• Title/Summary/Keyword: 관절성형

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Surgical Treatment of Metastatic Tumor in Pelvis (골반부 전이성 종양의 수술적 치료)

  • Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.61-70
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    • 2004
  • Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

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Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

Repair of Large to Massive Rotator Cuff Tears in the Elderly Patients (65세 이상 고령 환자의 대형 및 광범위 회전근 개 파열에 대한 봉합술)

  • Jung, Hong Jun;Chun, Jae Myeung;Jeon, In-Ho;Kwon, Jun;Ha, Sang-Ho;Yang, Sung Wook;Lee, Ji-Ho
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.91-98
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    • 2012
  • Purpose: The objective of this study is to evaluate the functional outcome and identify prognosis of retear patients in patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear. Materials and Methods: From 1995 September to 2010 March, 147 patients aged 65years or over (40 male, 107 female, with an average age of 69.6) undergoing surgical repair for large to massive full thickness rotator cuff tear (large 67 cases, massive 80 cases). For functional evaluation, preoperative and postoperative 1 year range of motion and muscle power checked. For subjective evaluation, American shoulder and elbow surgeons score and Constant score were checked. For anatomical evaluation, 87 patients were checked shoulder MRI at the time of the postoperative 1 year. Results: ASES score improved from to 50.4 to 88.9, Constant score improved from 47.1 to 75.2. Supraspinatus power improved from 51.1% to 80.8%, external rotator muscle power improved from 64.5% to 83.1%. Forward elevation improved from 117.4 degrees to 153 degrees, external rotation improved from 23.6 degrees to 41.8 degrees. Follow up MRI showed re-tear in 23%, all re-tear patients were from massive tear except one patient. All re-tear patients showed improved clinical outcomes, but supraspinatus and external rotator muscle power were not improved. Conclusions: Patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear showed successful outcomes over 90 percent. Re-tear patients also showed successful clinical outcomes. In elderly patients with large to massive full thickness rotator cuff tear, aggressive surgical repair leads good clinical outcomes.

Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

The Effect of Packing Method of Relining Material on the Flexural Strength of Denture Base Resin (첨상용 레진의 성형법이 의치상의 굴곡강도에 미치는 영향)

  • Kim, Min-Chul;Kim, Yu-Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.197-207
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    • 2011
  • The study aimed at examining how different reline resins affect flexural strength and flexural modulus of denture base. A total of 80 specimens ($64{\times}10{\times}3.3$ mm, according to ISO 1567:1999) of heat-polymerized resin, 40 specimens for (Lucitone199(Dentsply Int., NewYork, USA), SR Ivocap(Ivoclar AG, Schaan, Liechtenstein)) respectively, were polymerized according to the manufacturer's instructions and divided into eight groups(n = 10). Control group specimens remained intact. Specimens in the other groups were abraded on both sides to 2 mm thickness, and were relined in 1.3 mm thickness with 3 types of resins (Lucitone199(Dentsply), SR Ivocap(Ivoclar), and Rebase II(Tokuyama Co., Ltd, Tokyo, Japan)). All specimens were preserved in distilled water at $37^{\circ}C$ for 50 hours, and then were subjected to flexural strength testing in a universal testing machine using 3-point loading. A crosshead speed of 5 mm/min was used, and the distance between the supports was 50 mm. Data analyses included one-way analysis of variance(ANOVA) and the Tukey Honestly Significant Difference test (p=.05). Both heat-polymerized resin groups and auto-polymerized resin groups showed statistically low flexural strength and flexural modulus than control groups. Specimens relined with Lucitone 199 showed significantly higher flexural strength and flexural modulus than those relined with SR-Ivocap. Specimens relined with auto-polymerized resin showed significantly lower flexural strength and flexural modulus than those relined with heat-polymerized resin. Relining with heat-polymerized resins showed superior mechanical properties to relining with an auto-polymerized resin. Relining with the same heat-polymerized resin as the denture base does not affect mechanical properties of a denture. Lucitone199 using a compression-mould technique resulted in the highest flexural strength.

Development and Application of a Novel Mammalian Cell Culture System for the Biocompatibility and Toxicity of Polymer Films and Metal Plate Biomaterials (고분자필름과 금속막 의료소재에 대한 생체적합성 및 독성 평가를 위한 새로운 세포배양시스템의 개발 및 적용)

  • Kwak, Moon Hwa;Yun, Woo Bin;Kim, Ji Eun;Sung, Ji Eun;Lee, Hyun Ah;Seo, Eun Ji;Nam, Gug Il;Jung, Young Jin;Hwang, Dae Youn
    • Journal of Life Science
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    • v.26 no.6
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    • pp.633-639
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    • 2016
  • Biomaterials including polymer, metal, ceramic, and composite have been widely applied for medical uses as medical fibers, artificial blood vessels, artificial joints, implants, soft tissue, and plastic surgery materials owing to their physicochemical properties. However, the biocompatibility and toxicity for film- and plate-form biomaterials is difficult to measure in mammalian cells because there is no appropriate incubation system. To solve these problems, we developed a novel mammalian cell culture system consisting of a silicone ring, top panel, and bottom panel and we applied two polymer films (PF) and one metal plate (MP). This system was based on the principal of sandwiching a test sample between the top panel and the bottom panel. Following the assembly of the culture system, SK-MEL-2 cells were seeded onto Styela Clava Tunic (SCT)-PF, NaHCO3-added SCT (SCTN)-PF, and magnesium MP (MMP) and incubated at 37℃ for 24 hr and 48 hr. An MTT assay revealed that cell viability was maintained at a normal level in the SCT-PF culture group at 24 or 48 hr, although it rapidly decreased in the SCTN-PF culture group at 48 hr. Furthermore, the cell viability in the MMP culture group was very similar to that of the control group after incubation for 24 hr and 48 hr. Together, these results suggest the sandwich-type mammalian culture system developed here has the potential for the evaluation of the biocompatibility and toxicity of cells against PF- and MP-form biomaterials.

Effect of adaptive movement on durability and working time of twisted file (Adaptive movement가 twisted file의 내구성과 작업 시간에 미치는 영향)

  • Lee, Sang-Ho;Park, So-Ra;Cho, Kyung-Mo;Park, Se-Hee;Kim, Jin-Woo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.1
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    • pp.20-26
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    • 2019
  • Purpose: Recently TF-adaptive movement is developed in order to increase the durability of TF files. The purpose of this study was to assess the effects of adaptive movement on durability and performance of twisted files. Materials and Methods: Resin blocks simulating artificial J-shape canals were used for this study. In TFC group, TF-adaptive ML-1 (25/.08 size) files were used to prepare the canals under continuous rotation 500 rpm/4.0 Ncm. In TFA group, TF-adaptive ML-1 (25/.08 size) files were used to prepare the canals under adaptive movement. After preparing each artificial canal, TF files were observed under dental microscope for assessing existence of unwinding, distortion, and fracture. If unwinding of flute was observed, the number of artificial canals until unwinding of flute occurs was recorded. Required time until instruments reach working length and distance of unwinded portion of files from D0 were measured. All test results were conducted by Mann-Whitney U test at a 0.05 level of significance. Results: No Ni-Ti instrument's separation was observed. Number of resin blocks until file unwinding happens and working time was significantly high in TFA group compared to TF group. Distance of distortion from D0 didn't show significant difference between TFA, TF groups. Conclusion: The number of resin blocks prepared until unwinding happens and working time were significantly high in TFA group. The location of unwinding showed no significant difference between 2 groups. Adaptive movement increased the number of canals prepared until unwinding occurs and working time of twisted files.