• 제목/요약/키워드: proximal

검색결과 2,583건 처리시간 0.033초

비침습적인 전기자극이 임프란트의 골융합에 미치는 영향;토끼경골에서의 조직계측학적 평가 (Effects of noninvasive electrical stimulation on osseointegration of endosseous implants;A histomorphometric evaluation in the rabbit tibia)

  • 손성배;박진우;서조영
    • Journal of Periodontal and Implant Science
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    • 제35권3호
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    • pp.635-648
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    • 2005
  • The procedure that enhances osteogenesis and shortens the healing period is required for successful implant therapy. It has been introduced that osteogenesis is enhanced by the generation of electric field. Many researchers have demonstrated that application of electric and electromagnetic field promote bone formation. It also has been shown that electrical stimulation enhances peri-implant bone formation. Recently, several investigators have reported that noninvasive electrical stimulation using negatively charged electret such as polytetrafluoroethylene(PTFE) promotes osteogenesis. Therefore, we were interested in the effect of noninvasive electrical stimulation using negatively charged electret on the periimplant bone healing. After titanium implant were installed in the proximal tibial metaphysis of New Zealand white rabbit, negatively charged PTFE membrane fabricated by corana dischage was inserted into the inner hole of the experimental implant and noncharged membrane was applied into control implant. After 4 weeks of healing, histomorphometric analysis was performed to evaluate peri-implant bone response. The histomorphometric evaluations demonstrated experimental implant tended to have higher values in the total bone-to-implant contact ratio(experimental ; $49.9{\pm}13.52%$ vs control ; $37.5{\pm}19.44%$) , the marrow bone contact ratio(experimental ; $34.94{\pm}13.32%$ vs control ; $24.15{\pm}13.69%$), amount of newly formed bone in the endosteal region(experimental ; $1.00{\pm}0.30mm$ vs control ; $0.61{\pm}0.24mm$) and bone area in the medullary canal(experimental ; $13.55{\pm}4.98%$ vs control ; $9.03{\pm}3.05%$). The mean values of the amount of newly formed bone(endosteal region) and bone area(medullary canal) of the experimental implant demonstrated a statistically significant difference as compared to the control implant(p<0.05). In conclusion, noninvasive electrical stimulation using negatively charged electret effectively promoted peri-implant new bone formation in this study. This method is expected to be used as one of the useful electrical stimulation for enhancing bone healing response in the implant therapy

원위 쇄골 불유합의 수술적 치료 (Operative Treatment of Distal Clavicle Fracture Nonunion)

  • 강호정;윤항섭;한수봉;김성재
    • Clinics in Shoulder and Elbow
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    • 제10권2호
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    • pp.220-226
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    • 2007
  • 목적: 원위 쇄골 골절은 근위부나 중간부 쇄골 골절과는 다른 생역학적 구조를 가져서 지연유합과 불유합이 많이 발생한다. 원위 쇄골 불유합 치료에 대한 연구보고는 거의 없는 상태이다. 저자들은 원위 쇄골 골절 불유합에 대한 관혈적 정복 및 골이식의 수술적 치료 후 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다. 대상 및 방법: 2003년 8월부터 2006년 5월까지 원위 쇄골 불유합으로 수술 치료받은 8예를 대상으로 하였으며, 평균 연령은 38.9($21{\sim}62$세)세였고, 지배 수지 6예였다. 수상 초기 수술적 치료 후 발생한 불유합이 4예, 보존적 치료 후 발생한 불유합이 4예였고, 불유합 기간은 수상 후 평균 1년 5개월이었다. 전 예에서 자가장골 이식술 및 내고정술을 시행하였고, 내고정물은 금속판이 7예, 긴장대 강선 고정술이 1예였다. 결과: 평균 추시 기간은 14개월이었고, 방사선학적 골유합은 전 예에서 평균 8주에 관찰할 수 있었다. 최종 추시상 견관절의 운동범위는 모두 정상 소견이었고, Kona 등의 평가표에 의한 기능적 평가에서 7예에서 우수한 결과를, 1예에서 양호한 결과를 얻었다. 결론: 원위 쇄골 골절 불유합에 대한 수술적 치료는 조기 재활이 가능하고 견고한 골유합을 얻을 수 있어 추천할 만한 치료 방법으로 사료된다.

The Effects of Melatonin on Cisplatin-Induced Renal Cortical Cell Injury in Rabbits

  • Kim, Chung-Hui;Han, Jin;Kim, Na-Ri;Park, Ju-Hee;Yang, Young-Churl;Kim, Eui-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • 제5권3호
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    • pp.223-230
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    • 2001
  • Melatonin, a pineal gland hormone, is believed to act as an antioxidant via the stimulation of radical detoxifying enzymes and scavenging of free radicals. In this study, effects of in vitro and in vivo treatments of melatonin on the cisplatin-induced lipid peroxidation, LDH release and plasma creatinine were determined in rabbit renal cortical cells. The level of malondialdehyde (MDA) was assayed as an index of lipid peroxidation and the level of LDH release as an indicator of cellular damage. In in vitro studies, cisplatin increased the levels of MDA and LDH release in a concentration-and time-dependent manner. Melatonin inhibited the cisplatin-induced lipid peroxidation and LDH release in a concentration-dependent manner. The minimal effective concentration of melatonin that significantly reduced the $300\;{\mu}M$ cisplatin-induced lipid peroxidation and LDH release was 1 mM. In in vivo studies, the levels of lipid peroxidation and LDH release in renal cortical cells increased significantly 24 or 48 hours after a single injection of cisplatin (6 mg/kg). When the cisplatin-injected rabbits were pretreated with 10 mg/kg of melatonin, a significant reduction in both lipid peroxidation and LDH release was observed. The plasma creatinine level increased from $0.87{\pm}0.07$ mg/dl in control to $6.33{\pm}0.54$ mg/dl in cisplatin-injected rabbits (P<0.05). Melatonin partially prevented the increase in serum creatinine level $(1.98{\pm}0.11\;mg/dl)$ by cisplatin (P<0.05). In the proximal tubules from cisplatin-treated group, tubular cells had microvilli of variable heights. Necrotic debris was seen in tubular lumens. In most of cells, the mitochondria and lysosomes were increased in frequency. The endocytic vacuoles were not prominent and distribution of the brush border was irregular and shortened. These cisplatin-induced morphological changes were moderate in the melatonin-pretreated group. These results suggest that the toxicity of cisplatin is associated with the generation of reactive oxygen free radicals and that melatonin is a powerful antioxidant, which prevents some of the adverse effects of cisplatin.

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인간 골 간섭 나사못의 초기 고정력 (Initial Fixation Power of Human Bone Interference Screw)

  • 김정만;정양국;김양수;오인수;고인준
    • 대한정형외과스포츠의학회지
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    • 제1권1호
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    • pp.26-30
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    • 2002
  • 목적: 동종골-슬개건-골을이용한전방십자인대재건술시인간골간섭나사못의초기및조기고정력을알아보려고하였다. 대상및방법 : 동종골-슬개건-골을이용한전방십자인대재건술을28 슬관절에대해수술후6주, 12주, 6개월, 1년에추적조사하였다. Lachman test, flexion rotation drawer test, jerk test등의이학적검사를시행하였고KT-1000 측정을동시에시행하여경골의전방전위정도를측정하였다. Lachman test는 0$\~$2mm 전방전위까지를정상으로하였고KT-1000 측정은정상측과비교하여 2mm 이내는정상으로하였다. 마지막검사시M RI를시행하였다. 결과: 단일예를제외하고는모두이학적검사와KT-1000 측정상정상범위에속하였다. 실패한일례는수술소견상이식물이경골터널에서의근위전위되었으며이는넓어진터널을감안하지않고단하나의간섭나사못을사용한기술적실수로평가되었다. 결론: 인간골골피간섭나사못은전방십자인대의재건술을시행하는데충분한초기및조기고정력을보여주었다.

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한국 여성에서 좌골 신경 분지 위치에 대한 초음파 영상 (Ultrasound Imaging for Position of the Sciatic Nerve Division in Korean Female)

  • 남일현;여의동;유지수;이준호;이영구
    • 대한정형외과 초음파학회지
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    • 제7권1호
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    • pp.28-32
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    • 2014
  • 목적: 슬관절 이하 부위의 정형외과적 수술을 위해 좌골 신경 차단 술기가 흔히 시행되고 있다. 좌골 신경 분지는 해부학적 차이가 있어 통상적인 신경 차단은 불완전한 신경 차단을 유발한다. 본 연구는 마취의 성공율을 개선하기 위하여 한국 여성에서 좌골 신경 분지 위치를 초음파를 이용해 확인하였다. 대상 및 방법: 한국 여성 33명을 대상으로 하였으며 체중, 키를 측정하였다. 초음파 측정을 위해 M-Turbo ultrasound system (SonoSite,Bothell, WA,USA) 13-6 MHz, 38 mm high frequency linear array transducer를 사용하였다. 복와위 자세에서 슬와 주름부터 분지부까지의 거리, 분지부에서 피부부터 신경까지의 깊이를 cm 단위로 측정하여 체중과 키와의 상관관계를 확인하였다. 측정은 한 명의 전문의에 의해 측정되었다. 통계는 SAS version 9.3를 사용하여 multiple linear regression 방법으로 분석하였다. 결과: 33명 여성의 평균 나이는 53세(34~71세), 평균 체중 59.7(50~77.1 kg), 평균 키 157.4(145~173.9 cm), 평균 BMI 24.1(18.4-28.9)였다. 슬와 주름에서 좌골 신경 분지부까지의 평균 거리는 5.7(4.5~7.5 cm)이였으며, 분지부에서 피부부터 신경까지의 평균 깊이는 2.4(1.8~3.2 cm)였으며, 통계적 분석 결과에서 거리와 키 조사 p-value 0.55, 거리와 몸무게 조사 p-value 0.34, 깊이와 키 조사 p-value 0.5, 깊이와 몸무게 조사 p-value 0.036 이였다. 결론: 한국 여성의 좌골 신경 분지 위치는 차이가 있었으며, 특히 몸무게에 따른 깊이 변화는 의미가 있었다. 한국 여성에서 좌골 신경 차단 술기를 시행할 때 평균 거리, 깊이를 생각하고 몸무게를 고려한다면 성공율이 증가할 것으로 생각되며, 슬와 주름 7.5 cm 상방에서 시행할 것을 추천하다.

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Eugenol, Capsaicin과 Demethoxy - NE가 치수동통 반응에 미치는 영향 (EFFECTS OF EUGENOL, CAPSAICIN AND DEMETHOXY-NE ON THE PAIN RESPONSE OF DENTAL PULP)

  • 이은구;이정식
    • Restorative Dentistry and Endodontics
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    • 제17권1호
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    • pp.10-21
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    • 1992
  • The purpose of this study was to investigate the analgesic effect of eugenol, capsaicin and demethoxy-NE. Young adult cats, weighing 2.0 to 3.0kg, were used. Each animal was anesthetized (${\alpha}$-chloralose 60mg per kg body weight) and divided into four groups; control, eugenol, capsaicin and demethoxy-NE group. The anterior digastric muscles were exposed and a pair of electrodes was inserted to record the electromyograms. To expose the pulp, each canine teeth was prepared with a low speed bur under cooling and used for recording anterior digastric muscular EMGs evoked by noxious stimulation of dental pulp. To observe effects on jaw opening reflex, inferior alveolar nerve of both sides were exposed for drug application and wire electrodes were inserted in anterior digstric muscle for recording the EMGs. To observe effects on action potential, saphenous nerves of both sides were exposed and three tissue pools were made from surrounding tissue. The most distal pool was used for applying stimulation, the most proximal one for recording of action potential, and the other one for drug application. One side of inferior alveolar nerve and saphenous nerve were used for eugenol, capsaicin, or demethoxy-NE application, the other side of nerve for control experiments(only vehicle application). Anterior digastric muscular EMGs evoked by noxious stimulation of dental pulp were recorded before drug application, immediate after drug application, at 60 and 120 minutes, and 5 days after drug application. Action potentials were recorded before drug application, immediate after 30 minutes drug application, at 30, 60 and 120 minutes after drug had been washed out. The results were as follows; 1. Eugenol had a continuous blocking effect on the anterior digastric muscular EMGs evoked by noxious pulp stimulation and after 5 days, showed completely blocking effect. 2. After 5 days, demethoxy-NE applied to dental pulp had a considerable blocking effect on the jaw opening retlex evoked by noxious stimulation but capsaicin had no significant effect. 3. After 5 days, eugenol group showed the strongest blocking effect among the all experimental groups on the jaw opening reflex evoked by noxious stimulation of dental pulp and capsaicin group showed the weakest blocking effect. 4. Eugenol had a completely blocking effect on the action potential conductivity of peripheral nerve. Capsaicin and demethoxy-NE had the blocking effect on the action potential conductivity of ${\alpha}$-and C-nerve fibers. 5. Capsaicin, demethoxy-NE and eugenol applied to inferior alveolar nerve surppressed the jaw opening reflex evoked by noxious stimulation of dental pulp.

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두겹 압박방식 $3M^{TM}$ $Coban^{TM}$을 이용한 울혈성 정맥궤양의 치료: 증례보고 (Treatment of Venous Stasis Ulcer with $3M^{TM}$ $Coban^{TM}$ 2 Layer Compression System: A Case Report)

  • 추호준;손대구;김준형;한기환;김형태
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.699-702
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    • 2011
  • Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M $Coban^{TM}$ 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and $3{\times}4$ cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 $Coban^{TM}$ 2 Layer Compression Systems were used. The size of the ulcer decreased to $2.5{\times}2.5$ cm in one month, to $2{\times}2$ cm in 2 months, it was $1{\times}1.8$ cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M $Coban^{TM}$ 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.

신개발 키토산 제재의 지혈 효과에 대한 비교 (Experimental Assessment of Hemostatic Agents: Comparison with New Developed Chitosan-Based Material)

  • 조영규;이상윤;김태정;임현주;오은정;이수복;최강영;양정덕;조병채;정호윤
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.369-375
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    • 2011
  • Purpose: Many hemostatic agents and dressings have been tested with variable degree of success. Chitosan has a positive charge, it attracts red blood cells, which have a negative charge. Our goal is to test the efficacy of new developed chitosan-based hemostatic materials in providing durable hemostasis in a high-flow arterial wound model. Methods: We compared each group with SD rats motality tests and in vitro blood compatibility test by blood clotting index (BCI). We devided the SD rats into 6 groups (N =15) by type of hemostatic agents. A: 100% nonwoven chitosan (degree of the deacetylation: 90%). B: 50% N-acetylation on nonwoven of chitosan gel (degree of the deacetylation: 50%). C: 60% N-acetylation on nonwoven of chitosan ge (degree of the deacetylation: 40%)l. D: Cutanplast$^{(R)}$. E: HemCon$^{(R)}$ F: Gauze. In vivo test, a proximal arterial injury was created in unilateral femoral arteries of 90 anesthetized SD rats. Each materials was made same size and thickness then applied to the injury site for 3 minutes. In vitro test, we compared each group with BCI in human blood. Results: In vivo test, group A showed lower motality rate of 46% than any other groups, Group B and C showed lower motality rate of 60% than group D and E's motality rate of 66%. In vitro test, BCI of group A ($30.6{\pm}1.2$) and B ($29.3{\pm}1.0$) were showed nearly about group D ($29.1{\pm}1.8$) and E ($27.4{\pm}1.6$). Group C ($37.1{\pm}2.0$) showed higher BCI than group A and B, it means group C decreased blood clotting. Conclusion: In conclusion, this study suggests a newly developed chitosan-based hemostatic materials induced durable hemostasis and increased blood clotting, and are considered as effective biologic hemostatic agents.

뱀교상 후 발생한 연부조직 결손의 재건 (Reconstruction of Soft Tissue Defects after Snake Bites)

  • 이장현;장수원;김철한;안희창;최승석
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.605-610
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    • 2009
  • Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.

관상동맥 우회술의 장기 생존율 (Long-term Survival after Coronary Artery bypass Surgery)

  • 이미경;정은택;최종범
    • Journal of Chest Surgery
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    • 제38권2호
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    • pp.139-145
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    • 2005
  • 배경: 관상동맥 우회술 후 장기 생존율에 대한 우리의 보고는 많지 않다. 이 연구는 관상동맥 우회술 시작 초기에 수술 받은 환자들의 장기 생존율을 알아보았다. 대상 뜻 방법: 1990년 12월부터 1995년 12월까지 관상동맥 우회술을 받은 114예(남 79예, 여 35예, 평균연령 58.4세)를 대상으로 하였다. 대부분의 환자가 체외순환 하에 좌측 속가슴동맥과 하지 복재정맥으로 우회로술을 받았고 대동맥 차단상태에서 근위부 및 원위부 문합을 시행하였다. 결과: 평균 $135.5{\pm}17.9$개월의 추적 기간 동안 모두 37예$(32.5\%)$가 사망하였으며, 사망자 중 심장사망은 10예$(27\%)$뿐이었다 수술 후 전체 사망에 대한 1년, 5년, 10년, 13년의 생존율은 각각 $95.6\%,\;85.1\%,\;71.8\%,\;57.9\%$였고, 심장사망에 대한 1년, 5년, 10년, 13년의 생존율은 각각 $97.4\%,\;94.5\%,\;92.1\%,\;81.3\%$였으며, 장기 생존율에 대한 예상인자로는 성별 및 연령이었다 수술 후 관상동맥 조영술 및 중재술의 예상인자는 수술 전의 고혈압, 당뇨병, 고지혈증 등이었다. 결론: 초기의 관상동맥 우회술 후 장기생존율은 다른 보고와 비슷하였으며, 여성에서 장기생존율이 우수하였고 수술 전 고지혈증을 가진 환자에서 수술 후 관상동맥 중재술이 더 많았다.