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Bipolar radiofrequency system 사용 중 발생한 Tip의 분리 - 증례 보고 - (Separation of tip from the bipolar radiofrequency system in the arthroscopic surgery - Case Report -)

  • 최의성;박경진;김용민;김동수;손현철;박지강;배승환
    • 대한관절경학회지
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    • 제12권1호
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    • pp.66-68
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    • 2008
  • 최근 관절경 시술시 절제, 지혈, 수축(Shrinkage)을 효과적으로 수행할 수 있는 고주파 에너지를 이용한 bipolar radiofrequency system이 사용되고 있다. 저자들은 전방 십자 인대 재건술 후 방사선 사진상 관절 내 금속성 이물질을 발견, 이물질 제거술을 시행하여 bipolar radiofrequency system의 probe에서 분리된Tip을 제거하였다. 이후 견관절 견봉성형술 과정에서 Tip의 분리를 2예 추가적으로 경험하여 이를 보고하는 바이다.

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경비 인대 결합 나사못의 이상적인 삽입부위 (Ideal Insertion Position of Ankle Syndesmosis Screw)

  • 박홍기;문선상
    • 대한족부족관절학회지
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    • 제6권1호
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    • pp.60-65
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    • 2002
  • Purpose: The purposes of the present study were to find the ideal insertion position syndesmosis screw and relation to the surrounding anatomical structures when indirectly inserting the screw anteriorly at a 30 angle at 3 cm proximal portion of the ankle join t. Materials and Methods: We performed computed tomography from the axial view in 20 normal individuals at 3 cm proximal portion of the ankle joint and divided the lateral side of the fibula into 4 sections. We drew a line from the middle of each of these 4 sections to the posterolateral tibia at a 30 angle and determined the relationship between each of these lines and the surrounding anatomical structures and confirmed the site at which each of these 4 lines passed through the posterolateral tibia which divided into 3 sections and the site of the fibula at which each of these lines passed through the middle 1/3 portion of the tibia. Results: The posterior 3/4 portion of the fibula that passed through the middle 1/3 portion of the posterolateral tibia in 18 cases. The portion did not approach the surrounding anatomical structures(Peroneal vessels and the muscular portion of FHL). Conclusion: The ideal insertion position of syndesmosis screw at 3 cm proximal portion of the ankle joint at a 30 angle is the posterior 3/4 portion of the lateral side of the fibula, and injury to the surrounding anatomical structures could be avoided when the screw passes through the middle 1/3 portion of the posterolateral tibia.

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치근 및 치주조직 형성과정 동안 Sonic Hedgehog signaling의 역할 (Roles of Sonic Hedgehog Signaling During Tooth Root and Periodontium Formation)

  • 황재원;조의식;양연미
    • 대한소아치과학회지
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    • 제45권2호
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    • pp.144-153
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    • 2018
  • 본 연구는 치근 및 치주조직의 형성과정동안 Sonic Hedgehog (SHH) signaling의 역할에 대해 알아보고자 치성간엽에서 조직특이적으로 Smoothened (Smo)가 활성화 또는 차단되는 mouse를 제작하여 분석하였다. 생후 28일경 Smo 활성화모델에서는 H-E 염색 시 얇은 두께의 치근상아질, 넓어진 치수강, 치주인대공간에 느슨하게 배열되어있는 섬유들이 관찰되었다. 면역조직화학염색 시 Smo 활성화모델은 wild type mouse와 비교하여 백악질, 치주인대 그리고/또는 백악모세포의 표식자인 Bsp, Dmp1, Periostin, Ank 같은 기질 단백질들의 발현이 현저히 감소하였다. 그러나 Smo 차단모델은 wild type mouse와 비교하여 이러한 기질 단백질들의 발현에 차이가 보이지 않았다. 본 연구를 통하여 치근 및 치주조직의 정상적인 형성과정에 낮은 수준으로 조절되는 SHH signaling이 필요하다는 것을 확인할 수 있었다.

비글견 1벽성 골내낭에서 Poly Lactic-co Glycolic Acid (PLGA)/Inorganic Filler Matrix의 생체 친화성 및 흡수성에 대한 조직학적 연구 (Histological Evaluation on the Biocompatibility and Degradation of Poly Lactic-co Glycolic Acid (PLGA)/Inorganic Filler Matrix in Surgically Created Intrabony 1-wall Defect in Beagle Dog.)

  • 이재연;김종관
    • 대한치과의사협회지
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    • 제47권6호
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    • pp.364-372
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    • 2009
  • 치주 질환으로 인하여 소실된 치주조직을 재생시키려는 여러 술식이 많이 연구되고있다. 그 중 bioactive factor의 적용은 치주조직의 재생에 있어서 우수한 치료법으로 평가되고 있으며, 이를 수용부에 적절히 적용하기 위한 운반체로 생체친화적인 중합체가 이용되고 있다. 본 연구의 목적은 PLGA를 Inorganic filler에 혼합시킨 재료를 성견의 일벽성 골내낭에 적용하여 이 재료의 생체 친화성과 생체 흡수도를 보고자 하는 것이다. 5마리의 비글견에서 제 3 소구치를 모두 발치한 뒤, 8주간의 치유기간이 지나고 제 2 소구치 원심면과 제 4 소구치 근심면에 5mm 깊이, 4mm폭의 일벽성 골내낭을 형성하였다. 좌측 defect에는 PLGA/inorganic filler matrix를 이식하였고 우측에는 아무것도 이식하지 않은 대조군으로 나누어 술 후 8주에 희생하여 치유 결과를 조직학적으로 비교 관찰하였다. 조직학적 분석 결과, 모든 결손부에서 염증의 소견이 관찰되지 않았으며 치근흡수와 유착은 발견되지 않았다. 백악질과 치조골, 치주인대를 포함한 치주조직의 재생에 있어서 대조군, 실험군 간에 조직학적으로 치유양상에 있어 차이를 많이 보이지 않았으며 PLGA/inorganic filler matrix는 8주 내에 완전히 흡수되어 결합조직이나 신생골내에서 그 흔적을 발견할 수 없었다. 이러한 결과는 PLGA/inorganic filler matrix는 생체친화성 및 생체흡수성이 우수한 재료로서 치주 조직의 재생 치료에 있어서 신체활성인자의 scaffold로 사용될 수 있는 가능성을 보여주었다.

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후종인대 골화증 3례에 대한 임상적 고찰 (Clinical studies on Ossification of posterior longitudinal ligament(OPLL))

  • 김숙경;서원희;최성권;문익렬;박종태
    • Journal of Acupuncture Research
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    • 제19권6호
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    • pp.264-279
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    • 2002
  • Objective : Ossification of the posterior longitudinal ligament(OPLL) is considered kind of degenerative disease usually found in the cervical vertebrae. Most of cases of OPLL have radiculopathy, myelopathy or both of them such as neck pain, numbness, myatonia. These symptoms seems to be similar with those of HIVD(Herniated intervertebral disc), sprain, spondylosis of C-spine. Lost of patients who have those symptoms are visiting oriental medicine hospital, clinic so we thought that making differential diagnosis, treating and prognosing might be needed with acupuncture, Herb medication. Methods : We examined the 3 patients of OPLL who visited Dong-in-dang Oriental Medicine Hospital from 1st November 1999 to 1st February 2002. We treated patients of OPLL with Oriental Medicine care (Acupuncture, Herb medication, Negative treatment) based on oriental diagnosis of neck pain(項强痛), numbness(痺證), myatonia. Results : clinical grade of 3 cases was all Gr III. After treated with oriental medical care, 2 cases were evaluated poor, I cases were evaluated fair and resulted in Clinical grade II. Conclusions : Treating OPLL with oriental medical carte was very difficult to palliate symptoms, to stop progress of OPLL. We might need to reconsider oriental medical care as conservative treatment for OPLL.

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Intrusion arch wire activation시 상악 견치에 가해진 초기응력의 유한요소법을 통한 고찰 (A FEM ANALYSIS FOR INITIAL STRESS ON THE UPPER GAMINE BY ORTHODONTIC FORCE OF INTRUSION ARCH WIRE ACTIVATION)

  • 강정원;차경석;이진우
    • 대한치과교정학회지
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    • 제28권3호
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    • pp.391-398
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    • 1998
  • 본 연구는 유한요소법을 사용하여 상악견치에 intrusion arch wire를 강제로 engage시켰을 때 상악 견치와 치근막에서 발생되는 압축력과 인장력의 분포의 양을 알아보고 어느 부분에 집중되는가를 분석하였다. 또한 각 부분에서의 압축력과 인장력의 비율을 비교하기 위해서 시행하여 다음과 같은 결과를 얻었다. 1. 상악 견치의 FA point와 백악법랑경계부분에서는 압축력과 인장력의 비율이 거의 비슷하게 나타났다. 2. 치근첨 부분에서는 압축력이 인장력의 거의 4배정도 크게 나타났다. Intrusion force적용시 치근흡수 정도가 치근첨에서 발생되는 것을 정량화시켜서 보여준 결과이다. 3. 백악법랑경계부분은 즉 FA point를 제외하고는 압축력과 인장력이 가장 큰 값을 보이고 있다. 즉 치아에 교정력이 직접 적용된 부분을 제외하고는 치아와 치주인대가 처음 접촉되는 백악법랑경계부에서 응력이 집중되는 것을 유추할 수 있다.

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원위경비인대결합 손상 정복 후 관찰된 측면 방사선 영상의 임상적 중요성 (Clinical Significance of Lateral Ankle Radiograph after the Reduction of a Syndesmosis Injury)

  • 서재완;박현우
    • 대한족부족관절학회지
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    • 제21권4호
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    • pp.128-134
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    • 2017
  • Purpose: To introduce reliable and newly developed radiographic measures based on a lateral ankle radiograph to assess a syndesmotic reduction after screw fixation and to compare with the radiographic measures based on the anteroposterior (AP) and mortise radiographs. Materials and Methods: The postoperative ankle radiographs of 34 ankle fracture cases after screw fixation for concurrent syndesmosis injury were reviewed. Two radiographic parameters were measured on each AP and mortise radiograph; tibiofibular clear space (TFCS) and tibiofibular overlap (TFO). Five radiographic parameters were measured on the true lateral radiographs; the anteroposterior tibiofibular (APTF) ratio, anterior tibiofibular ratio (ATFR), posterior tibiofibular ratio (PTFR), distances of intersection of the anterior fibular border and the tibial plafond to anterior cortex of the tibia (AA'), and the intersection of posterior fibular border and tibial plafond to the tip of the posterior malleolus (BB'). In addition, the distance (XP) between the fibular posterior margin (X) crossing tibial plafond or the posterior malleolus and posterior articular margin (P) of the tibial plafond was measured on the lateral view. Results: Using TFCS and TFO in the AP and mortise radiographs, malreductions of syndesmosis were estimated in 17 of 34 cases (50.0%). Using the introduced and developed radiographic measures in the lateral radiographs, syndesmotic malreductions were estimated in 16 out of 34 cases (47.1%). Seventeen cases (50.0%) showed no evidence of postoperative diastasis using the radiographic criteria on the AP and mortise view, 10 cases (58.8%) of whom showed evidence of a malreduction on the lateral radiograph. The newly developed measurements, XP, were measured 0 in 11 out of 34 cases (32.4%). Conclusion: The reduction of syndemosis after screw fixation can be accurately assessed intraoperatively with a combination of several reliable radiographic measurements of the lateral radiograph and traditional radiographic measurements of the AP and mortise radiograph.

법랑기질 단백질 유도체가 치주인대양세포 및 조골양세포에 미치는 영향 (Effects of enamel matrix protein derivatives on the periodontal ligament like fibroblast and osteoblast like cells)

  • 김동운;정진형;임성빈;고선일
    • Journal of Periodontal and Implant Science
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    • 제33권2호
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    • pp.225-246
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    • 2003
  • Recent study on the enamel matrix derivatives explained on the effects of new bone and new attachment formation in infrabony pocket of periodontal defects. The purpose of this study was to investigate on the biological effects of enamel matrix derivatives to attachment, proliferation and activation of periodontal ligament and osteoblast cells, After treatment of osteoblast and PDL cells with various Emdogain concentration level(0.03${\mu}g$/ml, 3${\mu}g$/ml, 300${\mu}g$/ml), activation of osteogenetic factor, calcified nodule formation and measuring alkaline phosphatase activity(ALP) were performed. 1. Both osteoblast and PDL cell showed increasing initial cell attachment with 300${\mu}g$/ml Emdogain concentration. 2. At the level of 300${\mu}g$/ml, accelerated proliferation of oseoblast and PDL cell was appeared. 3. As Emdogain's concentration increased, increased ALP activation of osteoblast was shown. In case of PDL cell, Emdogain increased ALP activation prominently at the level of 300${\mu}g$/ml. 4. No statistically significant activating change were founded at all of the concentrations of Emdogain on the activating of transcript factor Runx2 for differentiating osteoblast. 5. At the level of 300${\mu}g$/ml, calcified nodule formation was increased prominently to compare with other concentration. These results indicated that Emdogain should activate initial attachment, proliferation and activation, but not on Runx2 activation and can be used for useful tool of the treatment of periodontal tissue regeneration.

니코틴이 배양인체 치은섬유모세포 및 치주인대세포의 활성에 미치는 효과 (THE EFFECTS OF NICOTINE ON HUMAN GINGIVAL FIBROBLAST & PERIODONTAL LIGAMENT CELLS IN VITRO)

  • 공영환;유형근;신형식
    • Journal of Periodontal and Implant Science
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    • 제25권2호
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    • pp.181-191
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    • 1995
  • The ability of fibroblasts attach to teeth is of paramount imporance in re-establishing the lost connective tissue attachment after periodontal therapy. Tobacco contains a complex mixture of substances including nicotine. various nitrousamines, trace elements. and a variety of poorly characterized substances. The effects of nicotine on fibroblasts have reported an altered morphology and attachment of fibroblasts to substrates and disturbances in protein synthesis and secretion. This study examined the effect of nicotine, a major component of the particulate phase of tobacco smoke, on human gingival fibroblasts and periodontal ligament cells attachment to tissue culture surfaces and cellular activity of human gingival fibroblasts and periodontal ligament cells. Pooled human gingival fibroblasts made from extraction of 3rd molar were utilized between passage 4 and 5 and plated in 96 well plate at 20,000 cells per well. Cell number were determined using 3-(4,5-dimethylthiazole-2-y)2,5-diphenyltetrazolium bromide(MTI) , which is reflection of mitochondrial dehydrogenase activity. The concentration of nicotine used were 0.025, 0.05, 0.1, 0.2 and $0.4{\mu}M$, the average serum concentration for a smoker being approximately $0.1{\mu}M$. The results were as follows : 1. Attachment effects of nicotine on human gingival fibroblasts and periodontal ligament cells Excepts of $0.4{\mu}M$, the effects on attachment with increasing numbers of cells attaching with increasing nicotine concentrations, compared to control group. But over the 60min, return to control value. 2. The effect of cellular activity on human gingival fibroblasts and periodontal ligament cells. The cellular activity of human gingival fibroblasts and periodontal ligament cells were similar or decrease to control value at 1st incubation day. At 2nd incubation day, 0.05, 0.1, 0.2, $0.4{\mu}M$ concentrations were statistically different from control value on gingival fibroblasts group. But at 3rd incubation day, cellular activities of all experimental group were significantly decrease than control group.

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전열침 시술에 호전되지 않는 요통환자에 대한 봉독약침 치료 증례보고 2례 (The Two Cases Report of Bee Venom Injection on Patient with Low Back Pain Maintaining after Heating-Conduction Acupuncture Therapy)

  • 연창호;박현건;이운섭;김종연;정석희
    • 척추신경추나의학회지
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    • 제7권2호
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    • pp.75-81
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    • 2012
  • 장요인대 염좌 환자 2명에게 전열침 치료를 시행하여 통증 강도가 증가하였지만 봉독약침 치료를 시행한 후 통증 강도와 요추 가동범위 및 이학적 검진상에서 호전되었음을 보고한다. 이와 같이 봉독약침에 의해 호전 될 수 있는, 염증성 병변을 내재하였거나 진행 될 가능성이 있는 환자에 대한 사전의 감별 진단에 대한 연구 및 전열침 치료의 효과 및 부작용에 대한 체계적인 연구가 추후에 필요할 것으로 사료된다.

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