Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.36
no.5
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pp.380-385
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2010
Introduction: The iliac crest has been the accepted place to obtain bone for reconstruction in oral and maxillofacial surgery. The iliac crest has many advantages because of its accessibility, large amount of cancellous bone, relative ease of bone harvest, possibility of two team approach and ability to close the wound primarily. This study evaluated retrospectively the morbidity of bone harvesting from the anterior iliac crest to provide a logical guide for recognizing the complications and morbidities of an iliac crest bone graft. Materials and Methods: Fifty healthy patients (mean age of 35.5 years; range 7 to 59) underwent iliac crest bone harvesting for a maxillofacial reconstruction from January 2007 to September 2009 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University Hospital. Age, sex, size and kind of grafted bone, duration of pain on donor site, duration of gait disturbance, sensory deficit, scar, contour defect were measured in each patients by retrospective research. Results: The mean duration of pain is 6.7 days, and mean duration of gait disturbance is 7.2 days. Most patients were free from gait disturbances and pain within 2 weeks and there was no correlation between the size of the harvesting block bone and the duration of gait disturbance or pain. However, this study showed that the duration of pain is associated with gait disturbance. In addition, most patients had no complaints regarding their surgical scar and contour defect, and only one patient had permanent impairment of the sensory function. Moreover, an iliac bone graft did not extend the length of hospitalization. Conclusion: This study suggests that split thickness bone harvesting from the inner table of the anterior iliac crest is a well accepted procedure with relatively low morbidity.
Mun Seong-Kwon;Choi Ihl-Bohng;Kang Young-Nam;Jang Ji-Sun;Kang Ki-Mun;Choi Byung-Ock
Radiation Oncology Journal
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v.24
no.2
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pp.88-95
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2006
Purpose: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). Materials and Methods: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of $60{\sim}64 Gy$ were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). Results: Follow-up period was $3{\sim}15$ months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. Conclusion: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.32
no.5
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pp.410-417
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2006
The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.
Purpose: This study was performed to compare and evaluate the effect of recipient site depths and diameters of the drills on the primary stability of implant in pig's ribs. Materials and methods: An intact pig's rib larger than 8 mm in width and 20 mm in height; RBM(resorbable blasting media) surface blasted ${\phi}3.75mm$ and 8.0 mm long USII Osstem Implants (Osstem Co., Korea) were used. To measure the primary stability, $Periotest^{(R)}$ (Simens AG, Germany) and $Osstell^{TM}$ (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden) were used. They were divided into 6 groups according to its recipient site formation method: D3H3, D3H5, D3H7, D3.3H3, D3.3H5, D3.3H7. Each group had, as indicated, 10 implants placed, and total 60 implants were used. The mean value was obtained by 4-time measurements each on mesial, distal, buccal, and lingual side perpendicular to the long axis of the implant using $Periotest^{(R)}$ and $Osstell^{TM}$. For statistical analysis one-way ANOVA was used to compare the mean value of each group, and the correlation between placement depths and the primary stability, and that of measuring instruments was analyzed using SPSS 12.0. Results: The primary stability of the implants increased as the placement depths increased (p<0.05), and showed a proportional relationship (p<0.01). The primary stability increased when the diameter of the recipient site was smaller than that of the implant but with no statistical significance. There was a strong correlation between $Osstell^{TM}$ and $Periotest^{(R)}$ (p<0.01). Conclusion: These results suggest that increasing the placement depth of implants enhances the primary stability of implant.
The stone artifacts in Bronze age from the Sinsongri sites in Seosan, Korea were studied on material characteristics and provenance presumptions. The use and rock names of the artifacts are a stone before processing, two semifinished stone arrowheads and a grinding stone plate by slates. In addition, there is semifinished stone arrowhead by andesitic rocks. The slate could be observed easily around the site, and the andesitic rock could be confirmed typical occurrences of the all kinds of rocks around the Kanwoldo and Hwangdori, Anmyun area above 10km from the site. As a result of analysis which is comparing between stone artifacts and same kinds of raw material rocks, the stone artifacts made by slates have similar lithology and geochemical characteristics however, the stone artifacts made by andesitic rocks are found a some different part of characteristics to the same kind of raw material rocks. Comparing of major, rare earth, compatible and incompatible elements about stones artifacts made by slates and by the same kinds of raw material rocks have same geochemical patterns. However stone artifacts made by andesites and the raw material rocks are confirmed some differences of geochemistry. Therefore the slate stone artifacts in Sinsongri site suggest that these are domestic-type which are made of the rocks around the site, and it was understood that the andesitic stone artifacts are foreign-type which need to get more geological survey and study about different volcanic artifacts of the site around the area.
Kim, In-Ki;Lee, Dong-Chul;Seo, Jae-Sung;Ahn, Myun-Whan;Kim, Se-Dong;Ahn, Jong-Chul
Journal of Yeungnam Medical Science
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v.9
no.1
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pp.130-136
/
1992
Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their enumerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fractrure and the remaining 11 were open. The comminuted and segmental fractures were 18(57.7%) in number and the most common fracture site was the middle one third(53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
Kim, Yong-Ha;Kim, Sung-Ho;Seul, Jeung-Hyun;Lee, Kyung-Ho
Journal of Yeungnam Medical Science
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v.13
no.1
/
pp.22-31
/
1996
It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.
Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So complications of the supracondyle fractures including joint stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989, Dec. To 1992, Jan. The results were as follows : 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification. 4 cases were type A, 4 in type B, 12 in type C (10 in type $C_2$&$C_3$). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in conservative treatment and 67% in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
Background: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. Materials and Methods: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. Results: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. Conclusion: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.
The present study was performed to investigate the effect of $HTR^{(R)}$ (Hard Tissue Replacement) on osteogenesis in the mandibular bone defects. Eight adult male white rabbits weighing 2.5 to 3.0kg were used. Four bone defects (8mm in diameter and 4mm in depth) were made at the both mandibular body. In the control group, the right mesial bone defect was filled with blood clot and spontaneously healed. In the DFDB group, the right distal bone defect was filled with xenogenic demineralized freeze-dried bone. In the $HTR^{(R)}$ group, the left mesial bone defect was filled with $HTR^{(R)}$. In the $HTR^{(R)}-membrane$ group, the left distal bone defect was filled with $HTR^{(R)}$ and covered with BioMesh membrane. The rabbits were sacrified at 2,4,6 and 9 weeks after the operation and microscopic examination was performed. Results obtained were as follows: In the control and DFDB groups, inflammatory cells and the fibrous connective tissue existed and the bone growth was slower than $HTR^{(R)}$ group by 6 week, and there was intervention of the soft tissue at 9 week. In the $HTR^{(R)}$ group, bone trabeculi extended between the $HTR^{(R)}$ particles without intervention of inflammatory cells and the connective tissue at 4 and 6 weeks. In addition, extensive osseous ingrowth into the $HTR^{(R)}$ particles was observed at 9 week. Bone formation was more active in the $HTR^{(R)}$ group than the control and DFDB groups. There was not obvious difference in the bone healing rate between the $HTR^{(R)}$ and the $HTR^{(R)}-membrane$ group. These results suggest that the $HTR^{(R)}$ promotes osteogenesis in the bone defects and the $HTR^{(R)}$ group has no difference in comparison with the $HTR^{(R)}-BioMesh^{(R)}$ membrane group in bone healing.
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