. Patient adaptability was evaluated using an occlusal splint and interim restoration. After 3 months of stabilization with interim restoration, definitive prostheses were fabricated. Satisfactory functional and esthetic outcomes are observed after 6 months of follow up.

• The Journal of Korea CHUNA Manual Medicine
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• v.5 no.1
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• pp.213-222
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• 2004

Objectives : To investigate contributing degree of other factors except pelvic tilting to F.L.L.D by analizing with Gonstead technique on the correlation between femur head height discrepancy on the standing pelvic AP view and F.L.L.D caused by pelvic tilting. Method : We analysed standing pelvis AP X-ray of 70 patients who had visited at the department acupunture and moxibustion in Conmaul oriental medical hospital, during May, 1st, 2004 - July, 30th, 2004, with low back pain or lower extremity pain. We excluded the person with any past history of polio, genetic defect, malunited fracture, growth plate injury, infection and overgrowth attributable to hemangioma, or arteriovenous fistula. Results & Conclusion : The functional leg length discrepancy caused by pelvic tilting and femur head height difference had no statistical difference(p=0.132) but poorly correlated(Pearson ${\nu}=0.05$). In the 94.28% of subjects, the femur head height difference wasn't in accord with F.L.L.D. caused by pelvic tilting. In 47.14% of subjects were expected to have over $3^{mm}$ of leg length discrepancy after pelvic adjustment. The mean of measurement difference between two methods was $3.76{\pm}3.12^{mm}$ and the range was $0{\sim}11.4^{mm}$. Consequently, we must consider not only functional leg length discrepancy caused by pelvic tilting but also anatomical leg length discrepancy, misalignment of ankle, knee or hip joint etc.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.659-662
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• 2006

Purpose: Alloplastic implants, such as methylmethacrylate, Teflon, silicone, Supramid are commonly used to cover the floor defect and to prevent reherniation of the displaced orbital tissue in orbital floor fracture. Silicone implant has been used for reconstruction of orbital wall defects because of pliability, advantage of carving and chemically inert nature. However, silicone implant also has complications including infection, extrusion, pain, dystopia and tissue reaction. Cyst formation around the silicone implant is a very rare complication. According to many reports, cysts around alloplastic implant in an orbital area are mostly hemorrhagic cysts consisted of blood breakdown product with fibrous capsule cell in histologic examination. Methods: The authors report atypical case and successful treatment of intraorbital hemorrhagic cyst around silicone implant of a 37-year-old male patient. Results: Preoperative symptoms of diplopia, exophthalmos, proptosis, vertical dystopia and ectropion of lower eyelid were resolved after surgical removal of implants with surrounding capsule. Conclusion: Clinical suspicion of plastic surgeon is important in diagnosis of intraorbital cyst of patients who have history of silicone implantation and computed tomography is the standard tool of diagnosis. During the operation, caution must be taken on delivering the whole capsule of intraorbital cyst along with silicone implant to prevent recurrence of the cyst.

• Journal of the Korean Institute of Gas
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• v.2 no.3
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• pp.78-87
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• 1998

The mechanical properties, heat treatment and the history for the development of Ni-bearing ferritic steels for the application at low temperatures are reviewed. Ni-bearing ferritic steels are classified into $2-3\%$ Ni steels, $5.5\%$ Ni steel, $9\%$ Ni steel and $13\%$ Ni steel., of which $9\%$ Ni steels are most widely used for the large LNG storage tanks owing to their encellent fracture toughness up to $-196^{\circ}C$. The effect of retained austenite on the tensile properties and toughness was precisely discussed. As the size of LNG storage tank increases, thicker plates are needed. Thus, the recent efforts for the improvement of low temperature toughness and homogeneity are also introduced.

• Women's Health Nursing
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• v.15 no.4
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• pp.362-371
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• 2009

Purpose: This study was implemented to investigate the level of awareness of osteoporosis among urban women. Methods: A survey was conducted with a sample size of 434 adult females who resided in metropolises in Korea such as Seoul, Gyeonggi-do, Pusan, Gyeongsangnam-do, Kangwondo, Jeju-do and Jeollanam-do. Osteoporosis Awareness Scale was consisted of five areas with total number of 31 questions. The questionnaire's scale was 1 to 4 point, 4 point being the highest understanding level. The collected data were analyzed using descriptive statistics method. Results: The average awareness level of subjects was 2.38 and significant different depending on participants' age, education level, previous encounter with any information about osteoporosis, preventive behavior of osteoporosis, bone mineral density test, fracture history, diet control experience, and regular exercise. In osteoporosis awareness level by five areas, preventive behaviors 2.76 resulted in the highest score and characteristics of osteoporosis 2.51, bone physiology 2.46, improving bone health 2.38, and risk factors 1.80 followed respectively. Conclusion: We should implement bone health programs from a various perspective in order to raise women's osteoporosis awareness. In addition, We need follow-up studies on whether or not the increase on awareness level actually would result in changing in their behavior.