• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.53-66
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• 2020

This study is aimed at investigated and compared the differences in the affect of hospital specialization according to hospital size using claims data of the Health Insurance and Review Assessment National Inpatient Sample in 2018 for diseases of the musculoskeletal system and connective tissue. To this end, we used multivariate hierarchical linear models(a.k.a., multi-level models) using two-tier data from 106,599 patients discharged after diseases of the musculoskeletal system and connective tissue from 734 hospitals. Multivariate results indicate that patients who were discharged with diseases of the musculoskeletal system and connective tissue from specialized hospitals with 200 beds or less stayed shorter and paid less inpatient charge than those who were discharged from less specialized hospitals. But for hospitals with 201-300 beds, no positive impact relationship was found between hospital specialization and operational performance. This finding may be limited evidence that the affect of a hospital's specialization strategy may vary depending on the size of the hospital. We discussed several managerial and health policy implications below.

• Journal of Periodontal and Implant Science
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• v.27 no.2
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• pp.379-394
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• 1997

Several methods have been used for regeneration of tissue lost by periodontal disease. Subepithelial connective tissue graft technique, one of the technniques of mucogingival surgery, is used for the regeneration in esthetic problems such as recession, and denuded root coverage. This study is performed to evaluate the healing process and the regeneration and reattachment of periodontal tissue, including the reconstruction of junctional epithelium, and connective tissue. Alveolar defects in five adult dogs were treated with periodontal surgery and were attained by removing the marginal alveolar bone by $4{\time}3mm$ from CEJ in the labial side of incisors, and root surfaces were planed. The experimental sites were divided into two groups as follows. 1. root planing alone(control group) 2. with connective tissue graft (Experimental Group) In the two groups flaps were positioned and sutured tightly, the healing processes were observed and were histologically compared with each other after 2days, 4days, 1week, 2weeks, 4weeks. The results were obtained as follows : 1. In the two groups blood clots were observed as early as 2 and 4 days, and were resorbed at 1 week. 2. In the two groups moderate inflammation was observed as early as 2 and 4 days, decreased at 1 and 2 weeks, and disappeared at 4 weeks. 3. Junctional Epithelium migration was more significant in the control group, and was restrained by graft materials in the experimental group. 4. Features of connective tissue fiber attachment partially showed the parallel pattern in the two groups from 2 weeks, and entirely from 4weeks. 5. Anastomosis, between graft and connective tissue, appeared from 4 days in the experimental group and the border between them was not discriminated at 4weeks.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.625-636
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• 2007

Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.

• Journal of Veterinary Clinics
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• v.18 no.1
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• pp.88-92
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• 2001

A subcutaneous mass foud in a nine-year-old male Iguana (Iguana iguana) was pathologically and microbiologically examined. Grossly, this mass, measuring $2 cm{\times}1.5 cm{\times}1 cm$ in size, contained white to yellow caseous-crumbly material which was surrounded by the thin connective tissue. Histopathologically, a mass consisted of central caseous necrotic debri in which heterophils and macrophages were scattered, and peripheral fibrous connective tissue in which scattered heterophils, macrophages and lymphoid cell aggregates were present. This mass composed of central necrotic core and peripheal connective tissue did not have any detectable microorganisms including acid-fast bacteria and fungi. Histopathologically, severe atrophy of seminiferous tubules in both testicles was observed. In addition, peripheri of ductus deferens was thickened by fibrous connective tissue. This is the first report of subcutaneous caseous necrotic mass of an Iguana in Korea. In addition, the bilateral severe atrophy of seminiferous tubules may be due to fibrosis of ductus deferens.

• Applied Microscopy
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• v.27 no.3
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• pp.321-332
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• 1997

The dermal papilla is known to playa major role in influencing the form and dynamics of the hair follicle, which probably involves regulatory substances crossing the basal lamina. But little is known about the junctions between the dermal papilla and the surrounding epithelial cells of the hair bulb, or between the connective tissue and the epithelial cells on the outside of the hair follicle. This study was performed to identify the ultrastructural differences between dermoepidermal junction of the skin and connective tissue-epithelial junctions on the outside of the hair follicle and around the dermal papilla of normal anagen hair follicles in the human fetal scalp skin. Electron microscopic findings of dermoepidermal junction in scalp skin showed that basal lamina was very irregular and undulated, and it contained many attachment plaques of hemidesmosomes with sub-basal dense plates, tonofilaments, and anchoring filaments. Also invaginations of plasma membrane of basal keratinocytes were seen. There were clear differences both on the outside of the follicle and around the dermal papilla as compared with similar junction in the skin. In particular, neither hemidesmosomes nor tonofilaments, as seen in dermoepidermal junction, were observed in the dermal papilla. Also attachment plaque, sub-basal dense plate and anchoring filaments were not observed at the junction on the outside of the follicle and the dermal papilla. There were some differences between connective tissue-epithelial junctions on the outside of the hair follicle and around the dermal papilla, ie, smoothness of basal lamina and orthogonal arrangement of collagen fibers were seen in the outside of hair follicle, but not in the dermal papilla. These results indicate that the mechanical connection between the hair follicle and the connective tissue component is much weaker than that between the corresponding components in skin, and it reflects the dynamic processes during the anagen phase of the hair follicle compared to the relatively permanent state of the epidermis.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.231-236
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• 2008

Purpose: The treatment of gingival recessions is needed to reduce root sensitivity and improve esthetical satisfaction. Several surgical techniques have been proposed to achieve these goals. The use of connective tissue grafts has made esthetic root coverage a predictable procedure. Numerous clinical studies have represented that using connective tissue grafts to cover exposed root surface showed high success rates. This is a case report which demonstrates the technique to obtain root coverage of a buccal recession defect. Materials and Methods: A 35-year-old patient with a high level of oral hygiene was selected for the study. This patient had one Class I Miller recession defect in the mandible. A coronally advanced flap in combination with the connective tissue graft was chosen for the treatment. After surgery, the patient was told to visit the hospital once a week for his oral management and professional prophylaxis. The depth of initial recession was 4.0 mm. Result: After three months, it reduced to 0.0 mm, and the average recession reduction was 4.0 mm. The average root coverage was 100%. Conclusion: The connective tissue graft is both effective and predictable way to produce root coverage in increasing the width of CAL and KT of various adjacent gingival recessions.

• Journal of Periodontal and Implant Science
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• v.30 no.3
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• pp.651-661
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• 2000

A mucogingival grafting procedure has been developed to cover denuded root surface. The subepithelial connective tissue graft technique is very predictable and allows for a good esthetic results and minimum patient discomfort on the palate. However, in areas where there is a lack of vestibular depth and keratinized attached tissue, the presence of frena or heavy muscle attachment, covering the connective tissue graft with a mucosal flap is very difficult. The purpose of this study is to evaluate an alternative technique of root coverage using the free connective tissue graft. The results were as follows: 1. Probing depths didn't seem to vary significantly from the preoperative to postoperative period. 2. The amount of keratinized tissue showed an increase of $5.9{\pm}0.97mm$ from the preoperative level. 3. Total clinical exposed root coverage increase 72.2% compare with preoperative level. 4. The shrinkage from gingival margin is $4.2{\pm}1.15mm$ and the mean shrinkage rate is 40.1%. 5. The depth of the vestibule increased with the average distance from cementoenamel junction to mucogingival junction being $7.4{\pm}1.65mm$.

• Toxicological Research
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• v.20 no.1
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• pp.13-20
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• 2004

The purpose of this study is to compare the biocompatibility of commercial purity Ti, Ti-6AI-4V and Ti-6AI-7Nb alloy specimens with and without surface treatment in mouse abdominal connective tissue in vivo. Each metal was implanted into specific abdominal subdermal tissue site of female mouse. After 4 weeks, the implants were removed and abdominal tissues were fixed, dehydrated and embedded in glycol methacrylate resin. And the tissues were histologically prepared for microscopical evaluation. It was characterized by the presence of connective tissue with fibrous capsule surrounding the implant. The fibrous tissue surrounding the implant was studied to determine the biocompatibility of implanted metals. The average thickness of the fibrous capsule formed around the implant was much thinner for the hydrogen peroxide added hydrochloric acid solution-treated specimen than for the others. The results of this evaluation indicate that modification of the surface properties of titanium and titanium alloy implants changes the biological properties in the abdominal connective tissue. In conclusion, these observations suggest that the proper surface treatment performed in the study is effective for the improvement of biocompatibility.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.674-679
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• 1996

The peripheral odontogenic fibroma (WHO type) is a relatively rare and characteristically benign and unencapsulated, exophytic gingival mass of fibrous connective. Odontogenic epithelium is found within the gingival mass, but usually appears to playa minor role when compared to the fibrous component. The connective tissue is ranged from markedly cellular to relatively acellular and well collagenized. but the connective tissue in this case report appears less cellular. Peripheral odontogenic fibroma must be differentiated histologically from peripheral ossifying fibroma, Peripheral cemental epithelial odontogenic tumor and Peripheral ameloblastoma. The author reports the following conclusions after clinical and radiological examination, excisional biopsy and reviewing literatures. 1. Peripheral odontogenic fibroma is rare lesion and frequently occurs in interdental papila as a form of fibroblastic connective tissue including odontogenic epithelium within the lesion. 2. Peripheral odontogenic fibroma must be differentially diagnosed with Peripheral ossifying fibroma by including less cellular connective tissue, odontogenic epithelium and dysplastic dentin 3. Treatment consists of surgical excision including removal of alveolar bone which is eroded under the lesion

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.330-337
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• 2016

Gingival recession could occur after orthodontic or endodontic treatment. This could influence not only functional and aesthetic problem, but also patient's treatment satisfaction. There are a lot of techniques for preventing gingival recession, but laterally positioned flap with subepithelial connective tissue graft could get definite advantages such as increase of keratinized gingival width and harmonious color match between graft tissue and surrounding tissue. Clinician should select a right patient case and diagnosis with clinical and radiography exam. In a surgical procedure, getting enough amounts of subepithelial connective tissue and flap coverage should be taken into consideration. The clinical outcomes in this case report shows laterally positioned flap with subepithelial connective tissue graft could be a treatment with predictive outcome.