• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.206-216
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• 2000

Predictional study for lateral change between pre- and post-orthognathic surgery has been emphasized mainly on anterior area of lateral profile; upper lip, lower lip and chin et al. So interest for lateral profile change has been less in posterior area of lateral profile and literature analyzing gonial angle change is rare. The purpose of this study is to make prediction for gonial angle change possible and to offer somewhat treatment guidance for gonial angle to be improved by investigating overall gonial angle change between pre- and post-orthognathic surgery and inquiring into factors influencing on pattern of genial angle change. For this study 35 patients were selected retrospectively. Lateral cephalometric radiographs were taken in just pre-op time, pod 1 day, pod 1 year. They were analyzed and genial angles were measured. The results were as follows : 1. Gonial angle at pod 1 day was decreased about $9.3^{\circ}$ than pre-op and gonial angle at pod 1 year was increased about $4.0^{\circ}$ than pod 1 day. So genial angle at pod 1 year was decreased about $5.3^{\circ}$ than pre-op genial angle(p<0.01). 2. Mean pre-op gonial angle was $129.4^{\circ}$, showing significantly high value than normal and mean gonial angle at pod 1 year was $124.1^{\circ}$, showing value near to normal. 3. Mean gonial angle change between pre-op and pod 1 year was decreased about $5.4^{\circ}$ in female and $5.3^{\circ}$ in male. There was no statistically significant difference between male and female(p>0.05). 4. Principal factor influencing on decreased gonial angle in gonial angle change between pre-op and pod 1 year was amount of mandibular setback. 5. Principal factor influencing on increased gonial angle in gonial angle change between pod 1 day and pod 1 year was % horizontal relapse, and it was thought that resorption and bone remodelling on posterior area in mandibular distal segment also were related to increased gonial angle. 6. It is thought that sagittal split ramus osteotomy in mandibular prognathic patients with high value of gonial angle is effective to improvement of gonial angle, and In patients who have normal range of gonial angle and are required with excessive mandibular setback, short lingual cut method, additional resection of posterior margin of distal segment, Obwegeser II method will be considerd. 7. More prudent operation and careful post-op management will be responsible for maintenance of postoperative stable gonial angle.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.241-257
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• 2000

Autogenous periosteal grafts are an attractive alternative to existing barrier membrane materials since they meet the reqiurements of an ideal material. But no histological data are available on the effectiveness of periosteal membranes in the treatment of periodontal defects. The purpose of this study was to evaluate effect of autogenous periosteal graft on periodontal regeneration histologically. Class II furcation defects were surgically created on the second, third and the fourth premolars bilaterally in the mandibules of six mongrel dogs. The experimental sites were divided into three groups according to the treatment modalities; control group - surgical debridement only; Group I- autogenous periosteal membrane placement after surgical debridement; Group II-autogenous periosteal membrane placement after surgical debridement and bone grafting. The animals were sacrificed at 2, 4 and 12 weeks after periodontal surgery and the decalcified and undecalcified specimens were prepared for histological and histometrical analysis. Clinically all treated groups healed without significant problems. Under light microscope, at 2 weeks, control group showed significant apical epithelial migration and bone remodelling only below the notch area. But for the group I, II with autogenous periosteal graft, less apical migration of epithelium appeared and large amount of osteoid tissue showed above the notch area. Grafted periosteal membrane was indiscernable at 4 weeks, so periosteal membrane might be organized to surrounding tissues. Histometrically, at 4 and 12 weeks, all the test and control groups didn't show significant change of epithelial zone but new attachment level tended to be gained in the test groups than control group. These results suggest that autogenous periosteal grafts should be a good alternative for guided tissue regeneration.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.168-175
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• 2003

Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.107-120
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• 2001

Nitric oxide(NO) has been reported to be one of the mediators relating to bone remodelling. Nitric oxide is synthesized from L-arguinine by nitric oxide synthetase(NOS), which is largely divided Into two groups. One group which is composed of $NOS_1\;and\;NOS_3$, is dependent of calcium or calmodulin. The other consisted of $NOS_2$, which is independent of calcium or calmodulin. NOS is thought to be a possible intermediate affecting in the course of tooth movement. This study was designed to evaluate the expression of nitrous oxide synthetase(NOS) in periodontal tissue during the experimental movement of rat incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for $NOS_2\;and\;NOS_3$. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats), and 6 experimental groups(24 rats), to which 75g of force was applied, with helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 12 hours, 1, 4, 7, 14 and 28 days after force application, respectively. After that, the tissues of the control group and experimental groups were studied immunohistochemically. The results were as follows: 1. In control group, the expression of $NOS_3$ was rare in gingiva, dentin, periodontal ligament and alveolar bone, and was mild in the capillaries of pulp and intermaxillary suture. And the expression of $NOS_2$ showed similar pattern to that of $NOS_3$. 2. There were no differences in the expression of $NOS_2\;or\;NOS_3$ in dentin, gingiva, cementum, cementoblast and odontoblast, between control and experimental groups, regardless of the duration of the force application. 3. The expression of $NOS_3$ began to increase at 4 days and showed to the highest degree at 7 days after force application, in the apical region of pressure side of periodontal ligament in experimental groups. 4. The expression of $NOS_3$ in alveolar bone was rare until 7 days, after which it increased to mild degree at 14 days through 28 days in experimental group. But there was no difference between pressure and tension side of periodontal ligament. 5. The expression of $NOS_2$ in periodontal ligament was mild from 7 days after force application, regardless of the side of periodontium, which was generally more evident than that of $NOS_3$. 6. The expression of $NOS_2$ in alveolar bone increased to mild degree at 14 days after force application, and it was evident in osteoblasts, osteoclasts and osteocytes. And the expression of $NOS_2$ was little more stronger in the tension side than that of pressure side of alveolar bone.

• Tuberculosis and Respiratory Diseases
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• v.48 no.6
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• pp.887-897
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• 2000

Background : Since the exact pathogenesis of sepsis-induced ARDS has not been elucidated, the mechanisms of enhanced neutrophilic respiratory burst were probed in endotoxin primed neutrophils associated with the roles of phospholipase A2(PLA2), platelet activating factor(PAF) and apoptosis. Methods : In isolated fresh human neutrophils, effects of the inhibition of PLA2 and PAF on the apoptosis were examined by the method of Annexin-FITC/dual PIflow cytometry. The roles of PLA2 and PAF on the neutrophilic respiratory burst were also examined by measuring oxidant generation in cytochrome-c reduction assay. Activities of the PLA2 and lysoPAF acetyltransferase (lysoPAF AT) of the neutrophils were determined to understand the effect of endotoxin on these enzymatic activities which may be related to the neutrophilic respiratory burst and apoptosis. In addition, the role roles of PLA2 and PAF in neutrophilic adhesion to bovine endothelial cells were examined in vitro by neutrophil adhesion assay. To investigate the effect of oxidants on pulmonary surfactant, cytochemical ultrastructural microscopy was performed. To inhibit PLA2 and PAF, non-specific PLA2 inhibitor mepacrine (100 nM) and WEB 2086 (100 nM) or ketotifen fumarate (10 ${\mu}g$/ml) were used respectively in all in vitro experimental sets. WEB 2086 is PAF receptor antagonist, and ketotifen fumarate is a lyso PAF AT inhibitor. Results: The mapacrine treatment, provided and the endotoxin (ETX) treatment, resulted in increased apoptosis of neutrophils (p<0.001) while treatments of WEB 2086 and ketotifen did not. The inhibition of PLA2 and PAF decreased (p<0.001) production of oxidants from PMA-stimulated neutrophils. While endotoxin increased the PLA2 activity of neutrophils (p<0.01), mepacrine supressed (p<0.001) the activity, provided after treatment of ETX. The lyso PAF actyltransferase activity (lyso PAF AT) increased (p<0.01) after treatment of ETX. In contrast, mepacrine, WEB 2086 and ketotifen showed a tendency of decreasing the activity after treatment of ETX. The treatment of ETX incresed (p<0.001) neutrophil adhesion to endothelial cells, which was reversed by inhibition of PLA2 and PAF (p<0.01). The binding of oxidants to pu1monary surfactant was identified histologically. Conclusions : The enhanced neutrophilic respiratory burst by ETX plays a pivotal role in the pathogenesis of ARDS in terms of oxidayive oxidative stress. Increased production of oxidants from neutrophils is mediated by the activations of PLA2 and lyso PAF AT.