• 제목/요약/키워드: proximal

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임플란트 사이에 있는 자연치 함입 증례 (Intrusion phenomenon of natural tooth bounded by implant-prostheses: a clinical report)

  • 김중현;양순봉;조영성;박영범
    • 대한치과보철학회지
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    • 제52권4호
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    • pp.324-330
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    • 2014
  • 임플란트와 자연치를 연결하여 보철물을 제작할 경우, 자연치에 함입현상이 일어날수 있음은 여러 보고로 알려져 있다. 이를 설명하는 메커니즘은 여러가지가 있으며, 이에 임플란트와 자연치를 연결 하는 보철물 형태는 권장되지 않는다. 본 증례는 임플란트와 인접 하지만, 연결되어 있지는 않은 자연치가 인접면 접촉과 연관되어 함입이 일어난 증례이다. 68세 여성이 상악 좌측 제2소구치 및 제2대구치 발치후, 임플란트 수술 및 보철수복을 받았으며, 임플란트 사이의 제1대구치는 크라운 치료를 받았다. 2.5년 후, 제2대구치 근심면의 접촉이 느슨해져 상기 보철물의 근심면 합착을 시행하였다. 그로부터 7개월후, 제1대구치의 약 2 mm 함입이 발생하였으며, 치주문제로 인한 통증도 발생하였다. 제1대구치의 크라운을 제거하고 다시 정출이 일어났고, 치주 통증도 사라졌다. 이에 본 증례를 분석, 보고하는 바이다.

Patterns of failure and prognostic factors in resected extrahepatic bile duct cancer: implication for adjuvant radiotherapy

  • Koo, Tae Ryool;Eom, Keun-Yong;Kim, In Ah;Cho, Jai Young;Yoon, Yoo-Seok;Hwang, Dae Wook;Han, Ho-Seong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • 제32권2호
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    • pp.63-69
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    • 2014
  • Purpose: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. Materials and Methods: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. Results: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (${\geq}37U/mL$) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). Conclusion: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.

지실이 대장의 위상성 자발수축운동에 미치는 영향 (Effects of Ponciri Fructus on Spontaneous Phasic Contractions of Colon in Rats)

  • 최철원;이문영
    • 동의생리병리학회지
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    • 제22권6호
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    • pp.1518-1524
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    • 2008
  • Ponciri Fructus (PF), the immature fruit of Poncirus trifoliata, has been used for treatment of constipation in Korean traditional medicine. It has been reported that PF has a prokinetic effect on gastrointestinal tract, but little is known about the effect on colonic contraction. The aim of this study was to investigate the effect of PF on spontaneous contractions of proximal and distal colon in rats. The aqueous extract of PF was centrifuged and filtered and its supernatant was used for in vitro motility study. The removed colon from rats was divided into proximal and distal segments. Each segment was mounted in a 10 ml organ bath and measured the change of the spontaneous contraction with increasing dose (1, 5, 10, 50, 100, 500, $1000{\mu}g/ml$) of PF extract administration. Also the effect of PF on the spontaneous contraction was measured under treatment of atropine, acetylcholine (Ach), and tetrodotoxin (TTX). PF increased the spontaneous phasic contraction of distal colon dose dependently, but there was no change in proximal colon. The contractile response induced by PF in distal colon was lower than that of Ach and was partially blocked by atropine ($10^{-6}M$). TTX increased the spontaneous contraction and it was reinforced with Ach addition. But the extract of PF had no or little contractile effect of TTX in colon. PF increased spontaneous contractions selectively in distal colon. The prokinetic effect of PF may be due to enhancement of cholinergic related excitatory neural system.

무당거미(Nephila clavata L. Koch) 병상선(甁狀腺)의 미세구조(微細構造) I. 대병상선(大甁狀腺)의 분비관(分泌管) (Ultrastructure of the Ampullate Gland in the Orb Web Spider, Nephila clavata L. Koch I. Excretory Duct of the Large Ampullate Gland)

  • 문명진;김창식;김우갑
    • Applied Microscopy
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    • 제18권2호
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    • pp.77-90
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    • 1988
  • The ultrastructure of the excretory duct of the large ampullate gland in the orb web spider, Nephila clavain L. Koch are studied with light and electron microscopes. The excretory ducts of the large ampullate glands connected with the large spinning tubes(spigots) on the anterior spinnerets are basically composed of three superposed types of the layers which are inner cuticles, monolayered epithelial cells and peripheral connective cells. According to the morphological characteristics of the cuticles and internal textures of the epithelial cells, the long excretory ducts are subdivided into three(distal, middle and proximal) portions. Especially, at the distal portion of the ducts near the spinning tubes, the electron lucent subcuticles which had the functions of water removal and orientation of silk fibers are well distributed, whereas at the middle and proximal portions these layers disappeared and instead of these, endocuticles are developed. The endocuticle contains two types of bands, which are electron dense and electron lucent. And along the length of the cuticular stem in the excretory duct, these two alternating bands are twisted spirally. In the cytoplasm of the columnar epithelial cells of the distal portion, rough endoplasmic reticula and Golgj complexes, related to the production of the cuticular materials are well developed. Between the adjacent epithelial cells, specialized septate junctions and desmosomes are formed along the plasma membranes. At the proximal portion of the duct, densely accumulated secretory materials appeared, and these are released to the inner canal by the apocrine secretion.

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운동선수의 제5 중족골 피로골절 (Fifth Metatarsal Stress Fracture)

  • 이경태;박영욱;제갈혁;김준범
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.87-93
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    • 2012
  • Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.