• Title/Summary/Keyword: Bone lead

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Daily Setup Uncertainties and Organ Motion Based on the Tomoimages in Prostatic Radiotherapy (전립선암 치료 시 Tomoimage에 기초한 Setup 오차에 관한 고찰)

  • Cho, Jeong-Hee;Lee, Sang-Kyu;Kim, Sei-Joon;Na, Soo-Kyung
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.99-106
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    • 2007
  • Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

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Considerations for minimizing complications in immediate placement of dental implant (즉시 식립 임플란트 - 합병증을 줄이기 위한 고려 사항)

  • Park, Kwan-Soo
    • The Journal of the Korean dental association
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    • v.58 no.9
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    • pp.564-572
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    • 2020
  • Implant treatment has long been established as the main stream for the recovery of lost teeth. Implant therapy, which began to be practiced under the concept of osseointegration, was performed on the completely healed bone, but implant placement immediately after extraction, which began to be introduced in the 1970s, began to become a widely used treatment modality since the 2000s. However, as with all other procedures, immediate implant placement is not omnipotent. If you are obsessed with the obsession that you need to provide quicker implant treatment to the patients, and if you do it as if you are being chased by time, it is the immediate implant placement that can lead to various embarrassing situations. In this article, to reduce complications, the author will look at some issues that need to be considered when placing implants immediately after extraction.

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Treatment of Deformity in Polyostotic Fibrous Dysplasia Using Interlocking Intramedullary Nailing (다발성 섬유성 골이형성증 변형에 대한 나사못 맞물림 골수정을 이용한 치료)

  • Lee, Kwang-Suk;Oh, Jong-Keon;Koo, Ja-Seong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.249-253
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    • 1995
  • The fibrous dysplasia is a progressive and disabling condition that lead to deformity, especially weight bearing bones. The morbidity that is associated with the polyostotic fibrous dysplasia is the recurrent fracture and deformity. Various methods of treatment had been failed to control this problem. We used osteotomy and reconstruction nailing for polyostotic fibrous dysplasia occured in the proximal part of right femur with varus deformity and reconstruction nailing in left femur without osteotomy, and interlocking intramedullary nailing in right tibia to prevent pathologic fracture. These methods brought a good result of bone union and full weight bearing ambulation after 1 year and 6 month follow up. We think these methods are useful methods to control refracture and deformity, so we reported this case with bibliographic reviews.

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CONSERVATIVE CARE OF NONUNION OWING TO OSTEOMYELITIS ASSOCIATED WITH FRACTURE OF MANDIBLE;REPORT OF 3 CASES. (하악골절부 골수염에 의한 비유합의 보전적 처치;증례보고)

  • Kim, Jong-Bae;Yoo, Jae-Ha;Choi, Byung-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.5
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    • pp.471-477
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    • 2001
  • Failure to use effective methods of reduction, fixation, and immobilization may lead to nonunion with osteomyelitis, owing to the compound nature of most fractures of the mandible. Nonunion results in fibrous pseudoarthrosis at the fracture site with instability that, once formed, does not improve spontaneously. Once the nonunion with osteomyelitis secondary to fractures has become established, intermaxillary fixation and drainage of infected tissue should be instituted as early as possible, because the fixation & drainage enhances the patient comfort and hinders ingress of microorganisms & debris by movement of bone fragments. The authors treated three cases of nonunion with osteomyelitis by intermaxillary fixation, incision & persistent drainage on the previous fistula site and endodontic drainage of infected teeth in the fracture site of mandible. The localization & sequestration of the infected bone around the fracture was better performed persistently by natural homeostatic mechanism in $8{\sim}10$ weeks and the bony union was then attained without bone grafting.

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Calcaneal Apophyseal Avulsion Fractures with Achilles Tendon Rupture in a 10-Year-Old Patient: A Case Report (10세 남자 운동선수에서 발생한 아킬레스건 파열을 동반한 종골 골단의 견열 골절: 증례 보고)

  • Lee, Jun Young;Bak, Yi Gyu;Lim, Jae Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.74-77
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    • 2018
  • Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.

Corticotomy and the Intrusive Tooth Movement (피질골 절제술을 응용한 치아의 함입 이동)

  • Kim, Sang-Cheol;Tae, Ki-Chul
    • The korean journal of orthodontics
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    • v.33 no.5 s.100
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    • pp.399-405
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    • 2003
  • Tooth movement facilitated by corticotomy and distraction osteogenesis, new paradigm in orthodontics, was discussed. Intrusive tooth movement of anterior or posterior teeth was thought to be difficult or impossible. In this study, a part of cortical bone, which was a sort of resistance to tooth movement in alveolar bone, was removed. On the other hand, active bone deposition was made possible in the tension side. That was the main concept of tooth movement facilitated by corticotomy and distraction osteogenesis. Teeth moved at such a speedy tate as we could not imagine in conventional tooth movement, which lead to the reduction of total treatment Period. And intrusive movement was Possible without a side effect, lot example, root resorption or the periodontal breakdown. Those were the superior aspects to the conventional orthodontics.

A Bone-like Small Intestinal Wooden Foreign Body in a Dog (개의 소장에서 관찰된 뼈와 같은 형태의 나무 이물)

  • Jeoung, Seok-Young;Kim, Doo;Ahn, So-Jeo;Park, In-Chul;Woo, Heung-Myong;Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.375-379
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    • 2006
  • Detection of wooden foreign body represents a clinical challenge. Wood is typically radiolucent, so wooden foreign bodies are generally cannot be seen on survey radiography. Failure to locate and remove foreign bodies can lead the patient to the long-term secondary inflammatory reactions or infections. The dog described in the present report ingested a wooden foreign body(cotton swab stick) a year ago. The foreign body remained in the intestinal tracts which were attached to each other due to the prior abdominal operation. The wooden piece in the intestine functioned as a nidus and inorganic matters were gathered forming calculus on the outer layer of foreign body. In the radiograph, the foreign body appeared to be a chicken bone which of it's inner area was more radiolucent than the outer layer. Because the wooden foreign bodies that have remained for long time in the intestinal tract can be seen like a bone by mineralization, the diagnosis of the wooden foreign bodies should be done prudently.

A Research on the ORyungJinAekByeol(五륭津液別) of the Young Chu(靈樞) (靈樞${\cdot}$五륭津液別에 대한 硏究)

  • Jeong, Jong-Guk;Sin, Yeong-Il
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.155-155
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    • 2000
  • Body fluid(津液) is a general term for normal mucus in human body, including saliva, gastric juice, intestinal juice and articular fluid in joints as well as tear, running nose, sweat, etc.. The formation of Body fluid goes through two phases. First phase is digestion of food at stomach, and then evaporation and classification of energy at Triple warmer(三焦). More technically speaking, Body fluid is divided into the Jin(津) & the Aek(液). Aek is a very mild and water-like fluid, runs deep into the internal organs. Jin is a thick and sticky liquid, running shallow under the skin or in the joints of limbs. Major roles of body fluid over the body are to moisturize the internal organs, flesh, skin, etc., to soften the joints, to fill the bone marrow, and to balance Yin and Yang. This article deals with the role of body fluid and how to differentiate them, the liquid metabolism in the human body, and the formation and change of sweat, urine, tear, spit, bone marrow, etc.. The imbalance of Yin and Yang and disturbance of Triple warmer's evaporation lead into lumbago, leg weakness and edema is also explained here.

A Research on the ORyungJinAekByeol of the Young Chu(靈樞) (영추(靈樞).오륭진액별에 대한 연구(硏究))

  • Sin, Yeong-Il;Jeong, Jong-Guk
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.156-171
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    • 2000
  • Body fluid(津液) is a general term for normal mucus in human body, including saliva, gastric juice, intestinal juice and articular fluid in joints as well as tear, running nose, sweat, etc.. The formation of Body fluid goes through two phases. First phase is digestion of food at stomach, and then evaporation and classification of energy at Triple warmer(三焦). More technically speaking, Body fluid is divided into the Jin(津) & the Aek(液). Aek is a very mild and water-like fluid, runs deep into the internal organs. Jin is a thick and sticky liquid, running shallow under the skin or in the joints of limbs. Major roles of body fluid over the body are to moisturize the internal organs, flesh, skin, etc., to soften the joints, to fill the bone marrow, and to balance Yin and Yang. This article deals with the role of body fluid and how to differentiate them, the liquid metabolism in the human body, and the formation and change of sweat, urine, tear, spit, bone marrow, etc.. The imbalance of Yin and Yang and disturbance of Triple warmer's evaporation lead into lumbago, leg weakness and edema is also explained here.

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CLINICAL STUDY OF BISPHOSPHONATE-INDUCED OSTEONECROSIS OF MANDIBULAR AND MAXILLARY BONE (비스포스포네이트로 인한 하악 및 상악골에 발생한 골괴사에 대한 임상적 연구)

  • Joeng, Hye-Rin;Kim, Tae-Wan;Lee, Jeong-Keun;Song, Seung-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.353-360
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    • 2009
  • Bisphosphonates are compounds widely used in the treatment of various metabolic and malignant bone disease. Recently, an association between bisphosphonate use and a rare dental condition termed 'osteonecrosis of the jaw(ONJ)' has been reported. Bisphosphonate-related osteonecrosis of the jaw(BRONJ) is rare, but serious, side effect of bisphosphonate therapy in affected patients. It is characterized by poor wound healing and spontaneous intra-oral soft tissue break down, which lead to exposure of necrotic maxillary and mandibular bone. We reviewed 11 patients of BRONJ visited Ajou University Hospital Dental clinic from May 2007 to November 2008. The management of the patients included cessation of bisphosphonate therapy and various surgical restorative procedures and conservative care there after. Aggressive debridement is contraindicated. A new complication of bisphosphonate therapy administration, osteonecrosis of jaws, seems to be developing. The improved results after cessation of the medication should make clinicians reconsider the merits of the rampant use of bisphosphonates, while further investigation is needed to completely elucidate this complication.