• 대한골관절종양학회지
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• 제13권2호
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• pp.105-112
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• 2007

목적: 최근 골 및 연부조직 종양을 포함한 각종 악성 종양에서 cyclooxygenase-2 (COX-2) 의 발현 증가가 보고되고 있다. 그러나 연골 종양에서의 COX-2 발현에 대해서는 별로 알려진 바가 없다. 대상 및 방법: 내연골종 10예, 연골모세포종 11예, 연골점액양섬유종 5예, 통상적 연골육종 17예, 투명세포 연골육종 7예, 간엽성 연골육종 6예를 대상으로 COX-2에 대한 면역조직화학법을 시행하였다. 결과: 양성 연골 종양 중 연골모세포종 11예 중 6예(54.5%)에서 특징적인 강한 양성 반응을 나타내었다. 내연골종과 연골점액양섬유종은 단 1예를 제외하고는 모든 증례에서 음성이었다. 통상적인 연골육종에서 3예(17.6%)는 COX-2에 대해 강한 양성 반응을 보였는데 이러한 양성 증례는 모두 조직학적 등급 3의 분화가 나쁜 연골육종이었다. 투명세포 연골육종 중 2예(28.5%)는 국소적인 양성 반응을 나타내었고 모든 간엽성 연골육종은 음성이었다. 결론: 이러한 결과는 통상적인 연골육종에서 COX-2 과발현이 조직학적 등급 진행과 관계된 소견임을 시사한다. 연골모세포종의 COX-2 발현은 특별히 이 종양에 동반되는 종양 주변부의 염증성 변화를 유발하는 중요한 요소로 생각된다.

• 대한족부족관절학회지
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• 제16권4호
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• pp.247-256
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• 2012

Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using mini-open sinus tarsi approach for displaced intraarticular calcaneal fractures. Materials and Methods: We studied 18 cases (16 patients) of intraarticular calcaneal fractures who were treated with sinus tarsi approach by same surgeon. The mean age of patients was 44.8 years, and mean follow-up period was 17.2 months. The measurement of B$\ddot{o}$hler angle, Gissane angle, the degree of articular surface depression, and the period to union were performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: B$\ddot{o}$hler angle and Gissane angle had improved significantly from preoperative average $9.8^{\circ}$, $117.6^{\circ}$to average $22.4^{\circ}$, $113.4^{\circ}$ immediate postoperatively, and had maintained to average $21.8^{\circ}$and $114.2^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 5.2 mm to 1.2 mm at the last follow-up. All cases achieved bone union, and the period to union was average 10.5 weeks. AOFAS score was average 86.2 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the CNHF scale. Therefore, 16 cases (88.8%) achieved satisfactory results. Conclusion: The minimally invasive sinus tarsi approach using headless compression screw seems to be an effective surgical method for displaced intraarticular calcaneal fractures, because of the possibility of accurate restoration of articular surface and the low risk of postoperative soft tissue complications.

• 대한족부족관절학회지
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• 제23권4호
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• pp.166-172
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• 2019

Purpose: This study evaluated the clinical and radiological results after reinforcement of the weakened medial joint capsule using Internal Brace (Arthrex) for treating severe hallux valgus. Materials and Methods: This study reviewed 56 cases of 50 patients that were followed-up postoperatively for at least 12 months, from September 2017 until August 2018. An extended distal chevron osteotomy combined with a distal soft-tissue release was performed by a single surgeon to treat severe hallux valgus. Internal Brace was applied in 12 cases (group A) who had weakened medial joint capsules, and capsulorrhaphy was performed in 44 cases (group B), and these two groups were compared postoperatively for the clinical and radiological results. The postoperative complications were also investigated. Results: No significant differences at 1-year follow-up on the Manchester-Oxford Foot Questionnaire and the patients' satisfaction scores were found between the two groups (p=0.905 and p=0.668, respectively). For the radiology, the changes of the values between before surgery and at 1-year follow-up according to the group showed no significant differences in the hallux valgus angle, intermetatarsal angle, and the hallux interphalangeal angle (p=0.986, p=0.516, p=0.754, respectively). Recurrence of hallux valgus was reported in two cases in group A, and in three cases in group B. Transfer metatarsalgia occurred in 4 cases in group B. Conclusion: Based on these results, we recommend the capsule reinforcing technique using Internal Brace as a successful operative option for treating a weakened medial capsule in patients with severe hallux valgus.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권3호
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• pp.265-286
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• 1997

Bone morphogenetic proteins(BMPs) are a group of transforming growth factor beta(TGF-${\beta}$)-related factors and multifunctional proteins, especially the only known biologic factors capable of inducing endochondral bone formation at an extraskeletal site. This study was performed to investigate the effect of the partially purified porcine BMP(pBMP) at an ectopic site. PBMP was partially purified from porcine bone matrix and its activity was monitored by an in vivo bioassay. The purification method utilized extraction of the bone-inducing activity with 4M guanidine, followed by chromatography on heparin-Sepharose. Active fractions were assayed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. And the fractions were reconstituted with inactive insoluble collagenous bone matrix from rats, acid soluble type I collagen from rat tail and chondroitin-6-sulfate sodium salt and implanted into the pectroralis muscle pouches of Sprague-Dawley rats. And the carrier complex was implanted on the opposite side as control. The rats were sacrificed at the day of 1st, 3rd, 5th, 7th, 11th, 14th and 21st after implantation and examined histologically, radiologically and biochemically. And alkaline phosphatase activity and calcium content were used as indices of bone formation. The results were as follows ; 1. Active fractions were localized in a zone between 31 and 40 KDa on SDS-PAGE. 2. The implanted 3.0mg of the partially purified pBMP induced cartilage and bone in the muscle tissue of rats through an endochondral ossification process. 3. Inactive insoluble bone matrix, type I collagen and chondroitin-6-sulfate have functioned as carriers for pBMP, but revealed some foreign body reactions. 4. Soft X-ray didn't reveal significant change between the experimental and the control group. 5. The alkaline phosphatase activities in the experimental group of 5th, 7th, 11th, 14th and 21st were increased significantly compared with control (p<0.01) with the peak in the group of 11th day. 6. With time, the calcium content of the experimental group increased. And the calcium contents in the experimental group of 11th, 14th and 21st were increased significantly compared with control (p<0.01).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권2호
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• pp.100-105
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• 2012

Purpose: In general, the surgical treatment for mandibular retrognathism is represented by two methods, distraction osteogenesis (DO) and mandibular osteotomy surgery. The DO is mostly preferred when the degree of advancement of mandible is large. However, the postoperative stability of mandibular advancement using DO have not been actively investigated. Therefore, in the present study we have compared the postoperative stability between DO and bilateral sagittal split ramus osteotomy (BSSRO) in mandibular retrognathism. Methods: Seven patients who had been treated by DO and thirteen patients with BSSRO were included in this study. Serial lateral cephalograms were analyzed by manual tracing and the amount of the mandibular elongation was measured. To evaluate the postoperative stability, positional changes of the condylar position and B point were analyzed. Results: Mean amount of mandibular advancement was $6.51{\pm}3.57mm$ for BSSRO group and $12.43{\pm}4.35mm$ for DO group, respectively. There was no significant difference in age between the two groups (P>0.05). Mean follow up periods were 10.77 months for BSSRO group and 11.28 months for DO group, respectively. After mandibular advancement, mean positional changes in the condyle were $0.56{\pm}1.43mm$ horizontally and $0.72{\pm}1.61mm$ vertically for BSSRO group and $0.53{\pm}1.56mm$ horizontally and $0.56{\pm}1.75mm$ vertically for DO group, respectively. Mean change of distance from B point to Y-axis was $-1.76{\pm}0.83mm$ for BSSRO group and $-2.14{\pm}1.82mm$ for DO group, respectively. According to the condylar position and B point, there were no significant differences in postoperative stability between the two groups (P>0.05). Conclusion: There was no significant difference in postoperative stability between DO and BSSRO group according to condylar position and B point. Based on the results of the present study, it is hypothesized that DO would be a good treatment choice for severe mandibular retrognathism because DO could achieve more mandibular advancement and concurrent soft tissue elongation.

• 대한치과교정학회지
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• 제34권2호
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• pp.109-119
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• 2004

이 연구는 제 2 대구치를 발거하고 하악 제 1 대구치의 후방이동을 위해 CPHG(cervical pull head gear)와 경우에 따라 III급 고무줄을 사용하여 고정성 교정장치로 치료한 III급 부정교합자의 치료전후 안면골 및 치아치조부, 연조직의 평균변화를 알아보기 위해 시행되었다. 평균 ANB가 $-1.4^{\circ}$ 이고 IMPA가 $85^{\circ}$인 중등도이하의 III급 부정교합자 15명을 대상으로 치료전후 측모두부 X-선 규격사진의 평균 두개안면부 측면 중첩모식도를 작성하고 계측 분석한 바 다음과 같은 결과를 얻었다. 1. 전안면고경에 대한 전하안면고경의 비율은 $0.6\%$증가(P<0.01)하였고, 하악 평면각이 $1.5^{\circ}$증가(P<0.05)하였다. 2. 전방 두개저에 대한 하악골 위치는 미약하게 후하방회전하였다. 3. 하악 제 1 대구치가 4.06mm(P<0.001)후방경사이동하였고 하악 전치는 설측으로 $3.2^{\circ}$경사이동(P<0.05)하였다. 4. 하순의 후퇴로 인한 안모의 개선이 이루어졌다. 이상의 결과를 종합할 때 골격성 부조화가 중등도 이하인 III급 부정교합자에서 하악 제 1대구치의 후방이동을 용이하게 하고 하악 전치의 지나친 설측경사를 피하기 위해 제 2 대구치를 발거하는 것은 조심스러운 증례의 선택시 치료에 유용하리라 사료된다. 그러나 본 연구에서는 제 2 대구치 발거 후 제 3대구치의 맹출 및 치료후 예후에 대한 장기적인 관찰은 이루어지지 못하여 향후 이에 대한 계속적인 연구가 필요하리라 생각된다.

• Journal of Periodontal and Implant Science
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• 제31권3호
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• pp.641-649
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• 2001

The aim of present study was to assess the thickness of masticatory mucosa on the hard palate and tuberosity as a potential donor site for mucogingival surgery. Thickness measurement was performed in 30 dental college students who are periodontally healthy, with a recently developed, ultrasonic device(SDM). The mean age of study subjects was 23.7(range 21-29) years old and the subjects were composed of 18 males and 12 females. Eighteen standard measurement points were defined on the hard palate, located on 3 lines which ran at different distances parallel to the gingival margin. Six positions were designated on each of these 3 lines between the level of the canine and the second molar. On the tuberosity, 6 standard measurement points were defined, located on 2 lines running parallel to the gingival margin at different distances. Data were analyzed to determine differences in gender, between different positions, and between lines, by an analysis of variance. The results showed that the mucosa of the tuberosity was significantly thicker than that of the hard palate region. Gender did not influence the thickness of masticatory mucosa, either on the hard palate or the tuberosity. On the hard palate, mucosa thickness increased as the distance from the marginal gingiva increased. The mucosa over the palatal root of the maxillary first molar was significantly thinner than that at all other positions on the hard palate. Measurement error at palate was 0.25mm, at tuberosity 0.51mm. No difference in the thickness of masticatory mucosa on palate and tuberosity was found between men and women. On the hard palate, soft tissue thickness progressively increased in sites further from the gingival margin. Therefore, we may harvest more thicker graft on the tuberosity that has more masticatory mucosa thickness than hard palate, however the width may not be sufficient for using.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.223-237
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• 2006

The purpose of the present study was to evaluate the effect of bone graft materials including deproteinized bovine bone(DBB), demineralized freeze-dried bone(DFDB), freeze-dried bone(FDB) on bone formation in guided bone regeneration using perforated titanium membrane(TM). 16 adult male rabbits(mean BW 2kg) were used in this study and 4 rabbits allotted to each test group. Intramarrow penetration(diameter 6.5mm) was done with round carbide bur on calvaria to promote blood supply and clot formation in the wound area. The test groups were devided into 4 groups as follows: TM only(test 1), TM +DBB(test 2), TM +DFDB(test 3), TM +FDB(test 4). Perforated titanium membrane was contoured in rectangular parallelepiped shape(0.5mm pore diameter, 10mm in one side, 2mm in inner height), filled the each graft material and placed on the decorticated carvaria. Perforated titanium membrane was fixed with resorbable suture materials. The animals were sacrificed at 2, 8 weeks after the surgery. Non-decalcified preparations were routinely processed for histologic analysis. The results of this study were as follows: 1. Perforated titanium membrane was biocompatible. 2. Perforated titanium membrane had capability of maintaining the space during the healing period but invasion of soft tissue through the perforations of titanium membrane decreased the space available for bone formation. 3. In test 1 group without bone graft material, the amount of bone formation and bone maturation was better than other test groups. 4. Among the graft materials, the effect of freeze-dried bone on bone formation was best. 5. In the test groups using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was a little. The spacemaking capability of the membrane may be crucial for bone formation. The combined treatment with the perforated titanium membrane and deproteinized bovine bone or demineralized freeze-dried bone failed to demonstrate any added effect in the bone formation. Minimization of size and numbers of perforations of titanium membrane or use of occlusive titanium membrane might be effective to acquire predictable results in the vertical bone formation.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.167-177
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• 2006

연구배경 임플란트에 관한 전통적인 연구들은 주로 임플란트 매식체와 골조직간의 결합에 중점을 두어왔다. 최근 임플란트의 심미적 관점에 대한 관심이 높아지면서 임플란트 주위 연조직의 재건 및 유지에 대한 연구들이 많이 이루어지고 있다. 이번 연구는 임플란트 주위 연조직이 임플란트 지대주의 모양에 따라 어떻게 반응하는지 알아보고자 한다. 연구방법 및 재료 2 마리의 성견을 대상으로, 먼저 하악의 모든 소구치를 발치하고, 3개월의 치유 기간 후에 각 4분악에 실험에 사용된 3개의 다른 모양의 지대주를 가진 임플란트를 식립하였다: (1) 위로 벌어진 모양의 지대주 (2) 안쪽으로 오목하게 좁아진 지대주 (3) 평행한 모양의 지대주. 식립 순서는 무작위로 하였으며, 3개월 후 실험동물을 희생하고 조직 표본을 얻었다. 조직 표본은 광학 현미경을 통해 관찰하고, 상피, 결합조직, 전체 연조직의 수직적 거리를 측정하여 비교하였다. 연구 결과 이번 연구에서 임플란트 주위의 연조직을 측정한 결과, 접합 상피는 1.21 ${\pm}$ 0.47 mm, 결합조직은 1.16 ${\pm}$ 0.39 mm, 전체 연조직 두께는 2.37 ${\pm}$ 0.47 mm로 이전의 연구들과 비슷한 결과를 보였다. 지대주 주위의 연조직 중 결합조직이 많은 부위에서는 여러 주행 방향의 교원 섬유들이 관찰되었다. 그 중에서 결합조직이 차단막으로써의 역할을 할 수 있도록 하는 원형으로 주행하는 교원 섬유들이 모든 지대주 모양에서 관찰되었다. 특히 오목하게 좁아진 모양을 가진 지대주에서는 오목하게 파인 부분으로 많은 원형으로 주행하는 교원 섬유들이 관찰되었다. 오목한 모양의 지대주는 다른 모양의 지대주에 비해서 측면 방향의 연조직 두께가 두꺼웠다. 특히 위로 벌어진 모양의 지대주에 비해서 두꺼운 연조직을 확보할 수 있었으며, 내부에 많은 결합조직 교원 섬유들을 관찰할 수 있었다. 결론 이번 연구에서 오목한 모양의 지대주가 연조직을 두껍게 유지하고, 많은 원형으로 주행하는 교원 섬유들을 확보할 수 있었다. 이를 통해 오목한 여태의 지대주가 연조직 유지에 더 유리하고, 따라서 심미적인 부위에서 연조직의 퇴축을 예방하는데 더 유리하다고 할 수 있다.

• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.573-580
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• 2004

The Palatal masticatory mucosa was widely used as a donor site in periodontal and implant surgery. but there were relatively few studies investigating the thickness of the palatal mucosa in dentate subjects. The purpose of this study was to study the thickness of palatal masticatory mucosa in korean subjects by direct clinical technique. Forty systemically and periodontally healthy subjects(20 males:20 females) participated in this study. A bone sounding method using a periodontal probe with minimal anesthesia and a prepared clear acrylic stent was utilized to assess the thickness of palatal mucosa at 24 measurement points defined according to the gingival margin and mid palatal suture. The results are as follows; 1. Mean thickness of palatal masticatory mucosa was $3.5{\pm}0.4mm$. and no gender differences were identified in the thickness of palatal masticatory mucosa. 2. The thickness of palatal masticatory mucosa increased from canine to second molar area(with the exception of the first molar area). canine and first molar areas were significantly thinner than other areas(P<0.05). 3. The thickness of palatal masticatory mucosa significantly increased in the sites farther from the gingival margin towarding the mid-palate(P<0.05). The results suggest that within the limits of the present study, premolar area appears to be the most appropriate donor site for soft tissue grafting procedures.