Purpose: To consider the proper management of proximal humerus fracture on gunshot wounds. Materials and Methods: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done. Result: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus. Conclusion: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.
The purpose of this study is to provide the fundamental information fer the rehabilitation of hand injury and to emphasize the point of early treatment of hand injury after operation. The subjects are composed with the physical therapists who care hand injury and are engaged in 76 university hospitals,59 general hospitals and 88 semi and local clinics respectively. Investigator take the research form chart with 41 questionnaire and use the cross tabulation frequencies and one-way ANOVA of SPSS WIN(ver 10.0) for the statistic analysis. The results of this research are as follows :1. The number of physical therapists who care hand injury are 110 men and 113 women. 2. The beginning period of active assistive exorcise on the various type of injuries are as follows: At the case of flexor tendon injury, the most part of physical therapists make response to the period that is above 4 weeks in the rate of 29.1%. At the case of fracture, the most part of physical therapists make response to the period those are from 3 weeks to less than 4 weeks and from 4 weeks to less than 5 weeks in the rate of 28.7% respectively. At the case of crushing injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 32.2%. At the case of amputation injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 40.4%. 3. In the physical therapy request, treatment period are mentioned in 22.0%. 4. The most difficult factors in the hand treatment is to contracture soft tissue and joint to physical therapist in the rate of 59.6%. 5. Among the reasons of the intervention between physical therapy request and actual treatment, the case of wrong physical therapy request is examined in 69.4%.
This study was carried out to investigate the amino acid and protein concentrations in amniotic fluid and the potency of the teratogenic effect of ethylenethiourea(2-imidazolidinethione, ETU) in the fetuses due to different dose amounts of this compound. The S.P.F. Sprague-Dawley female rats(10 weeks) were used in this study and these animals were divided into four groups; control group(25pregnant female rats), group I (dosed ETU from day 7 to day 17 of gestation at 10mg/kg/day), group II (dosed ETU from day 7 to day 17 of gestation at 30mg/kg/day), group III (dosed ETU from day 7 to day 17 of gestation at 50mg/kg/ day). 250mg/100mg ETU in group I, 750mg/100ml ETU in group II and 1,250mg/100ml ETU in group III were administered 4ml/kg 13.W by oral route. The results obtained were summarized as follows; 1. The anomalies of the external examination werf meningocele in the head, kinky tail, clubfoot and sharp tail.(Meningocele, in group III, significantly increased from control value at p<0.001). 2. The skeletal variations and delayed ossification were Lumbar ribs, asymmetric sternebrae, asymmetric 13th rib and delayed ossification of skull. Asymmetric sternebrae(group III ) was significantly increased from control value at p<0.05 and delayed ossification of skull (group II and III ) were significantly increased from control value at p<0.05 and p<0.01, respectively. 3. The internal soft tissue anomalies were hydroencephaly of 3th lateral ventricle, dilatation of ureter, dilatation of renal pelvis and cleft palate. (Hydroencephaly, 28.1% in group I, 88.3% in group II and 100% in group III ). 4. Protein values in amniotic fluids are not significantly decreased in 10mg/kg group but significantly(p<0.05) decreased in 30mg/kg group and 50mg/kg group from control group. 5. In the levels of amino acid in amniotic fluids, the levels of glntamic acid, iso-lencine, leucine, tyrosine and phenylalanine of 10mg/kg group are significantly decreased from control group. In 50mg/kg group, except for glycine, valine and methionine, all amino acid levels are significantly(p<0.05) decreased from control group.
The Journal of the Korean bone and joint tumor society
/
v.19
no.1
/
pp.14-19
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2013
Purpose: We analyzed the oncologic characteristics and outcome of patients with inflammatory myofibroblastic tumor of extremities. Materials and Methods: Among the soft tissue tumor patients who were treated between 1999 and 2012, 5 patients who were pathologically confirmed as the inflammatory myofibroblastic tumor of extremities were analyzed retrospectively. Results: There were 1 man and 4 women with mean age of 44 years (37-55 years). The average follow up was 34.6 months (8-87 months). All patients underwent surgical treatment. Only 1 patient had wide resection margin and remaining 4 had marginal (3) or intralesional (1) resection margin. All of 4 patients without wide resection margin developed local recurrence at 10.3 months (8-19 months). Malignant transformation to fibrosarcoma was occurred in 2 patients who developed local recurrence, and 1 patient developed multiple metastases to lung, liver and lymph nodes and expired at 37 months. Three of 5 patients had tumor location abutted to or invasion to major arteries and 1 patient had tumor invading sciatic nerve. Conclusion: It is observed that inflammatory myofibroblastic tumor of extremities is usually located near the major neurovascular structure. Wide resection should be considered as the initial surgical treatment because this tumor showed a high local recurrence rate and possibility of malignant transformation.
Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.
Kim, Yun-Jeong;Park, Ji-Man;Kim, Sungtae;Koo, Ki-Tae;Seol, Yang-Jo;Lee, Yong-Moo;Rhyu, In-Chul;Ku, Young
Journal of Periodontal and Implant Science
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v.46
no.6
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pp.372-381
/
2016
Purpose: The aim of this study was to determine the relationship between buccal bone thickness and gingival thickness by means of a noninvasive and relatively accurate digital registration method. Methods: In 20 periodontally healthy subjects, cone-beam computed tomographic images and intraoral scanned files were obtained. Measurements of buccal bone thickness and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0-5 mm from the alveolar crest on the superimposed images. The Friedman test was used to compare buccal bone and gingival thickness for each depth between the 3 tooth types. Spearman's correlation coefficient was calculated to assess the correlation between buccal bone thickness and gingival thickness. Results: Of the central incisors, 77% of all sites had a buccal thickness of 0.5-1.0 mm, and 23% had a thickness of 1.0-1.5 mm. Of the lateral incisors, 71% of sites demonstrated a buccal bone thickness <1.0 mm, as did 63% of the canine sites. For gingival thickness, the proportion of sites <1.0 mm was 88%, 82%, and 91% for the central incisors, lateral incisors, and canines, respectively. Significant differences were observed in gingival thickness at the alveolar crest level (G0) between the central incisors and canines (P=0.032) and between the central incisors and lateral incisors (P=0.013). At 1 mm inferior to the alveolar crest, a difference was found between the central incisors and canines (P=0.025). The lateral incisors and canines showed a significant difference for buccal bone thickness 5 mm under the alveolar crest (P=0.025). Conclusions: The gingiva and buccal bone of the anterior maxillary teeth were found to be relatively thin (<1 mm) overall. A tendency was found for gingival thickness to increase and bone thickness to decrease toward the root apex. Differences were found between teeth at some positions, although the correlation between buccal bone thickness and soft tissue thickness was generally not significant.
Du, Feng;Yuan, Peng;Wang, Jia-Yu;Ma, Fei;Fan, Ying;Luo, Yang;Xu, Bing-He
Asian Pacific Journal of Cancer Prevention
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v.16
no.3
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pp.903-907
/
2015
Background: Among human epidermal growth factor receptor 2 (HER2)-positive breast cancer, more than half are also hormone receptor (HR)-positive. Although HR is a predictive factor for the efficacy of hormone therapy, there are still some uncertainties in regard to the effects on patients with HR-positive and HER2-positive metastatic breast cancers due to the potential resistance to hormone therapy caused by co-expression of HR and HER2. There are no clinical trials directly comparing the efficacy of hormonal therapy with chemotherapy. Materials and Methods: To examine the real-world effect of hormone therapy on patients with HR-positive and HER2-positive metastatic breast cancers, a cross-sectional study of a representative sample of the Chinese population was conducted. The study included 113 patients who received first-line and second-line palliative treatment between 2005 and 2010 in the Cancer Institute and Hospital, Chinese Academy of Medical Science. The effect of hormone therapy on overall survival (OS) was studied. Results: The patients who received hormone therapy (n=51) had better overall survival in contrast to those who received chemotherapy with anti-HER2 therapy (n=62) in first- or second-line treatment. The difference was of borderline statistical significance (51.8m vs 31.9m, p=0.065). In addition, the effect of hormone therapy did not differ significantly with other prognostic factors, including age (${\leq}50$ years or >50 years), disease free survival (${\geq}2$ years or < 2 years) and site of metastasis (visceral or bone/soft tissue). On multivariate analysis, administration of hormone therapy was associated with a trend toward a favorable prognosis (p=0.148, HR=0.693, 95%CI 0.422-1.139). Age more than 50 years was the sole independent harmful prognostic factor (p<0.001, HR=2.797, 95%CI 1.676-4.668). Conclusions: Our data suggest that hormonel therapy may improve outcomes of the patients with ER-positive and HER2-positive metastatic breast cancer.
Purpose: Tibial plateau fractures cause a variety of problems in the knee joint. The purpose of this study was to investigate the characteristics of the meniscus injuries in tibial plateau fracture arthroscopically. Materials and Methods: Thirty-three out of 39 consecutive patients diagnosed with tibial plateau fractures underwent arthroscopy between March 2007 and March 2010. According to Schatzker classification, there were 1 type I (3.3%), 19 type II (53.3%), 4 type III (13.3%), 2 type IV (6.6%), 2 type V (6.6%) and 5 type VI (20%) fracture patterns in 33 patients. Results: Twenty-five cases (75.8%) had lateral meniscus tears. There were 18 meniscal tears in 19 cases of Schatzker type II fractures (94.7%), 3 meniscal tears out of 4 cases of Schatzker type III fractures (75%) and 4 meniscal tears out of 5 cases of Schatzker type VI fractures (80%). The most commonly affected site (22/25) was the anterior horn of the lateral meniscus. Of the 25 documented meniscal tears, all but one were vertical longitudinal tear at meniscocapsular junction so most cases are amenable to arthroscopic repair. Conclusion: Arthroscopy for the meniscal injuries in tibial plateau fractures is a valuable diagnostic and treatment tool, we recommend arthroscopy in tibial plateau fracture.
The purpose of this study was to evaluate the dentofacial characteristics and the fost-treatment dentofacial changes of those treated by four premolar extractions and to investigate the factors affecting extraction decision. The sample consisted of 35 patients (27 females, and 8 males) with no more than 7.0mm crowding, diagnosed as Class I protrusion. Pre-treatment and post-treatment lateral cephalograms were evaluated. Computerized statistical analysis was carried out using SPSS/PC+ program. The results were as follows. 1. There was no significant change in skeletal pattern after treatment while there was significant change in dentoalveolar and soft tissue pattern. 2. In pre-treatment skeletal pattern, a tendency toward vertical discrepancy was found. 3. In pre-treatment dental pattern, interincisal angle was $113.11^{\circ}$, U1 to FH was $117.78^{\circ}$ and L1 to A-Pog was 7.94mm. Pre-treatment upper and lower lip position was 2.88mm and 5.43mm to E line. 4. After treatment, interincisal angle increased $14.46^{\circ}$ and upper and lower lip moved back 2.45mm and 3.2mm to E line.(p<0.001) 5. The EI was 138.71 before treatment and 148.2 after treatment.
Kim Won-Cheol;Hwang Eui-Hwan;Lee Sang-Rae;Hong Jung-Pyo
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.24
no.2
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pp.263-274
/
1994
The purpose of this study was to investigate the remodeling process of the streptozotocin-induced diabetic rat's resected condyle. This experiment was performed with male Sprague-Dawly strain rats weighing approximately 250 gm, which were rendered diabetic by an intravenous injection of streptozotocin(70㎎/㎏ body weight). After condylectomy, experimental rats were serially terminated on the 1st week, the 2nd week, the 3rd week, and the 4th week. The following termination, the mandibles were dissected out to make specimens. Each mandibular condyle was radiographed with Hitex HA-80(Hitex Co., Ltd. Japan). In addition to radiographic observation, the mandibular condyles, further decalcified and embedded in paraffin, were sectioned and stained with Hematoxylin and Eosin, Toluidine blue and Masson's trichrome. They were observed with a light microscope and a polarizing microscope. The results were as follows. 1. Soft X-ray radiograms revealed proliferation of bone after 1 week in both groups. Irregularly repaired bones and dense trabeculae were clearly observed in experimental group. 2. The resected condyles were repaired by intramembraneous and endochondral bone formation in both groups. 3. Bone tissue repair was initiated from the adjacent margin of resected bone, and cartilaginous tissues were observed at the top of repaired bone in both groups. 4. The number of osteoblasts of experimental group was small, compared with control group. Each osteoblast was small and flat. The thin trabeculae were irregularly formed. 5. Collagens of bone were gradually matured in both groups, but the degree of maturation was lower in experimental group. 6. Fibrous tissues covered the upper parts of repaired bone were densely arranged in the both groups. Conclusively, atrophied osteoblasts, immature collagen of bone, and thin and irregular trabeculae which were characterized in the diabetes experimental group showed diabetes disturbed osteoblastic function and caused disturbance of remodeling process of bone.
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