• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.139-155
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• 2009

Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.54-59
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• 2014

Purpose: We report the diagnosis, treatment outcomes and prognosis of the patients with soft tissue malignant myoepithelioma in the extremities. Materials and Methods: We retrospectively reviewed 6 patients with soft tissue malignant myoepithelioma in the extremities who were treated at our institution between 2008 and 2014. Two patients received unplanned excision at another hospital and remaining 4 patients underwent the biopsy procedures and received wide excision at our hospital. Results: There were 3 men and 3 women with mean age of 41 (33-54) years. The average follow up was 28 (9-45) months. Among the 6 patients, only 4 patients underwent biopsy procedures under the impression of malignant soft tissue sarcoma. Surgical margins for these 4 patients were negative. Two patients who had unplanned excision received another re-excision and one of them showed no residual tumor in the resected specimen. Local recurrences were developed in all patients and distant metastasis in 4 patients. All 4 patients who developed distant metastasis died due to disease progression. Among the 2 patients who developed local recurrence only, one patient has another local recurrence after re-operation and remaining one patient is no evidence of disease for 2 years after resection of locally recurred mass. Conclusion: Soft tissue malignant myoepithelioma in the extremities is a rare disease and shows an aggressive behavior. Appropriate biopsy under the impression of soft tissue malignancy is necessary and complete surgical resection with wide margins is the recommended treatment of choice.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.61-66
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• 2009

Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.130-137
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• 2021

Purpose: The various suture techniques can be utilized in order to maximize the keratinized tissue healing around dental implants. The aim of this study is to compare the soft tissue healing pattern between two different suture techniques after implant placement. Materials and Methods: 15 patients with 18 implants were enrolled in this study. Simple implant placement without any additional bone graft was performed. Two different suture techniques were used to tug in the mobilized flap near the healing abutment after paramarginal flap design. Digital intraoral scan was performed at baseline, post-operation, stitch out, and 3 months after operation. The scan data were aligned using multiple points such as cusp, fossa of adjacent teeth, and/or healing abutment. After subtracting scan data at baseline with other time-point results, closed space indicating volume increment of peri-implant mucosa was selected. The volume of the close space was measured in mm³. The volume between two suture techniques at three time-points was compared using nonparametric rank-based analysis. Results: Healing was uneventful in both groups. Both suture technique groups showed increased soft tissue volume immediately after surgery. The amount of volume increment significantly decreased after 3 months (P < 0.001). Flap folding suture group showed higher median of volume increment than interrupted suture group after 3 months without any statistical significance (P > 0.05). Conclusion: After paramarginal flap reflection, the raised flaps stabilized by flap folding suture showed relatively higher volume maintenance after 3-month healing period. However, further studies are warranted.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.2
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• pp.97-109
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• 2022

Purpose: This study aims to investigate the risk indicators contributing to implant failure, and analyze the relationship between risk indicators and marginal bone loss (MBL) through long-term follow-up over 3 years. Materials and Methods: From 2003 to 2017, patients' medical charts with a history of dental implant surgery at Chonnam National University Dental Hospital were reviewed retrospectively. The patient's demographic variables, and clinical variables were recorded. Periapical radiographs were used to evaluated the changes in MBL around implants. And we analyzed implant survival rates. Multiple regression analysis with backward elimination was conducted to correlate the patient's clinical variables and implant failure and Pearson correlation analysis was performed to the correlated between implant long-term survival rates and MBL and initial stability. Results: In multiple regression analysis, there was a statistically significant negative correlation between abutment connection type (β = -.189, P < .05), with or without SPT (β = -.163, P < .05), diabetes (β = -.164, P < .05), osteoporosis (β = -.211, P < .05) and MBL. Anticoagulant medication influenced the long-term success rate of implants. PTV values at the second implant surgery showed a statistically significant negative correlation with long-term implant survival (P < .05). Conclusion: For the long-term success of the implant, the appropriate abutment connection type must be selected and the periodic SPT is recommended. Systemic diseases such as diabetes and osteoporosis and anticoagulant medication should be considered. Furthermore, since high PTV at the second implant surgery correlated with the long-term survival rates of the implant, initial stability should be carefully considered before undergoing the prosthetic procedure.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.53-65
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• 2001

Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.166-173
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• 2003

Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.

• Tuberculosis and Respiratory Diseases
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• v.59 no.2
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• pp.151-156
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• 2005

Background : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in hospital-acquired infection, and is prevalent in intensive care units (ICU). The MRSA colonization rates of the nares and throat were examined in both the ICU and general ward. This study was performed to investigate the MRSA rate and necessity for MRSA screening cultures in patients admitted to ICU. Methods : Between June and September 2004, those patients admitted to both the medical ICU and general ward participated in this study. Bacterial cultures were performed on swabs of the nares and throat taken within 24 hours of admission. Clinical data were also collected. Results : One hundred and twenty one patients and 84 patients, admitted to the medical ICU and medical general ward, respectively, were investigated. The numbers of nasal MRSA colonization in the ICU and general ward were 3 (2.5%) and 3 (3.6%), respectively. There were 2 (1.7%) cases of throat MRSA colonization in the ICU, but none in the general ward. The MRSA colonization rates of the nares and throat were no different between the ICU and general ward. There were no significant differences in the previous admission, operation history and admission route between the ICU and general ward groups. Conclusion : The MRSA colonization rates of the nares and throat were 3.3 and 3.6% in the ICU and the general ward, respectively. The MRSA screening test does not appear to be required in all patients admitted to the ICU, but further studies, including high-risk patients, are recommended.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.14-21
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• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.1-8
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• 2006

Purpose: To analyze the clinical outcome of stage IIB osteosarcomas arisen in the long bones. Materials and Methods: Since February 1993, 58 Enneking stage IIB osteosarcomas arisen in long bones were managed and followed at least one year at our four university hospitals. There were 48 wide resections, 2 marginal resections and 8 amputations. The mean follow up period was 4.1years (up to 12.2years). Local recurrence, distant metastasis, complication, survival rate, and oncologic and functional results were evaluated. Results: At the last follow up, 35 patients were CDF, 9 were NED, 5 were AWD, 7 were DOD and the remained 2 died with unrelated disease. Eight local recurrences (13.8%) and 18 distant metastases (31.0%) were occurred. Nine infections were developed after 48 reconstructions (18.8%). Overall functional outcome was 24.3 (81.%). The 5 year overall survival rate was 84.6% and the continuous disease-free survival rate was 68.7% at 5 years and 42.3% at 10 years. Conclusion: Forty-six of 58 stage IIB osteosarcomas arisen in long bones (79.3%) showed CDF or NED at an average 4.1 year follow up. Overall 5-year survival rate was 84.6% and overall functional outcome score was 24.3, which were comparable to those of other studies.