• Journal of Life Science
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• v.18 no.4
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• pp.427-434
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• 2008

Osteonecrosis of the femoral head (ONFH) is a multifactorial disease and certain individuals are more at risk or may be predisposed to it. An altered lipid metabolism is one of the major risk factors for osteonecrosis, especially corticosteroid therapy and alcoholism. 3-hydroxy-3-methylglutaryl coenzyme A. (HMG-CoA) reductase inhibitors, stalin used as lipid-clearing agent, have been known to decrease the risk of osteonecrosis in patients receiving steroids and affect coagulation and fibrinolysis. Therefore we evaluated the association of HMG-CoA reductase gene polymorphisms and haplotypes between osteonecrosis patients and normal controls. We directly sequenced the HMG-CoA reductase gene in 24 Korean individuals, and identified five sequence variants. Four SNPs (-6933C>T, -6045T>G, +12673G>A, and +18128C>T) were selected and genotyped in 349 male ONFH patients and 300 male control subjects. The genotypes, allele frequencies, and haplotypes of the polymorphisms in the total patients as well as in the subgroup by etiology were not significantly different from those in the control group. In addition, no significant differences between each genotype of the polymorphisms and plasma lipid level could be found in the control group. These results suggest that the polymorphisms and haplotypes of HMG-CoA reductase gene are unlikely to be associated with a susceptibility to ONFH.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.72-80
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• 1994

There are several methods to reconstruct an amputated or lost thumb such as toe to thumb transfer, pollicization and other variety of free flaps. In 1980, Morrison and O'Brien advocated reconstruction of the thumb with a free wrap-around flap from the big toe to recreate a stable, sensate and functional digit, including the nail. From March, 1982 to December, 1992, thirty cases of thumb reconstructions were performed using the wrap-around procedure at Korea University Hospital. 1. 29 cases of total 30 cases were successful and can be obtained the excellent results in functional and cosmetic aspect. 2. In postoperative complications, one case is graft failure, six cases in partial skin necrosis, one case in malunion, 15 cases in resorption of grafted bone piece were come out. 3. Even if the 1st metacarpal neck amputation is occurred, thumb reconstruction with a free neurovascular wrap-around flap was also possible, however, the limitation of the mobility of the reconstructed thumb and resorption of grafted bone piece were come out. We concluded that cosmesis and fuctional results were quite satisfactory despite of some complications. The thumb reconstruction with a wrap around free flap from the big toe in thumb amputated patients is the excellent method in the cosmetic and functional aspect and can be considered as the most useful method because of less morbidity to the donor site and the operator should be trained to get the meticulous microsurgical technique and to detect the complications.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.531-548
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• 2024

Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.318-332
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• 2000

The purpose of this study was to investigate the effects of demineralized freeze-dried bone (DFDB) on mechanically exposed pulp of dog by evaluating the pulpal inflammation and healing process, formation of dental hard tissue, and structural changes of fibroblasts of the remaining pulp tissue. Teeth of 4 dogs, weighing 10kg, were used in this study. Class V cavities were prepared followed by exposed the pulp tissue mechanically by sterilized round bur. In control group, exposed pulps were capped with calcium hydroxide paste followed by sealed with IRM. In experimental groups, the exposed pulps of one group were capped with the collagen and those of the other group were capped with DFDB. All cavities were sealed with same manor as control group. The animals were sacrificed at the intervals of 3, 7, 14, and 28 days for histopathlogic evaluation. The specimens were observed by the light microscope and trans-electron microscope. The results were as follows: 1. Pulp necrosis was not observed in all groups. Inflammatory response was disappeared from 1 week in control group and group 2. But it was not disappeared until 2 weeks and also irregular arrangement of odontoblasts was showed at the lateral walls of root canal just beneath the amputated site of the pulp in group 1. 2. Dentinal bridge was formed incompletely at 2 weeks but it was formed completely at 4 weeks in control group. Odontoid tissue was also found in control group at 4 weeks from treatment. Amputated site of pulp was encapsulated with fibrous tissue and odontoblast and dentinal bridge was not found in group 1. Preodontoid tissue and reparative dentin which were formed by odontoblast differentiated around DFDB were found, but dentinal bridge was not found in group 2. 3. Cell with large basophillic-stained nuclei infiltrated to amputated site and DFDB at 1 week from treatment in control group and group 2. They were found more in group 2 than in control group. Odontoblasts arranged more regularly and reparative dentin was found more as time elapsed. 4. Dentin-formative odontoblasts which showed ultramicrostructure of cytoplasm with polarized nucleus, rEM, Golgi complex, secretory granules, secretion of organic matrix in control of group and group 2. In regards to above results, the demineralized freeze-dried bone(DFDB) induce odontoblastic differentiation and further come up to the dentin formation in amputated pulp.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.110-119
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• 2019

Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.204-208
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• 2005

Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.89-94
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• 2006

When the old schwannoma has the degenerative changes, it is named as the ancient schwannoma which was rarely reported. The degenerative changes are perivascular hyalinization, calcification, cystic necrosis, marked decrease of Antoni type A area, and degenerative nuclei and the ancient schwannoma may be misinterpreted as sarcomatous pleomorphisms. We experienced the ancient schwannoma which has massive hemorrhage and hematoma, cystic change, calcification, and marked decrease of Antoni A area in leg on 75 year old male patient, and report it.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.199-202
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• 2006

The effects of acute hematogenous osteomyelitis vary with a patient's age because of the differences in the blood supply and structure of the bone. In children older than 2 years of age, this process results in extensive abscess formation when both the endosteal and periosteal blood supply are destroyed. Thorough drainage of abscess cavity and removal of all dead or necrotic material are not always possible although large skin incision is made along the abscess. Authors successfully managed acute osteomyelitis of the tibia with extensive large abscess in a 11 year-old female, using minimal incisions and 4-mm endoscope.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.167-172
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• 2009

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.5.1-5
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• 1983

Esophageal foreign body is not uncommon problem among the esophageal disease and it is cured by removal of foreign body under the esophagoscopy in the most case. But it can cause esophageal perforation, periesophageal abscess, mediastinitis, pneumothorax, pyothorax, lung abscess and subcutaneous emphysema, and then may threat the life if early diagnosis and prompt management is not carried out. Esophageal perforation can be developed by sharp pieces of metal, bone or long term lodgement of foreign bodies in the esophagus. The authors have experienced the patient with periesophageal abscess after drawing out the sharp fish bone, and achived the good result by drainage via cervical mediastinotomy with continuous irrigation.